When a horse fractures the point of his shoulder—the supraglenoid tubercle, located in the lower scapula—it’s usually career-ending. In fact, in many cases, it’s career-preventing; this type of fracture is most common in young horses that haven’t yet started training and often occurs as a result of direct trauma to the shoulder or avulsion fractures caused by tension of the biceps tendon. And even when surgeons repair the fracture successfully, complications such as fixation failure, arthritis, nerve damage, and muscular atrophy can cause chronic lameness.

Researchers in Switzerland recently took a look at a potential new solution for this problem: a locking plate designed for human geriatric patients. The team found that the distal femoral locking plate (DFLP), used to repair femur fractures in elderly patients with porous bones, showed promise in healing broken equine scapulas. The plate allows surgeons to place multiple screws into the fracture fragment for better fixation. The trick, however, is not to damage the highly sensitive suprascapular nerve in the process.

“The suprascapular nerve innervates the muscles in the shoulder area that provide lateral support to the shoulder, and if it’s damaged, those muscles are going to atrophy,” said Andrea Bischofberger, DrMedVet, Dipl. ACVS, ECVS, an equine surgeon at the University of Zürich Vetsuisse-Faculty Equine Hospital.

Placing a 16- to 20-centimeter-long plate along the flat scapula bone risks damaging, even crushing, that suprascapular nerve that lies across the surface of the bone, she said. Given the stability benefits of the plates compared to fixation using only screws, the researchers sought to find a solution for protecting the nerve