Catastrophic fetlock injuries: an update

Catastrophic injuries of the fetlock pose complex clinical and ethical challenges in equine practice. Appropriate case selection and timely stabilisation are critical to maximise the likelihood of survival. This article outlines a practical approach to the surgical management of catastrophic fetlock injuries, focusing on highly comminuted proximal phalanx fractures and traumatic disruption of the suspensory apparatus. Current methods of immediate immobilisation, external fixation and internal fixation using locking compression plate constructs are described and compared. Particular attention is given to the principles of arthrodesis, including joint preparation, fixation stability and postoperative management. Reported outcomes, common complications and realistic expectations following surgery are discussed to support informed decision-making. This review will assist clinicians in selecting appropriate candidates for surgical intervention and to optimise long-term comfort and functional outcomes rather than return to athletic performance.