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Topic:Fractures
Fractures in horses refer to the disruption in the continuity of a bone, often resulting from trauma, excessive stress, or pathological conditions. These injuries can vary in severity, from simple, non-displaced fractures to complex, comminuted fractures involving multiple bone fragments. Fractures can affect any bone in a horse's body, but they are most commonly observed in the limbs due to the high mechanical loads these structures endure. Diagnosis typically involves clinical examination and imaging techniques such as radiography or ultrasound to assess the extent and nature of the fracture. Treatment strategies depend on the type and location of the fracture and may include rest, immobilization, surgical intervention, or a combination of these approaches. This page aggregates peer-reviewed research and scholarly articles focusing on the etiology, diagnosis, management, and outcomes of fractures in horses, providing insights into current veterinary practices and advancements in equine orthopedic care.
Endoscopic adhesiolysis of the flexor hallucis longus muscle. Flexor hallucis longus muscle can adhere to the distal tibia after tibial fracture. The patient may complain of deep posteromedial ankle pain, checkrein deformity of the hallux, hallux flexus or development of hallux rigidus. Surgical treatment of release of the FHL muscle or lengthening of the FHL tendon has been proposed. We described an endoscopic approach of release of the FHL muscle from the distal tibia with the advantage of minimal soft tissue dissection. Methods: Therapeutic Level V: Expert Opinion/Technique.
Outcomes following liver trauma in equestrian accidents. Equestrian sports are common outdoor activities that may carry a risk of liver injury. Due to the relative infrequency of equestrian accidents the injury patterns and outcomes associated with liver trauma in these patients have not been well characterized. Methods: We examined our experience of the management of equestrian liver trauma in our regional hepatopancreaticobiliary unit at a tertiary referral center. The medical records of patients who sustained liver trauma secondary to equestrian activities were analysed for parameters such as demographic data, liver function tests, patterns of in...
Clinical use of computed tomography and surface markers to assist internal fixation within the equine hoof. To describe clinical use of computed tomography (CT) and hoof surface markers to facilitate internal fixation within the confines of the hoof wall. Methods: Retrospective case series. Methods: Horses (n = 16) that had CT-guided internal fixation of the distal phalanx (DP) or distal sesamoid bone (DSB). Methods: Drill bit entry point and direction were planned from CT image series performed on hooves with grids of barium paste dots at proposed entry and projected exit sites. Post-implantation CT images were obtained to check screw position and length as well as fracture reduction. Imaging, ...
Computed tomographic imaging of subchondral fatigue cracks in the distal end of the third metacarpal bone in the thoroughbred racehorse can predict crack micromotion in an ex-vivo model. Articular stress fracture arising from the distal end of the third metacarpal bone (MC3) is a common serious injury in Thoroughbred racehorses. Currently, there is no method for predicting fracture risk clinically. We describe an ex-vivo biomechanical model in which we measured subchondral crack micromotion under compressive loading that modeled high speed running. Using this model, we determined the relationship between subchondral crack dimensions measured using computed tomography (CT) and crack micromotion. Thoracic limbs from 40 Thoroughbred racehorses that had sustained a catastrophic in...
Racing performance of Swedish Standardbred trotting horses with proximal palmar/plantar first phalangeal (Birkeland) fragments compared to fragment free controls. The aim of this study was to determine whether horses with a proximal palmar/plantar first phalangeal osteochondral fragment (POF) had comparable racing careers (prior to and following surgery) to horses without this fracture. A retrospective cohort study included 174 Swedish Standardbred trotters with osteochondral fragmentation in the palmar/plantar fetlock joint and 613 radiographically negative control horses presented for prepurchase examinations. Medical records and radiographs were examined for each horse. Racing data were retrieved from online Swedish Standardbred harness racing record...
Analysis of stress fractures associated with lameness in Thoroughbred flat racehorses training on different track surfaces undergoing nuclear scintigraphic examination. There is limited information regarding the impact of training track surface on the occurrence of stress fractures. Objective: To evaluate the impact of training track surface on the proportion of long bone and pelvic stress fractures associated with lameness in Thoroughbred horses in flat race training undergoing nuclear scintigraphic examination. Methods: Retrospective study. Methods: Scintigraphic examinations of Thoroughbred flat racehorses were evaluated from 2 hospitals (hospital A [Toronto Equine Hospital], 2003-2009, and hospital B [George D. Widener Hospital for Large Animals, Scho...
Equestrian trauma: injury patterns vary among age groups. Patients with equestrian injuries were identified in the trauma registry from 2004 to 2007. We a priori divided patients into three groups: 0 to 18 years, 19 to 49 years, and 50 years old or older. There were 284 patients identified with equestrian-related trauma. Injury Severity Score for the three major age categories 0 to 18 years, 19 to 49 years, and 50 years or older, were 3.47, 5.09, and 6.27, respectively. The most common body region injured among all patients was the head (26.1%). The most common injuries by age group were: 0 to 18 years, upper extremity fractures; 19 to 49 year olds, ...
Straight from the horse’s mouth: neurological injury in equestrian sports. Equestrian sports can result in a variety of injuries to the nervous system due to many factors. We describe our series of 80 patients with injuries sustained during participation in equestrian sports. Results: All patients seen at the regional trauma center with injuries associated with equestrian sports between 2003 and 2011 were reviewed; 80 patients were identified. Fifty-four per cent were female and the average age was 37 years (2·2-79·3). The mean injury severity score (ISS) was 9·9 ± 0·7. Only two patients had documented helmet use. Glasgow coma score (GCS) was 15 in 93% of patien...
On and off the horse: mechanisms and patterns of injury in mounted and unmounted equestrians. The purpose of this study is to determine whether discrepant patterns of horse-related trauma exist in mounted vs. unmounted equestrians from a single Level I trauma center to guide awareness of injury prevention. Methods: Retrospective data were collected from the University of Kentucky Trauma Registry for patients admitted with horse-related injuries between January 2003 and December 2007 (n=284). Injuries incurred while mounted were compared with those incurred while unmounted. Results: Of 284 patients, 145 (51%) subjects were male with an average age of 37.2 years (S.D. 17.2). Most injurie...
Equine orbital fractures: a review of 18 cases (2006-2013). To review the clinical features, treatments, complications, and outcomes of horses with traumatic orbital fractures. Methods: Retrospective study. Methods: Eighteen horses with confirmed orbital fractures. Methods: Medical records of horses presenting with orbital fractures between 2006 and 2013 were reviewed. Signalment, etiology of fracture, clinical signs, fracture descriptions, diagnostic imaging, treatments, complications, and outcomes were evaluated. Results: Eighteen horses presented with orbital fractures resulting from rearing in a confined space (n = 5), being kicked (4), colliding w...
Estimates of genetic parameters of distal limb fracture and superficial digital flexor tendon injury in UK Thoroughbred racehorses. A retrospective cohort study of distal limb fracture and superficial digital flexor tendon (SDFT) injury in Thoroughbred racehorses was conducted using health records generated by the British Horseracing Authority (BHA) between 2000 and 2010. After excluding records of horses that had both flat and jump racing starts, repeated records were reduced to a single binary record per horse (n = 66,507, 2982 sires), and the heritability of each condition was estimated using residual maximum likelihood (REML) with animal logistic regression models. Similarly, the heritability of each condition was ...
Accuracy of distal limb fracture diagnosis at British racecourses 1999-2005. Accurate diagnosis of racing injuries can be difficult. The objectives of this study were to describe the postmortem (PM) defined distribution of fatal distal limb fractures (DLF) affecting Thoroughbreds racing in Great Britain between February 1999 and August 2005 and then assess the accuracy of veterinary racecourse diagnoses and examine whether these improved following introduction of a computerised recording system. PM examinations were performed on limbs distal to radius or tibia from all cases of fatal DLF occurring on British racecourses during the study period. Results of these examina...
A genome-wide association study demonstrates significant genetic variation for fracture risk in Thoroughbred racehorses. Thoroughbred racehorses are subject to non-traumatic distal limb bone fractures that occur during racing and exercise. Susceptibility to fracture may be due to underlying disturbances in bone metabolism which have a genetic cause. Fracture risk has been shown to be heritable in several species but this study is the first genetic analysis of fracture risk in the horse. Results: Fracture cases (n = 269) were horses that sustained catastrophic distal limb fractures while racing on UK racecourses, necessitating euthanasia. Control horses (n = 253) were over 4 years of age, were racing during the s...
Unusual mechanism of injury resulting in a thoracic chance fracture in a rodeo athlete: a case report. To introduce the characteristics of a Chance fracture and increase awareness of the mechanism of injury that may occur during athletic activity. Background: A T12 Chance fracture was diagnosed in an 18-year-old male rodeo athlete. The rider was forced into extreme lumbothoracic hyperflexion when the horse bucked within the chute, pinning the rider's legs to his chest. Methods: Burst fracture, abdominal organ rupture, spinal dislocation, spinal cord injury, disk herniation, pars interarticularis fracture, spinal nerve injury, paralysis. Methods: The patient underwent an open reduction and fixat...
The microvasculature in the equine distal phalanx: implications for fracture healing. To describe the intra-osseous microvasculature of the distal phalanx of the equine forelimb with regard to its potential clinical relevance. Methods: Eleven clinically normal equine forelimbs were used from six adult horses (range: 4 to 18 years old) euthanatized for reasons unrelated to lameness. In each limb the median artery was catheterized at the level of the carpus and India ink was injected under constant manual pressure. The limbs were frozen and 5 mm thick sections of the foot were cut in the sagittal, coronal, or transverse planes on a band saw. The sections were fixed in 10% formali...
Plate fixation for management of plantar instability of the distal tarsus/proximal metatarsus in 5 horses. To report plate fixation for management of traumatic injuries resulting in plantar instability of the proximal intertarsal (PIT) and tarsometatarsal (TMT) joints. Methods: Case series. Methods: Medical records (October 1988 to August 2007) of horses that had internal fixation of the distal aspect of the tarsus were reviewed. Horses that had a broad dynamic compression plate (DCP) or broad locking compression plate (LCP) applied on the plantar-lateral aspect of the tarsus extending from the proximal calcaneus to the proximal one third of the metatarsus were included. Signalment, clinical signs,...
Recent advances in standing equine orthopedic surgery. In all surgeries with the patient standing under chemical and physical restraint, patient compliance is of the utmost importance. All fractures of the third metacarpal or metatarsal condyles and sagittal fracture of the first phalanx are not amenable to internal fixation with the horse standing, and young unhandled horses may not have a suitable disposition for standing surgical treatment of septic pedal osteitis, or implantation and removal of transphyseal screws. Previous operator experience in performing the procedure or technique under general anesthesia is beneficial. Appreciation of appr...
Biomechanical testing of a hybrid locking plate fixation of equine sesamoid osteotomies. To compare the biomechanical properties of a hybrid locking compression plate (LCP) construct with the compression screw technique as a treatment for transverse mid-body proximal sesamoid bone fractures. Methods: Ten paired forelimbs from abattoir horses were used. The medial proximal sesamoid bone of each limb was osteotomized transversely and randomly assigned, to either repair with a two-hole 3.5 mm LCP or a 4.5 mm cortical screw placed in lag fashion. Each limb was tested biomechanically by axial loading in single cycle until failure. The point of failure was evaluated from the load-displa...
Osteoinductivity of gelatin/β-tricalcium phosphate sponges loaded with different concentrations of mesenchymal stem cells and bone morphogenetic protein-2 in an equine bone defect model. Fracture is one of the most life-threatening injuries in horses. Fracture repair is often associated with unsatisfactory outcomes and is associated with a high incidence of complications. This study aimed to evaluate the osteogenic effects of gelatin/β-tricalcium phosphate (GT) sponges loaded with different concentrations/ratios of mesenchymal stem cells (MSCs) and bone morphogenetic protein-2 (BMP-2) in an equine bone defect model. Seven thoroughbred horses were used in this study. Eight bone defects were created in the third metatarsal bones of each horse. Then, eight treatments, namely con...
Dynamic compression plate (DCP) fixation of propagating medial condylar fractures of the third metacarpal/metatarsal bone in 30 racehorses: retrospective analysis (1990-2005). An in-depth review of dynamic compression plate (DCP) fixation of propagating medial condyle fractures of the third metacarpus or metatarsus has not been previously reported. Objective: To describe the technique, evaluate short-term outcome and long-term race performance of racehorses that underwent DCP fixation for repair of propagating or spiralling medial condylar fractures of the third metacarpal (McIII) or metatarsal (MtIII) bone. Methods: Retrospective case series. Methods: The surgical case records of 30 horses with propagating fractures of the medial condyle of McIII or MtIII were revi...
Frontal plane fractures of the accessory carpal bone and implications for the carpal sheath of the digital flexor tendons. Accurate radiological and ultrasonographic descriptions of frontal plane fractures of the accessory carpal bone (ACB) are lacking, and implications of these fractures for the carpal sheath and its contents have not previously been reported. Objective: Aims were as follows: 1) to describe the location and radiological features of frontal plane fractures of the ACB; 2) to document communication of displaced fractures with the carpal sheath and consequent injury to the deep digital flexor tendon (DDFT); 3) to describe ultrasonographic identification of lesions; and 4) to report tenoscopic evaluat...
Use of a modified transfixation pin cast for treatment of comminuted phalangeal fractures in horses. To (1) report a modified transfixation pin cast technique, using dorsal recumbency for fracture reduction, distal positioning of the pins in the epiphysis and distal metaphysis, and a hybrid cast, combining plaster of Paris (POP) and fiberglass casting, and (2) report outcome in 11 adult horses. Methods: Case series. Methods: Adult horses (n = 11) with comminuted phalangeal fractures. Methods: Horses were anesthetized and positioned in dorsal recumbency. The phalangeal fracture was reduced by limb traction using a cable attached to the hoof. Screw fixation in lag fashion of fracture fragments ...
Swellings of the angle of the mandible in 32 horses (1997-2011). Disorders of the horizontal ramus (body) of the equine mandible are well reported, but there is minimal documentation of disorders of the angle of mandible. A retrospective examination of the records of Edinburgh University Equine Hospital (1997-2011) showed that 32 horses were referred due to swellings of the angle of the mandible. The aetiology of these swellings was identified in just 13/32 cases (41%) including fractures (n=2), traumatic, localised periosteal/cortical lesions (n=4), traumatic soft tissue lesions (n=2), neoplasia (n=3), and inflammation of the adjacent salivary gland (n=1) ...
Myocardial contusion and rib fracture repair in an adult horse. To describe the clinical findings and management of myocardial injury secondary to blunt thoracic trauma and rib fracture in an adult horse. Methods: A 6-year-old Warmblood gelding presented for treatment of blunt thoracic trauma. Sonographic examination of the thorax revealed a complete, mildly comminuted fracture of the left 5th rib with a fragment overlying the left atrium and coronary artery, hemothorax, and subjective left ventricular dyskinesis. Evidence of myocardial injury included atrial fibrillation, ventricular ectopy, and increased plasma cardiac troponin I concentration. The rib f...
Equine ulnar fracture repair with locking compression plates can be associated with inadvertent penetration of the lateral cortex of the radius. To evaluate if the use of locking head screws (LHS) in the distal holes of a locking compression plate (LCP) applied to the caudal aspect of the ulna to treat equine ulnar fractures is associated with a risk of injury to the lateral cortex of the radius. Methods: Controlled laboratory study. Methods: Cadaveric equine forelimbs (n = 8 pair). Methods: After transverse ulnar osteotomy, osteosynthesis was performed with a narrow 10-13 hole 4.5/5.0 LCP applied to the caudal aspect of each ulna. The distal 3 holes were filled with 4.5 mm cortex screws (CS) in 1 limb (group 1) and with 5.0 mm LHS con...
Fractures of the third trochanter in horses: 8 cases (2000-2012). To determine history; clinical, radiographic, ultrasonographic, and scintigraphic features; management; and outcome associated with third trochanter fractures in horses. Methods: Retrospective case series. Methods: 8 horses. Methods: Records from 2000 to 2012 were reviewed, and signalment, case history, severity and duration of lameness, results of physical and lameness examinations, imaging findings, management, and outcome were evaluated. Results: All horses had a history of acute onset of severe lameness. Four of the 8 horses had localizing physical signs of fracture. No specific gait chara...
Radiographic configuration and healing of 121 fractures of the proximal phalanx in 120 Thoroughbred racehorses (2007-2011). Although fractures of the proximal phalanx are one of the most common long bone fractures of Thoroughbred horses in training, limited details on variations in morphology and radiological progression have been published. Objective: To describe in detail the configuration of parasagittal fractures of the proximal phalanx in a group of Thoroughbred racehorses, to report fracture distribution within this group of horses and to document radiological progression of fracture healing in cases treated by internal fixation. Methods: Restrospective case series. Methods: Case records and radiographs of Th...
Are there radiologically identifiable prodromal changes in Thoroughbred racehorses with parasagittal fractures of the proximal phalanx? Fractures of the proximal phalanx are generally considered to result from monotonic supraphysiological loads, but radiological observations from clinical cases suggest there may be a stress-related aetiology. Objective: To determine whether there are radiologically identifiable prodromal changes in Thoroughbred racehorses with confirmed parasagittal fractures of the proximal phalanx. Methods: Retrospective cross-sectional study. Methods: Case records and radiographs of Thoroughbred racehorses with parasagittal fractures of the proximal phalanx were analysed. Thickness of the subchondral bone p...
Intramodality and intermodality agreement in radiography and computed tomography of equine distal limb fractures. Computed tomography (CT) is increasingly accessible in equine referral hospitals. Objective: To document the level of agreement within and between radiography and CT in characterising equine distal limb fractures. Methods: Retrospective descriptive study. Methods: Images from horses that underwent radiographic and CT evaluation for suspected distal limb fractures were reviewed, including 27 horses and 3 negative controls. Using Cohen's kappa and weighted kappa analysis, the level of agreement among 4 observers for a predefined set of diagnostic characteristics for radiography and CT separately...
Preliminary genetic analyses of important musculoskeletal conditions of Thoroughbred racehorses in Hong Kong. A retrospective cohort study of important musculoskeletal conditions of Thoroughbred racehorses was conducted using health records generated over a 15 year period (n=5062, 1296 sires). The prevalence of each condition in the study population was: fracture, 13%; osteoarthritis, 10%; suspensory ligament injury, 10%; and tendon injury, 19%. Linear and logistic sire and animal regression models were built to describe the binary occurrence of these musculoskeletal conditions, and to evaluate the significance of possible environmental risk factors. The heritability of each condition was estimated us...
