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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.
Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases. A minimally invasive arthroscopic technique for removal of fractures of the lateral malleolus of the tibia is considered to be beneficial but data to this effect are required. Objective: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically feasible, provides a comprehensive evaluation of the tarsocrural joint and enables removal of remote comminuted fragments and disrupted short collateral ligaments. The technique is associated with low patient morbidity, requires only short periods of hospitalisation and affords a good prognosis to affected horses. Methods: T...
The use of small (2.7 mm) screws for arthroscopically guided repair of carpal chip fractures. Removal of large chip fractures of the carpal bones and the osteochondral deficits that result, have been associated with a worse prognosis than removal of small fragments in similar locations. Objective: Reducing the articular defects by repair of large osteochondral fragments may have advantages over removal. Methods: Horses with osteochondral chip fractures that were of sufficient size and infrastructure to be repaired with small (2.7 mm diameter) AO/ASIF cortex screws were identified and repair effected by arthroscopically guided internal fixation. Results: Thirty-three horses underwent su...
Are bi-axial proximal sesamoid bone fractures in the British Thoroughbred racehorse a bone fatigue related fracture? A histological study. To investigate whether microfractures and alterations in the trabecular bone area are associated with catastrophic bi-axial proximal sesamoid bone fractures (PSBF). Methods: Proximal sesamoid bones (PSB) from 10 racehorses with PSBF and from 10 control racehorses without musculoskeletal injury were examined using the bulk basic fuchsin method. Bone histomorphometric and microfracture analysis was performed, and cases and controls compared using two-sample t-test, paired t-test, and Mann-Whitney U test. Results: There was no significant difference in the microfracture density and the trabecular...
Arthroscopic removal of fractures of the lateral malleolus of the tibia in the tarsocrural joint: a retrospective study of 13 cases. There is limited information on the treatment of lateral malleolus (LM) fractures in the horse, with no previously published case series for the outcome following arthroscopic removal of such fractures. This report reviews and evaluates findings of a retrospective study of 13 horses admitted to a private equine referral hospital over a 10 year period (1999-2009) that underwent arthroscopic removal of fractures of the LM. Hospital records were reviewed and details including patient history, aetiology of the fracture and limb affected, results of all diagnostic tests and surgical reports were do...
The effect of variable waveform low-intensity pulsed ultrasound in a fourth metacarpal osteotomy gap model in horses. The objective of this study was to evaluate the effects of variable waveform low-intensity ultrasound on the healing of a fracture gap of the fourth metacarpal bone in horses. A randomized, blinded, controlled trial was conducted in eight healthy adult horses. In each horse, a 1-cm osteotomy of the fourth metacarpal bone was created. One randomly selected metacarpal gap was treated daily with a 40-min session of ultrasound and the opposite gap was managed similarly with an inactive transducer. The fourth metacarpal bones were radiographed weekly. Fluorescent markers were administered at 14, 28...
Third metacarpal condylar fatigue fractures in equine athletes occur within previously modelled subchondral bone. Bone modelling and remodelling reduce the risk of fatigue fractures; the former by adapting bone to its loading circumstances, the latter by replacing fatigued bone. Remodelling transiently increases porosity because of the normal delay in onset of the formation phase of the remodelling sequence. Protracted intense loading suppresses remodelling leaving modelling as the only means of maintaining bone strength. We therefore hypothesized that race horses with fatigue fractures of the distal third metacarpal bone (MC3) will have reduced porosity associated with suppressed remodelling while contin...
Catastrophic biaxial proximal sesamoid bone fractures in UK Thoroughbred races (1999-2004): horse characteristics and racing history. Catastrophic biaxial proximal sesamoid bone fractures (PSBF) have not yet been described in detail in the UK racing population. Objective: To determine the incidence and relative risk (RR) of PSBF in different types of racing in the UK; and to describe horse-level characteristics and racing histories of horses sustaining these injuries. Methods: Distal limbs were collected from all racehorses suffering catastrophic fractures during racing at all 59 racecourses in the UK, in a prospective study from February 1999 to December 2004. Post mortem investigation identified the anatomical location and...
Size and geometry of apical sesamoid fracture fragments as a determinant of prognosis in Thoroughbred racehorses. Analysis was performed to examine a method for refining the preoperative prognosis for horses that had surgery to remove apical fractures of the proximal sesamoid bones (PSBs). Objective: To determine if: 1) there was a difference in size or configuration of apical fractures between the different anatomical locations of the PSBs, which have been shown to affect the prognosis; and 2) the size or configuration could predict the prognosis for racehorses with these fractures. Methods: The study included 110 weanlings and yearlings and 56 training racehorses that underwent surgery to remove apical ...
Purulent necrotic dislocation of the hip joint associated with umbilical infection in a foal. A 42-day-old heavy draft horse fell into sudden astasia. Significant swelling and heat sensation of the left femoral region were observed. Because of a friction sound in the left hip, we supposed that the hip joint was dislocated or the hip bone was fractured. Computed Tomography (CT) examination showed that the left hip joint was dislocated and the left femoral head was disjunct. We carried out a pathological autopsy, and made a diagnosis of the foal as fracture of the hip bone and femoral head with suppurative umbilical arteritis. Pathologic changes in the umbilical artery and hind leg were ...
Comparison of macrostructural and microstructural bone features in Thoroughbred racehorses with and without midbody fracture of the proximal sesamoid bone. To compare macrostructural and microstructural features of proximal sesamoid bones (PSBs) from horses with and without PSB midbody fracture to gain insight into the pathogenesis of PSB fracture. Methods: PSBs from 16 Thoroughbred racehorses (8 with and 8 without a PSB midbody fracture). Methods: Parasagittal sections of fractured and contralateral intact PSBs from horses with a PSB fracture and an intact PSB from age- and sex-matched control horses without a PSB fracture were evaluated for visual, radiographic, microradiographic, histologic, and his-tomorphometric differences in bone porosity,...
Lag screw fixation of dorsal cortical stress fractures of the third metacarpal bone in 116 racehorses. The effectiveness and best method to manage dorsal cortical stress fractures is not clear. This study was performed to evaluate the success of lag screw fixation of such fractures in a population of Thoroughbred racehorses. Objective: Lag screw fixation of dorsal cortical stress fractures is an effective surgical procedure allowing racehorses to return to their preoperative level of performance. Methods: The records of 116 racehorses (103 Thoroughbreds) admitted to Equine Medical Centre, California between 1986 and 2008 were assessed. Information obtained from medical records included subject ...
In vitro mechanical evaluation of a novel pin-sleeve system for external fixation of distal limb fractures in horses: a proof of concept study. To evaluate the efficacy of a novel pin-sleeve cast (PSC) system for external fixation of distal limb fractures in horses and to compare it with the transfixation pin cast (TPC) system. Methods: Experimental. Methods: One bone substitute each was used for the TPC and PSC systems. The PSC was tested in 4 configurations characterized by different pin preloads. Methods: Specimens were loaded in axial compression in the elastic range. Variables compared statistically were: bone substitute axial displacement and axial strain measured above implants with strain gauges. Pin preload was correlated wit...
Use of a pinless external fixator for unilateral mandibular fracture repair in nine equids. To report use of a pinless external fixator (PEF) for unilateral mandibular fractures in 9 equids. Methods: Case series. Methods: Equids (n=9) with unilateral mandibular fractures. Methods: All fractures were stabilized with the AO/ASIF PEF using a minimum of 4 clamps, under general anesthesia. Fracture configuration, complications, outcome, and owner satisfaction were evaluated. Results: All fractures were stabilized; 2 equids were euthanatized; 1 because of an inability to stand after surgery and 1 because of owner decision after PEF dislodgement. Seven repairs healed with good outcome and o...
Combined nanoindentation testing and scanning electron microscopy of bone and articular calcified cartilage in an equine fracture predilection site. Condylar fracture of the third metacarpal bone (Mc3) is the commonest cause of racetrack fatality in Thoroughbred horses. Linear defects involving hyaline articular cartilage, articular calcified cartilage (ACC) and subchondral bone (SCB) have been associated with the fracture initiation site, which lies in the sagittal grooves of the Mc3 condyle. We discovered areas of thickened and abnormally-mineralised ACC in the sagittal grooves of several normal 18-month-old horses, at the same site that linear defects and condylar fracture occur in older Thoroughbreds and questioned whether this tissue ...
Associations between physiotherapy findings and subsequent diagnosis of pelvic or hindlimb fracture in racing Thoroughbreds. Physiotherapists who work in racehorse training yards routinely treat horses' backs and hindquarters and may be able to recognise signs that indicate the presence of (impending) pelvic or hindlimb fracture before it becomes catastrophic. Objective: To establish whether physiotherapy assessment findings in Thoroughbred racehorses referred for routine physiotherapy could be predictive of subsequent (within 30 days) pelvic or hindlimb fracture diagnosis. Methods: Retrospective veterinary and physiotherapy data from a cohort of Newmarket (UK) Thoroughbred racehorses, were used. A case-control stud...
In vitro comparison of a novel external fixator and traditional full-limb transfixation pin cast in horses. To compare the mechanical properties and failure modes of a standardized short oblique distal radial metaphyseal osteotomy stabilized using either a transfixation pin cast (TPC), a modular-sidebar external skeletal fixator (ESF), or a solid-sidebar ESF (modular- or solid-ESF, respectively) using static or cyclic axial loading to failure. Methods: In vitro study. Methods: Equine cadaver forelimbs. Methods: A 30 degrees oblique distal radial osteotomy was created and stabilized using 1 of the 3 fixation methods: (1) TPC, (2) modular-ESF, or (3) solid-ESF. Limbs were tested using static (TPC, mod...
An in vitro biomechanical comparison of a 5.5 mm locking compression plate fixation with a 4.5 mm locking compression plate fixation of osteotomized equine third metacarpal bones. To compare the monotonic biomechanical properties and fatigue life of a 5.5-mm-broad locking compression plate (5.5 LCP) fixation with a 4.5-mm-broad locking compression plate (4.5 LCP) fixation to repair osteotomized equine 3rd metacarpal (MC3) bones. Methods: In vitro biomechanical testing of paired cadaveric equine MC3 with a middiaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. Methods: Fifteen pairs of adult equine cadaveric MC3 bones. Methods: Fifteen pairs of equine MC3 were divided into 3 test groups (5 pairs each) for (1) 4-point bending single cycle to failure ...
Distal humeral Salter Harris (Type II) fracture repair by an ulnar osteotomy approach in a horse. To report repair of a comminuted distal humeral type II Salter-Harris fracture using an ulnar osteotomy approach and locking compression plates (LCP). Methods: Case report. Methods: A 3-month-old Standardbred filly with a type II Salter-Harris fracture of the distal humerus. Methods: Radiographic and computed tomography examinations were performed to assist surgical planning. The distal humeral fracture was approached by an ulnar osteotomy and repaired using a 7-hole broad LCP and screws inserted in lag fashion. The osteotomy was subsequently repaired using a 7-hole narrow LCP. Results: The di...
Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006). To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Methods: Case series. Methods: Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Methods: Medical records (1990-2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. ...
Maxillofacial fractures sustained by unmounted equestrians. Facial injuries caused by horses are relatively common among riding enthusiasts, but little is known about the nature of maxillofacial fractures sustained by those not mounted. We collected data on patients' characteristics, fractures sites, mechanisms of injury, and treatment of these fractures from the departmental records of the oral and maxillofacial unit at Christchurch Hospital, New Zealand between 1996 and 2008. Of 49 patients with equine-related facial fractures, 35 (mean (SD) age 35.8 (16.7) years) had sustained their injuries while unmounted (71%). Most of the fractures occurred in w...
Rib osteomyelitis in three foals. Three foals aged between 21 and 44 days were presented for evaluation of pyrexia and lameness. Each had subcutaneous abscessation associated with osteomyelitis of a rib at the costochondral junction and pathological fracture of the affected rib; one foal had more than one rib affected. Other localised sites of infection included other sites of osteomyelitis, omphalophlebitis, uveitis, enterocolitis, and calcaneal bursitis. The subcutaneous abscessation and rib osteomyelitis was treated surgically in two foals. Salmonella typhimurium was isolated from the subcutaneous abscess in one foal and fr...
Occult metastatic intestinal adenocarcinoma resulting in pathological fracture of the proximal humerus. Intestinal adenocarcinomas are rare but have been described in the literature. The present case is unusual in both its clinical presentation and in the distribution of metastatic lesions. The sequestrum formation and pathological fracture present are most commonly associated with osteomyelitis in horses and the details of the case highlight the need for differential diagnosis in these particular circumstances and of which clinicians should be aware.
Divergent diagnosis from arthroscopic findings and identification of CPII and C2C for detection of cartilage degradation in horses. The objective of this study was to investigate the changes in synovial fluid concentration of collagen type II cleavage site (C2C) and procollagen II C-propeptide (CPII), markers of joint cartilage degeneration and synthesis, respectively, in horses with intraarticular fracture or osteochondrosis dissecans (OCD), and to examine the relationship between arthroscopic findings and these biomarker levels. Synovial fluid was collected from 36 joints in 18 horses (6 fractures and 12 OCDs). Samples from contralateral normal joints, when available, served as controls (n = 12). Concentrations of C2C an...
In vitro evaluation of allogeneic bone screws for use in internal fixation of transverse fractures created in proximal sesamoid bones obtained from equine cadavers. To evaluate effectiveness of allogeneic bone screws and pins for internal fixation of midbody transverse fractures of equine proximal sesamoid bones (PSBs) in vitro. Methods: 14 forelimbs from cadavers of 3-year-old Thoroughbreds. Methods: Allogeneic cortical bone fragments were collected from the limbs of a male Thoroughbred, and cortical bone screws were prepared from the tissue by use of a precision desktop microlathe programmed with the dimensions of a metal cortical bone screw. A midbody transverse osteotomy of each PSB was performed by use of a bone-shaping oscillating saw and repaired v...
Compressive forces achieved in simulated equine third metacarpal bone lateral condylar fractures of varying fragment thickness with Acutrak Plus screw and 4.5 mm AO cortical screws. To compare compression pressure (CP) of 6.5 mm Acutrak Plus (AP) and 4.5 mm AO cortical screws (AO) when inserted in simulated lateral condylar fractures of equine 3rd metacarpal (MC3) bones. Methods: Paired in vitro biomechanical testing. Methods: Cadaveric equine MC3 bones (n=12 pair). Methods: Complete lateral condylar osteotomies were created parallel to the midsagittal ridge at 20, 12, and 8 mm axial to the epicondylar fossa on different specimens grouped accordingly. Interfragmentary compression was measured using a pressure sensor placed in the fracture plane before screw placement for ...
Comparative rheumatology: what can be learnt from naturally occurring musculoskeletal disorders in domestic animals? Examples of naturally occurring musculoskeletal disorders are extremely common in veterinary species and provide a valuable comparative research resource, which can provide compelling comparative data on the aetiopathogenesis and treatment of many common human musculoskeletal diseases. In particular, orthopaedic diseases are a common morbidity in both dogs and horses. In this review, we give an overview of the common musculoskeletal diseases encountered in these species: for instance, tendon and ligament injuries, arthropathies and stress fractures, as well as an insight into the basic biology...
Clinical and imaging features of suspected prodromal fracture of the proximal phalanx in three Thoroughbred racehorses. Sagittal fracture of the proximal phalanx (P1) is an important musculoskeletal injury of the performance horse. Although widely considered to be monotonic in nature, there is emerging evidence that some P1 fractures may have stress-injury aetiology. Three cases are described in which imaging features found were suggestive of prodromal bone injury. All cases returned to full performance use after a period of rest. The authors conclude that it is possible that some P1 fractures in the Thoroughbred racehorse may develop through stress/fatigue injury pathways. It is proposed that intervention prio...
Birth of live triplets in a mare. An 11-year-old American Buckskin mare gave birth to live triplets unattended at approximately 300 days gestation. All foals were small and dysmature, requiring intensive care. The smallest foal died 4 days after admission, the second was subjected to euthanasia 24 days after admission due to poor healing of a third metatarsal fracture. The remaining foal survived to discharge and was considered small but otherwise normal at age one year.
Computed tomography of temporal bone fractures and temporal region anatomy in horses. In people, specific classifications of temporal bone fractures are associated with clinical signs and prognosis. In horses, similar classifications have not been evaluated and might be useful establishing prognosis or understanding pathogenesis of certain types of trauma. Objective: We hypothesized associations between temporal bone fracture location and orientation in horses detected during computed tomography (CT) and frequency of facial nerve (CN7) deficit, vestibulocochlear nerve (CN8) deficit, or temporohyoid osteoarthropathy (THO). Complex temporal region anatomy may confound fracture id...
Musculoskeletal injuries in Thoroughbred racehorses: a study of three large training yards in Newmarket, UK (2005-2007). Musculoskeletal injury is the most common cause of lost training days in the young Thoroughbred horse in flat race training. To date, there has been little investigation of the regional patterns of injury frequently observed by clinicians in racehorse practice. The present study was conducted to determine incidence of musculoskeletal injuries in Thoroughbreds in training in Newmarket, United Kingdom. Veterinary records for all horses resident in three large (>100 horse) training yards were assessed for occurrence of significant musculoskeletal injury. A total of 248 injuries were recorded in 2...
