{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T05:55:44Z","timestamp":1790315744724,"version":"4.1.0"},"reference-count":54,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:00:00Z","timestamp":1756425600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["beva.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Equine Veterinary Journal"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Comminuted fractures of the proximal phalanx (CFPP) occur in adult horses. Various treatments have been described. It remains uncertain which is the best therapeutic option.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aims to review systematically the existing literature on CFPP in horses, evaluate treatment modalities, synthesise outcomes to assess treatment efficacy and survival rates, and identify knowledge gaps for future research.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Scoping review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted using online databases. The bias quality of each article was evaluated. Chi\u2010squared analysis was used to detect differences between types of CFPP in each paper (based on the presence [moderately comminuted, MCFPP] or absence [severely comminuted, SCFPP] of an intact cortical strut between both adjacent joints).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty\u2010nine papers met the criteria for inclusion in this review. In total, 409 cases were identified. The survival rate (SR) was 77% for MCFPP and 51% for SCFPP with a significant difference between fracture types (odds ratios [OR]: 3.16; 95% confidence interval [CI]:1.64\u20136.24;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). For MCFPP, the SR was 85% following lag screw fixation (SF). SF yielded significantly better outcomes compared to SF with transfixation cast (TFC) (SF vs. SF\u2009+\u2009TFC:\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). Cast immobilisation (CI) alone was associated with a SR of 50% (1\/2) and 85% (11\/13) for MCFPP and SCFPP, respectively. For SCFPP fractures, treatment with Ci showed significantly superior results compared to SF and TFC (CI vs. SF\u2009+\u2009TFC: OR: 6.65; 95% CI: 1.11\u201373.96;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04) and plate fixation with arthrodesis of two joints (PF2) (CI vs. PL2: OR: 9.60; 95% CI: 1.54\u2013110.23;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Limitations<\/jats:title>\n                    <jats:p>All reviewed studies were retrospective. Fracture definitions, data collection periods, follow\u2010up time and methods varied between studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study showed that SRs between 35% and 85% may be expected for CFPP. In MCFPP, SF appears to be a good treatment option. The merits of cast immobilisation alone should be discussed with owners if surgery is not an option in MCFPP or SCFPP.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/evj.70077","type":"journal-article","created":{"date-parts":[[2025,8,30]],"date-time":"2025-08-30T02:31:00Z","timestamp":1756521060000},"page":"664-673","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Scoping review of comminuted fractures of the proximal phalanx in horses"],"prefix":"10.1111","volume":"58","author":[{"given":"Charles","family":"de Chaisemartin","sequence":"first","affiliation":[{"name":"Center for Equine Health, \u00c9cole Nationale V\u00e9t\u00e9rinaire de Lyon, VetAgro Sup, University of Lyon  Marcy l'Etoile France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean\u2010Michel","family":"Vandeweerd","sequence":"additional","affiliation":[{"name":"Omnibus Animalibus Studia Sanitatis (Oasis)\u2010Namur Research Institute for Life Sciences (Narilis), Universit\u00e9 de Namur (UNamur)  Namur Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Schramme","sequence":"additional","affiliation":[{"name":"Center for Equine Health, \u00c9cole Nationale V\u00e9t\u00e9rinaire de Lyon, VetAgro Sup, University of Lyon  Marcy l'Etoile France"},{"name":"Research Unit ICE, Campus V\u00e9t\u00e9rinaire de Lyon  Marcy l'\u00c9toile France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,29]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/ebmed-2016-110401"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/evj.14000"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.2004.224.254"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2008.00461.x"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000050"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12874-016-0116-4"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/XEB.0000000000000054"},{"issue":"1","key":"e_1_2_10_10_1","first-page":"2","article-title":"Comminuted fractures of the proximal phalanx in horses: a multi\u2010center retrospective review of 159 cases with long\u2010term outcome (2002\u20132024) [Abstract]","volume":"54","author":"Chaisemartin C","year":"2025","journal-title":"Vet Surg"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.229.5.725"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/eve.13965"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ctep.2004.07.005"},{"issue":"45","key":"e_1_2_10_14_1","first-page":"111","article-title":"Efficiency of the screw fixation method in the treatment of horses with proximal phalanx fractures","volume":"1","author":"Chernigova SV","year":"2022","journal-title":"Vestn Omsk Gos Agrar Univ"},{"issue":"201","key":"e_1_2_10_15_1","first-page":"56","article-title":"Publication bias: reflection on a case of comminuted fracture of the proximal phalanx","volume":"51","author":"Chaisemartin C","year":"2019","journal-title":"Prat Vet Equine"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.2746\/0425164044868684"},{"issue":"1","key":"e_1_2_10_17_1","first-page":"69","article-title":"Osteoss\u00edntese por fixa\u00e7\u00e3o externa em fratura cominutiva de falange proximal em um equino: Relato de caso","volume":"5","author":"Prado LG","year":"2018","journal-title":"Rev Cienc Univ"},{"key":"e_1_2_10_18_1","first-page":"59","article-title":"New therapeutical approach for a case of closed comminuted bi\u2010articular first phalanx fracture on the hindlimb","volume":"29","author":"Heil\u00e8s PH","year":"1997","journal-title":"Prat Vet Equine"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13620-018-0117-1"},{"key":"e_1_2_10_20_1","first-page":"1054","article-title":"Managing equine fractures with external skeletal fixation","volume":"17","author":"McClure SR","year":"1995","journal-title":"Compend Contin Educ Pract Vet"},{"key":"e_1_2_10_21_1","doi-asserted-by":"crossref","unstructured":"KellerSA.The problem of pin breakage in equine transfixation pin casting: a retrospective clinical study and biomechanical testing of four different transfixation pin designs. 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