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.
Middleton SB, Foley SJ, Foy MA.National Hunt jockeys suffer a disproportionate number of clavicular fractures and their return to riding may be considerably delayed by refracture and symptomatic nonunion, with obvious implications. We report six such cases in which excision of the clavicular fragment distal to the fracture was associated with an early return to work and no recurrent injury to the shoulder.
Dyson SJ, Arthur RM, Palmer SE, Richardson D.The gross and functional anatomy of the suspensory ligament (SL) and its ultrasonographic variability are described. Injuries of the suspensory apparatus are divided into lesions confined to the proximal one third of the metacarpus or metatarsus (proximal suspensory desmitis and avulsion fractures), lesions of the body, and branch lesions. Complete breakdown injuries are also discussed. In view of the close association of the SL, the second, third, and fourth metacarpal or metatarsal bones, and the proximal sesamoid bones, associated bony lesions are also considered.
Montesso F, Wright IM.Clinical and radiographic examinations of three horses with histories of trauma and/or wounds to the stifle revealed chip fractures from the medial trochlear ridge of the femur of one of them and from the lateral ridges of the femurs of the others. The joints were evaluated and the fragments of bone were removed by arthroscopy. The results were good in all three horses.
Moore BR, Weisbrode SE, Biller DS, Williams J.A 19-year-old Appaloosa gelding was reluctant to move. Radiography revealed diffuse, permeative lysis of the cortex and subchondral bone of the phalanges, third metacarpal bones, proximal sesamoid bones, radius, carpal bones, tibia, mandible, and nasal bones of the skull. A comminuted fracture of the distal aspect of the left third metacarpal bone was identified on a lateral to medial radiographic view of the left metacarpophalangeal joint. Histologic examination of the first phalanx, third metacarpal bone, and sternum revealed multifocal infiltrates of nodular lymphosarcoma in cortical and su...
van de Velde LF.The placement of a brace for external fixation of multiple fractures of the carpus or tarsus is described. In these two foals and calf we succeeded in obtaining a combination of good immobilization and full loading of the affected leg.
Turner RM, McDonnell SM, Hawkins JF.Ejaculation was pharmacologically induced in a 13-year-old Quarter Horse stallion with a spiral fracture of the radius. The owners desired to have semen from the stallion frozen prior to euthanatizing the horse, but because of the debilitating injury, standard methods of semen collection could not be used. With the stallion standing quietly in a stall, a plastic collection bag was positioned over the stallion's penis, and clomipramine hydrochloride (2.2 mg/kg of body weight, IV) was administered. Fifty-five minutes later, xylazine hydrochloride (0.5 mg/kg, IV) was administered. The stallion ej...
Moore RM, Schneider RK.Arthroscopy was performed in 1 carpal joint unilaterally in 27 horses and either in 2 carpal joints unilaterally or 1 carpal joint bilaterally in 7 horses. All horses were lame, but the cause of lameness could not be determined from radiographs. Twenty-seven carpi did not have radiographically visible abnormalities; the remaining 14 had only mild to moderate lucency or sclerosis of the radial facet of the third carpal bone. The primary abnormalities identified during arthroscopy included a crush fracture of the third carpal bone (7 carpi), an incomplete fracture of the third carpal bone in the...
Rapoff AJ, Markel MD, Vanderby R.By use of wire ropes as the transosseous component, an external skeletal fixator for the repair of long bone fractures in horses and cattle has been designed and tested in axial compression. Theoretical methods were used in the design process to size fixator components; however, our results suggest that conventional methods of analyzing the displacement of the transosseous component may not apply to wire ropes. Large pretensions in the wire ropes are necessary to obtain functional stiffnesses for fracture fixation. Therefore, a method was sought for terminating the ropes so that an appropriate...
Holcombe SJ, Schneider RK, Bramlage LR, Gabel AA, Bertone AL, Beard WL.Medical records of 59 racehorses with noncomminuted midsagittal proximal phalanx fractures repaired by means of lag screw fixation between 1973 and 1991 were reviewed. Fractures were classified as short incomplete fractures (7), long incomplete fractures (32), complete fractures extending into the proximal interphalangeal joint (13), and complete fractures extending through the lateral cortex of the proximal phalanx (7). Time from fracture repair to first race following fracture repair, number of racing starts, and fastest race times before and after surgery were obtained from race records and...
Wright IM, Montesso F, Kidd LJ.This paper describes the clinical and radiological features, surgical techniques used and results obtained in 6 horses with fractures of the tibial tuberosity. The horses were presented between 24 h and 8 weeks following injury. In all 6 cases, the fragments were displaced proximocranially and in 2 of these, there was comminution. Four were treated by open reduction and internal fixation using an AO/ASIF narrow dynamic compression plate and in 2 cases the fragments were removed. All horses returned to full athletic function and remained sound in follow-up times of 17-36 months. Implant removal...
Kawcak CE, Bramlage LR, Embertson RM.Incomplete fracture of the distal palmar aspect of the third metacarpal bone was diagnosed in 5 horses. Mild to moderate lameness and positive response to flexion of the metacarpophalangeal joint were evident in all horses. Fractures were not detectable in 4 horses when the routine 30 degrees proximodorsal-palmarodistal radiographic view was used. Visualization of the fractures in these 4 horses required imaging of the palmar condylar surface by use of a dorsopalmar view of the flexed joint or a 125 degrees dorsoproximal-dorsodistal view. The dorsopalmar view of the flexed joint was used in a ...
Barnes HG, Tucker RL, Grant BD, Roberts GD, Prades M.A traumatic fracture of C2 was diagnosed radiographically in a 1-year-old German Warm-blood stallion. Fracture configuration was difficult to see on survey radiographs. Computed tomography yielded a more accurate assessment of the fracture and facilitated fracture repair with cortical lag screws. Precise screw placement, to avoid spinal cord damage, was obtained by use of computed tomography. Follow-up radiography revealed normal bone healing, and the horse was in dressage schooling 24 months after surgery.
Attenburrow DP, Goss VA.A case of acute destabilization of the right stifle joint associated with rupture of the anterior cruciate ligament and avulsion fracture of the tibial spine in a horse is reported. The diagnosis was obtained by scintigraphy and radiography. Post mortem investigations 6 weeks after injury demonstrated fibrillation of surface cartilage in regions unprotected by tibial menisci. No pathological change was demonstrated in the subchondral bone of the tibia in regions associated with loss of cartilage integrity.
Reed SM.Trauma to the nervous system in horses may involve the brain, brainstem, spinal cord, or peripheral nerves. Trauma may occur to any part of the nervous system with or without a fracture.
Schmidt B, Mayr J, Fasching G, Nöres H.The rate of pediatric equestrian injuries is relatively low, but the severity of injuries is greater than in many other pediatric sport activities. In a 4-year period the charts of 109 patients up through the age of 15 years, who were admitted for equestrian-related injuries were reviewed. Falls from horses are the most frequent cause of injuries and responsible for their anatomic localization and type of injury. In our study the upper extremity was the most common (38%) area injured and head injuries comprised the second largest group with 36%. Forty percent of all injuries were fractures, 72...
Bertone AL.Initial management of injuries includes safely gaining control of the animal and assessing and treating systemic shock. If hemorrhage is life threatening, it must be controlled. If the limb is nonfunctional it should be stabilized. Any open orthopedic injury should be treated by cleaning the tissues, protecting the exposed tissues, and administering systemic antibiotics. A commercial splint is available (Equine Regular Leg Saver Splint, Kimzey Welding Works, Woodland, CA) that can immobilize and relieve weightbearing for cases of phalangeal fracture, flexor tendon rupture, fetlock breakdown, a...
McClure SR, Watkins JP, Ashman RB.Breaking strength (torque at failure) of equine third metacarpal bones, with transfixation pins placed parallel in the frontal plane and 30 degrees divergent from the frontal plane, was determined in vitro. Two transfixation pins were placed through the distal metaphysis, using a jig designed to drill the holes in the assigned configuration. Paired metacarpal bones II through IV from 12 horses were tested in torsion. The torsional moment of the force applied through the transfixation pins at failure was compared for each limb. Metacarpal bones with divergent pins were significantly (P = 0.030)...
Christey GL, Nelson DE, Rivara FP, Smith SM, Condie C.Horseback riding injuries are responsible for an estimated 2300 hospital admissions annually among persons younger than 25 years of age in the United States, but injury rates, patterns of injury, and risk factors for this population have not been well studied. Methods: Study participants were selected from a list provided by a national mail-order company that sells riding equipment. A total of 557 persons younger than 25 years of age who rode horses at least six times a year completed survey questionnaires. Results: Among the study participants, 34 (6.1%) had been hospitalized at least once be...
Johnson BJ, Stover SM, Daft BM, Kinde H, Read DH, Barr BC, Anderson M, Moore J, Woods L, Stoltz J.Necropsies were performed on 496 horses that had a fatal injury or illness at a California racetrack during the period February 20th 1990 to March 1st 1992. The primary cause of death was categorised by breed, activity at time of injury or illness and organ system affected. Most of the submissions were Thoroughbred horses (432) and Quarter Horses (46). Most of the injuries occurred while racing (42%) and in training sessions (39%); with fewer non-exercise (12%) and accident (7%) related injuries or illnesses. Musculoskeletal injuries accounted for 83% of the Thoroughbred and 80% of the Quarter...
McD○ LA, Stover SM, Taylor KT, Les CM.The compressive, bending and torsional mechanical properties of osteotomized adult equine tibiae stabilized with an interlocking intramedullary nail (nail-tibia composite) were compared with those of intact tibiae to determine the clinical applicability of the the nail for repair of tibial fractures in adult horses. The mean yield load, failure load, and stiffness for the nail-tibia composites were significantly less (P < .05) than those for the intact tibiae in all loading configurations. The mean compressive yield load for the nail-tibia composites was greater than the compressive load ca...
Barr AR.An objective radiological method of assessing the degree to which horses are conformationally 'back at the knee' (hyper-extended) is described. The effects on the measurements of variations in the direction of the incident X-ray beam and variations in weight bearing by the horse were assessed. A change from a lateromedial projection towards a plamaro-lateral-dorsomedial oblique projection consistently tended to reduce the observed degree of hyperextension of the carpus. Raising the contralateral limb to increase the load on the carpus had little effect on the measurements. The carpi of 21 thor...
Mueller PO, Allen D, Watson E, Hay C.A 2-year-old Standardbred colt was admitted because of lameness of the left hind limb. Physical examination revealed marked effusion of the left femoropatellar and femorotibial joints and grade IV/V lameness of the left hind limb. Radiography of the left stifle revealed a complete fracture of the medial tubercle of the intercondylar eminence of the tibia. Arthroscopy was used to provide diagnostic, therapeutic, and prognostic information. A cranial approach to the medial compartment of the femorotibial joint was performed. Manipulation of the medial tubercle revealed it to be unstable, but a d...
Holcombe SJ, Bertone AL.A 9-week-old Thoroughbred x Holsteiner colt was referred for evaluation and treatment of lameness of the right hind limb. Radiography of the stifle revealed multiple bony fragments within the lateral portion of the femorotibial joint and a radiolucency of the distolateral portion of the femur in the area of the extensor fossa, which were consistent with avulsion of the origin of the extensor digitorum longus muscle. Arthroscopy of the lateral portion of the femorotibial joint revealed exposed subchondral bone in the area of the extensor fossa, and the origin of the extensor digitorum longus mu...
Rijkenhuizen AB, Németh F.The clinical signs, the radiographic appearance, and the treatment of two cases of fracture of the accessory carpal bone are described. The fractures were in the vertical plane. Surgical intervention consisted out of fixation of the fracture with two lag screws. Follow-up information revealed that one horse became sound and returned to complete athletic activity whereas the other horse remained lame. A brief literature review is given and the surgical treatment and the complications are discussed.
Zamos DT, Hunt RJ, Allen D.Fractures of the distal radius in two horses were repaired by open reduction and interfragmentary compression using screws placed in a lag fashion. One horse had a complete oblique fracture of the medial aspect of the epiphysis of the distal radius and was sound for riding 32 months after surgery. The other horse had an open spiral comminuted fracture with medial displacement of the distal radial fragment. Laminitis developed in the contralateral limb and this horse was euthanatized 5 weeks after surgery.
Ellis DR.The common spontaneous fractures of the third metacarpus and
metatarsus of young racehorses are split cannons or condylar
fractures. Meagher (1976) described a series of 45 cases involving
the lateral condyle and Richardson (1984) detailed 15 cases involving
the medial metatarsal condyle. Rick et al. (1983) published a clinical
and pathological study of 75 cases of third metacarpal and metatarsal
condylar fracture. In the United Kingdom, Barr et al. (1989) recorded
8 cases with long fractures, 3 lateral and 5 medial condylar. This
paper reports 124 cases of medial or lateral condylar f...
Blikslager AT, Bristol DG.A 3-month-old foal was examined because of lameness and fracture of the left lateral trochlear ridge of the femur. Arthroscopy of the left femoropatellar joint was elected. After induction of general anesthesia and placement of the foal in dorsal recumbency, it was noticed that the left hind limb was extended at the tibiotarsal joint and flexed at the femorotibial joint. Avulsion fracture at the origin of the peroneus tertius tendon was diagnosed. Fracture fragments were excised. The horse had mild left hind limb lameness at the time of follow-up evaluation 1 year after discharge.
Pilsworth RC, Shepherd MC, Herinckx BM, Holmes MA.During a two year period, sagittal fractures of the wing of the ilium were diagnosed in 10 Thoroughbred horses. All were spontaneous fractures sustained during normal exercise in training and racing, with no history of inciting trauma. When ultrasound scans of the surface of the pelvis were performed, the fracture was clearly visible as a discontinuity of the sacral wing of the ilium. In 3 horses, an irregular contour suggestive of periosteal callus was seen in the vicinity of the acute fracture. All horses examined by gamma scintigraphy had a focal increase in uptake of isotope just lateral t...
McClure SR, Hillberry BM, Fisher KE.To evaluate in vitro holding power and associated microstructural and thermal damage from placement of positive-profile transfixation pins in the diaphysis and metaphysis of the equine third metacarpal bone. Methods: Third metacarpal bones from 30 pairs of adult equine cadavers. Methods: Centrally threaded positive-profile transfixation pins were placed in the diaphysis of 1 metacarpal bone and the metaphysis of the opposite metacarpal bone of 15 pairs of bones. Tensile force at failure for axial extraction was measured with a materials testing system. An additional 15 pairs of metacarpal bone...
Braza ME, Girotto JA.A 4-year-old female with prior cranial vault remodeling for nonsyndromic bilateral coronal craniosynostosis sustained a severe traumatic brain injury with open skull fractures from a horse kick. Her post-traumatic course was complicated by persistently elevated intracranial pressure despite neurosurgical decompressions, maximum medical therapy, and trial of multiple pressure monitoring devices. She eventually had improvement in her intracranial pressures and made a full neurologic recovery. This case highlights the potential severity of horse kick injuries, the possible etiology of persistent ...
Dik KJ, Nemeth F.Six cases of patella fractures are reported. Three horses presented an avulsion fracture of the medial patellar angle. For a precise diagnosis of this fracture a radiographic skyline view was indispensable; lateral views were not diagnostic. One of these horses recovered after three months' rest but radiographically the fracture remained visible. One horse with a comminuted fracture recovered after five months' rest. A case with a contaminated longitudinal patella fracture was destroyed. The sixth horse had a chip fracture of the dorsomedial part of the patella. The outcome of this case is unk...
Barr AR, Sridhar B, Denny HR.Five horses with long incomplete longitudinal fractures of the third metacarpal bone and three horses with similar fractures of the third metatarsal bone were examined. In three of the metacarpal fractures a long incomplete fissure extended proximomedially, in association with the more common lateral condylar fracture of the third metacarpal bone, and in the other two cases the fracture originated from the medial aspect of the distal articular surface. In the three horses with fractures of the third metatarsal bone the fractures had a consistent spiral configuration.
Bolt DM, Burba DJ.A pregnant 9-year-old Peruvian Paso mare was evaluated because of a fracture involving the left radius. On examination, grade IV/V lameness of the left forelimb was observed; radiography of the limb revealed a longitudinal oblique displaced fracture that extended from the caudal cortex of the radial mid-diaphysis into the humeroradial joint. To minimize the development of degenerative joint disease in the humeroradial joint, repair with internal fixation was recommended. A dynamic compression plate was applied to the cranial aspect of the radius; three 2-mm stainless steel cable cerclages were...
Schneider RK, Andrea R, Barnes HG.An open, contaminated, comminuted fracture of the radius of a 500-kg adult horse was diagnosed. Antibiotic-impregnated polymethyl methacrylate implants were placed into the fracture site to help eliminate infection from the limb. Later in the course of treatment, lag screws were placed across the fracture to generate compression and healing. The fracture healed, and the horse was released to its owners. The implants were not removed, and only a mild lameness existed 90 days later.
McKibbin LS, Paraschak DM.Bone spavin, splint, and fractured splint bone injuries have been treated with varying methodologies at Wheatley Hall Farm Equine Clinic. Cryosurgery is the most successful. With cryosurgery the small, pain-producing afferent C fibers are destroyed, and painful neuromas do not return. Injured sites were cryosurgically treated with liquid nitrogen for a double freeze-thaw period of 45 sec. 5 sec, 45 sec. Before and after treatment comparisons were conducted on study standardbreds. In all three injury groups, results showed that the standardbreds tended to race as well or with improved times and...
Jalim SL, McKinnon AO, Russell TM.A Monteggia fracture is a humero-radial luxation combined with a fracture of the ulna. It is a rare injury, infrequently reported in the horse. This case report describes the surgical repair of such a fracture in a 4-month-old filly.
Amaniti EM, Diakakis N, Patsikas M, Savvas I.Epiphyseal fracture, also known as epiphysiolysis, is the loosening or separation, either partial or complete, of an epiphysis from the shaft of a long bone. Distal epiphyseal fractures in foals pose a substantial challenge due to their guarded prognosis. This report describes the clinical signs, diagnosis, successful conservative treatment of an 1-month-old, male Skyros pony with an epiphyseal fracture of the right third metacarpal bone (type II Salter-Harris). The owner declined surgical treatment because of financial considerations along with the unfavorable prognosis. Conservative fracture...
Wright IM, Montesso F, Kidd LJ.This paper describes the clinical and radiological features, surgical techniques used and results obtained in 6 horses with fractures of the tibial tuberosity. The horses were presented between 24 h and 8 weeks following injury. In all 6 cases, the fragments were displaced proximocranially and in 2 of these, there was comminution. Four were treated by open reduction and internal fixation using an AO/ASIF narrow dynamic compression plate and in 2 cases the fragments were removed. All horses returned to full athletic function and remained sound in follow-up times of 17-36 months. Implant removal...
Specht TE, Colahan PT.Eleven horses with acute or chronic incomplete cortical fractures of the left or right third metacarpal bone (McIII) were treated with surgical puncture (osteostixis). The fractures were diagnosed by physical examination and radiography. Four to eight holes, 2.7 or 3.5 mm in diameter, were drilled in the fractured bone. Radiographically, the fractures were healed by month 3, and the drill holes were inapparent by month 7. Nine horses (82%) returned to race competition, and two horses were retired, one the result of a surgical complication. The mean time between surgery and the first race was 9...
Frost GE, du Preez HR.A 3 year old thoroughbred colt in full training pulled up
acutely lame during a training gallop on a dirt track.
According to the trainer no reason for the injury was
evident. The horse refused to bear weight on the leg
and when forced to walk back to the stables it would
only touch the affected toe to the ground. The fetlock
soon became swollen and was very painful. The trainer
treated the animal for a sprain with ice packs and
bandages. No improvement occurred in 72 hours and
veterinary advice was sought.
Examination revealed the horse to be in obvious
pain. He was unable to bear ...
Bailey JV, Barber SM, Fretz PB, Jacobs KA.The records of 13 horses of various breeds with subluxation of the radiocarpal, intercarpal or carpometacarpal joint, or combinations of these were reviewed. Subluxation was most common at the carpometacarpal joint (n = 10) and concomitant fractures of individual carpal bones or metacarpus II and IV were seen (n = 12).Treatment comprised of immobilization in a full leg plaster cast for from four to 18 weeks. Three animals were euthanized, two because of cast complications and one because of a request by the owner. The remaining ten were saved to function as breeding animals.