Objective The aim of this article was to describe the technique and outcomes of standing surgical management of splint bone fractures and to compare outcome variables and hospitalization cost to a group with similar fractures treated under general anaesthesia. Study Design It is a single-institution retrospective study. Surgical technique, surgical time, hospitalization cost and complications were retrieved from the medical records of horses treated surgically for splint bone fractures (2008–2020). Owner telephone follow-up provided data about athletic outcome, client satisfaction and cosmetic appearance. Results Forty-nine horses (13 standing, 36 under general anaesthesia) with 57 fractures (18 contaminated and 39 non-contaminated) were included. Seven fractures were in the proximal third (4 standing, 3 under general anaesthesia), 18 in the middle third (5 standing, 13 under general anaesthesia) and 30 were distal (4 standing, 26 under general anaesthesia). No significant difference between groups in surgical time was found (p= 0.8). Average total cost was 522 CAN$ lower for the standing group for non-contaminated fractures (p= 0.02). Three horses of the general anaesthesia group demonstrated postoperative colic signs and one case of the standing group was re-operated due to sequestration. Based on follow-up information (range: 3.8-151.2 months), no significant differences in cosmetic and athletic outcomes were found between groups. Conclusion Surgical management of splint bone fractures in the standing horse is a valuable alternative for horses selected based on behaviour. When compared to general anaesthesia, standing management of splint bone fractures did not alter the surgical time or outcome variables and avoided general anaesthesia-associated risks.
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