## Overview Fractures of the central tarsal bone are uncommon slab or sagittal fractures, most often seen in racehorses and occasionally in sport horses. They typically run in a dorsomedial to plantarolateral orientation and may be complete or incomplete. Acute hind-limb lameness after fast work is the usual presentation. ## Causes Repetitive high-speed loading and conformational factors (including wedge-shaped third tarsal bones) predispose to fracture. Previous distal tarsal arthrodesis can also alter loading. ## Diagnosis Acute lameness localized to the hock, positive flexion, and radiographic demonstration of the fracture line are typical. Standing magnetic resonance imaging is particularly useful for incomplete fractures that are difficult to see on plain films. ## Treatment Lag-screw fixation is preferred for displaced or complete fractures when osteoarthritis is absent. Selected nondisplaced incomplete fractures may heal with conservative management, although surgical repair generally yields higher return-to-performance rates. ## Recovery and Prognosis Outcomes vary with fracture configuration and treatment. Concurrent osteoarthritis worsens the outlook. ## Prevention No specific prevention is established beyond sensible training progression in at-risk horses.
acute hindlimb lameness after fast work; positive hock flexion; pain on palpation of the distal tarsus; radiographic fracture line
## Overview Fractures of the central tarsal bone are uncommon slab or sagittal fractures, most often seen in racehorses and occasionally in sport horses. They typically run in a dorsomedial to plantarolateral orientation and may be complete or incomplete. Acute hind-limb lameness after fast work is the usual presentation. ## Causes Repetitive high-speed loading and conformational factors (including wedge-shaped third tarsal bones) predispose to fracture. Previous distal tarsal arthrodesis can also alter loading. ## Diagnosis Acute lameness localized to the hock, positive flexion, and radiographic demonstration of the fracture line are typical. Standing magnetic resonance imaging is particularly useful for incomplete fractures that are difficult to see on plain films. ## Treatment Lag-screw fixation is preferred for displaced or complete fractures when osteoarthritis is absent. Selected nondisplaced incomplete fractures may heal with conservative management, although surgical repair generally yields higher return-to-performance rates. ## Recovery and Prognosis Outcomes vary with fracture configuration and treatment. Concurrent osteoarthritis worsens the outlook. ## Prevention No specific prevention is established beyond sensible training progression in at-risk horses.
acute hindlimb lameness after fast work; positive hock flexion; pain on palpation of the distal tarsus; radiographic fracture line