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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.
Comparison of Radiography and Computed Tomography for Evaluation of Third Carpal Bone Fractures in Horses.
Animals : an open access journal from MDPI    April 25, 2023   Volume 13, Issue 9 1459 doi: 10.3390/ani13091459
Steel C, Ahern B, Zedler S, Vallance S, Galuppo L, Richardson J, Whitton C, Young A.Radiographs underestimate the extent of bone injury in horses with third carpal bone (C3) fractures (Fx). We aimed to describe bone pathologies identified using computed tomography (CT) and compare the diagnostic value of digital radiography (DR) and CT in horses with C3 Fx. CT images of 15 racehorses with C3 Fx and 10 controls were reviewed (Part 1) then DR and CT images of 26 racehorses (24 Thoroughbred, 2 Standardbred) with C3 Fx (Part 2) were evaluated. Agreement on fracture geometry and concomitant bone lesions was tested between DR and CT using the kappa statistic (Part 2). For agreement...
Horse and Cattle-Related Trauma: A Retrospective Review of Injuries and Management in a Regional Queensland Hospital.
Cureus    March 3, 2023   Volume 15, Issue 3 e35746 doi: 10.7759/cureus.35746
Savage G, Liesegang A, Campbell J, Lyon M, Fry D.Horse and cattle-related trauma is a common presentation to regional hospitals in Australia. We review local incidence and patterns of injuries relating to horse and cattle trauma over a three-year period at the Toowoomba Base Hospital within the Darling Downs region in Queensland, an area rich in cattle farming and equestrian recreation. Methods: We conducted a single-centre retrospective cohort study. The inclusion criteria were all patients presenting with injuries following cattle or horse-related incidents between January 2018 and April 2021. Primary outcomes were the mechanism of trauma,...
Metacarpophalangeal Joint Pathology and Bone Mineral Density Increase with Exercise but Not with Incidence of Proximal Sesamoid Bone Fracture in Thoroughbred Racehorses.
Animals : an open access journal from MDPI    February 24, 2023   Volume 13, Issue 5 827 doi: 10.3390/ani13050827
Noordwijk KJ, Chen L, Ruspi BD, Schurer S, Papa B, Fasanello DC, McDonough SP, Palmer SE, Porter IR, Basran PS, Donnelly E, Reesink HL.Proximal sesamoid bone (PSB) fracture is the leading cause of fatal musculoskeletal injury in Thoroughbred racehorses in Hong Kong and the US. Efforts are underway to investigate diagnostic modalities that could help identify racehorses at increased risk of fracture; however, features associated with PSB fracture risk are still poorly understood. The objectives of this study were to (1) investigate third metacarpal (MC3) and PSB density and mineral content using dual-energy X-ray absorptiometry (DXA), computed tomography (CT), Raman spectroscopy, and ash fraction measurements, and (2) investig...
Standing Surgical Management of Splint Bone Fractures in 13 Horses: A Comparison to Management Under General Anaesthesia.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    February 9, 2023   Volume 36, Issue 3 148-156 doi: 10.1055/s-0043-1761241
Auffret V, Bonilla AG. 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. Methods:  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 appeara...
Training drives turnover rates in racehorse proximal sesamoid bones.
Scientific reports    January 27, 2023   Volume 13, Issue 1 205 doi: 10.1038/s41598-022-26027-y
Shaffer SK, Stover SM, Fyhrie DP.Focal bone lesions are often found prior to clinically relevant stress-fractures. Lesions are characterized by low bone volume fraction, low mineral density, and high levels of microdamage and are hypothesized to develop when bone tissue cannot sufficiently respond to damaging loading. It is difficult to determine how exercise drives the formation of these lesions because bone responds to mechanical loading and repairs damage. In this study, we derive steady-state rate constants for a compartment model of bone turnover using morphometric data from fractured and non-fractured racehorse proximal...
Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies.
Journal of equine veterinary science    January 14, 2023   Volume 122 104226 doi: 10.1016/j.jevs.2023.104226
de Souza AF, Paretsis NF, De Zoppa ALDV.The aim of this study was to determine the clinical outcomes reported in retrospective studies of proximal interphalangeal arthrodesis (PIA) in horses through a meta-analysis of retrospective studies. CAB Abstracts, PubMed, ScienceDirect, Web of Science, and Scopus were searched. The primary outcomes included survival and surgical site infection (SSI) rates, return to activities, and time of hospital stay and casting. Subgroups were formed for fractures and other conditions. Meta-analyses were performed with fixed and random effects models to estimate proportions, mean values, and effect size ...
Comparison of Two Bandage Splint Constructs in an Ex Vivo Equine Metacarpal Fracture Model.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    December 28, 2022   Volume 36, Issue 2 82-86 doi: 10.1055/s-0042-1759867
Granello ME, Weatherall KM, Lutter JD, Beard WL. The aim of this study was to compare the deflection distance, deflection angle and pre-loading sub-bandage pressure of a transverse, mid-metacarpal fracture in an equine cadaver limb when loaded in bending while stabilized with either a Robert Jones Bandage (RJB) or a single-stack bandage (SS), each containing two orthogonal splints. Methods:  In an ex vivo experimental study, forelimb pairs from eight horses were collected, and one forelimb from each pair was assigned to either the SS or RJB groups. A transverse osteotomy was performed at the midpoint of the metacarpus. After bandaging, ...
Immediate pre-operative computed tomography for surgical planning of equine fracture repair: A retrospective review of 55 cases.
PloS one    December 28, 2022   Volume 17, Issue 12 e0278748 doi: 10.1371/journal.pone.0278748
Taylor CJ, Peter VG, Coleridge MOD, Bathe AP.Fracture configuration is often more complex than is radiographically appreciable. The objective of this study is to describe the influence of pre-operative computed tomography (CT) for surgical planning in a variety of fracture types. This has not been described in previous studies. All cases with pre-operative radiographs, admitted for CT and surgical repair of a suspected limb fracture from January 2010-December 2020 were reviewed. CT was acquired under general anaesthesia in a multi-slice helical scanner; any surgery was then performed immediately. Three diplomates (two surgical; one diagn...
Preclinical Use of FGF-18 Augmentation for Improving Cartilage Healing Following Surgical Repair: A Systematic Review.
Cartilage    December 21, 2022   Volume 14, Issue 1 59-66 doi: 10.1177/19476035221142010
DePhillipo NN, Hendesi H, Aman ZS, Lind DRG, Smith J, Dodge GR.To evaluate the efficacy of fibroblast growth factor-18 (FGF-18) augmentation for improving articular cartilage healing following surgical repair in preclinical () animal models. A systematic review was performed evaluating the efficacy of FGF-18 augmentation with cartilage surgery compared with cartilage surgery without FGF-18 augmentation in living animal models. Eligible intervention groups were FGF-18 treatment in conjunction with orthopedic procedures, including microfracture, osteochondral auto/allograft transplantation, and cellular-based repair. Outcome variables were: International Ca...
Novel computed tomographic analysis demonstrates differences in patterns of bone mineral content between fracture configurations in distal condylar fractures of the third metacarpal/metatarsal bones in 97 Thoroughbred racehorses.
American journal of veterinary research    November 7, 2022   Volume 83, Issue 12 ajvr.22.03.0060 doi: 10.2460/ajvr.22.03.0060
Posukonis MN, Daglish J, Wright IM, Kawcak CE.To evaluate bone mineral content patterns between fracture configurations using novel CT image analysis. Methods: CT images from 97 Thoroughbred racehorses with third metacarpal/tarsal condyle fractures provide the case population for analysis. Methods: Fractures were grouped by radiographic appearance. Image analysis objectively measured area of highly attenuating pixels (aHAP), areal density of highly attenuating pixels (dHAP) utilizing novel convex hull analysis, and subjective assessment of apparent attenuation intensity ranking (AAIR) for each fracture. Differences between fracture config...
Radiomics Modeling of Catastrophic Proximal Sesamoid Bone Fractures in Thoroughbred Racehorses Using μCT.
Animals : an open access journal from MDPI    November 4, 2022   Volume 12, Issue 21 doi: 10.3390/ani12213033
Basran PS, McDonough S, Palmer S, Reesink HL.Proximal sesamoid bone (PSB) fractures are the most common musculoskeletal injury in race-horses. X-ray CT imaging can detect expressed radiological features in horses that experienced catastrophic fractures. Our objective was to assess whether expressed radiomic features in the PSBs of 50 horses can be used to develop machine learning models for predicting PSB fractures. The μCTs of intact contralateral PSBs from 50 horses, 30 of which suffered catastrophic fractures, and 20 controls were studied. From the 129 intact μCT images of PSBs, 102 radiomic features were computed using a variety of...
[Unilateral mandibular fracture in horse – Treatment with fixateur externe, a complication during implant removal and procedure for removal of implant fragments].
Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere    November 2, 2022   Volume 50, Issue 5 340-347 doi: 10.1055/a-1945-4903
Vidović A, Jansen D.The first part of this case report describes the surgical treatment of a unilateral mandibular fracture in the standing horse by using a fixateur type I. By the time of implant removal, the fracture had completely healed. However, during implant removal, an implant failure of 2 of the 4 implants occurred with fragments remaining in the bone. The second part of the report focuses on the development of a special surgical instrument that was designed for removal of the implant fragments. Furthermore, the surgical method allowing the entire extirpation of the fragments within a second surgery is d...
Computed tomography findings in horses presented with signs of head-shaking.
Equine veterinary journal    October 18, 2022   Volume 55, Issue 4 649-655 doi: 10.1111/evj.13889
Perrier M, Manso-Díaz G, Dunkel B.Trigeminal nerve-mediated head-shaking (TNMH) in horses is a diagnosis made by exclusion. Computed tomography (CT) is frequently used to identify any disease process that could cause the clinical signs of head-shaking. Although abnormalities are frequently identified, it is unknown whether treatment of these conditions improves clinical signs. Objective: To ascertain the clinical significance of CT findings in horses presented with a complaint of head-shaking. Methods: Retrospective case series. Methods: CT and patient records were reviewed and all abnormal findings and any treatments subseque...
Treatment of a Mandibular Diastemal Fracture Using Locking Compression Plate and Cerclage Wire in a Mare.
Journal of veterinary dentistry    October 18, 2022   Volume 40, Issue 1 75-80 doi: 10.1177/08987564221129986
Godoy VM, Oliveira NFOE, Paretsis NF, Silva SCD, Souza AF, De Zoppa ALDV, Corrêa RR.This report describes the combination of two surgical fracture repair techniques and the postoperative management of a mandibular diastemal fracture in a two-year-old mare. The mare was referred to a veterinary hospital with a laceration over the body of the right mandible. Radiographic assessment revealed two mesial fracture lines involving the second premolar tooth and a ventrally displaced bone fragment. The mare was treated under general anesthesia and the fracture was corrected using open reduction and plate fixation. A 3.5 mm narrow 15-hole locking compression plate with seven locking ...
Use of Locking Compression Plate and Locking Compression T-Plate for Surgical Arthrodesis of the Carpometacarpal and Distal Tarsal Joints in 13 Horses.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    September 19, 2022   Volume 36, Issue 1 39-45 doi: 10.1055/s-0042-1756518
Lambert JL, García-López JM, Gasiorowski JC. The aim of this study was to describe the use of the locking compression plate (LCP) and locking compression T-plate (LCTP) in cases of carpometacarpal and distal tarsal arthrodesis for the treatment of osteoarthritis and small carpal or tarsal bone fractures, and to document clinical outcomes. Methods:  Case records of horses treated with carpometacarpal or distal tarsal arthrodesis via internal fixation using an LCP or LCTP between 2013 and 2021 were reviewed. All cases were evaluated retrospectively. Follow-up information was gained via phone conversation with owners and referring vete...
Equine hoof wall: Structure, properties, and bioinspired designs.
Acta biomaterialia    August 20, 2022   Volume 151 426-445 doi: 10.1016/j.actbio.2022.08.028
Lazarus BS, Luu RK, Ruiz-Pérez S, Bezerra WBA, Becerra-Santamaria K, Leung V, Durazo VHL, Jasiuk I, Barbosa JDV, Meyers MA.The horse hoof wall exhibits exceptional impact resistance and fracture control due to its unique hierarchical structure which contains tubular, lamellar, and gradient configurations. In this study, structural characterization of the hoof wall was performed revealing features previously unknown. Prominent among them are tubule bridges, which are imaged and quantified. The hydration-dependent viscoelasticity of the hoof wall is described by a simplified Maxwell-Weichert model with two characteristic relaxation times corresponding to nanoscale and mesoscale features. Creep and relaxation tests r...
Biomechanical Comparison of a Headless Compression Screw Fastener and AO Cortical Bone Screw for Fixation of a Simulated Equine Third Carpal Bone Slab Fracture.
Journal of equine veterinary science    August 7, 2022   Volume 118 104094 doi: 10.1016/j.jevs.2022.104094
Salinger A, Mochal-King C, Clinton K, Priddy LB, Elder S, Fontenot R, Eddy A, Wills R, Jaffe M.Frontal plane slab fractures account for the majority of third carpal bone (C3) fractures in racing and performance horses. Recommended treatment is stabilization with a lagged AO cortical screw. Associated complications are fragment splitting, fragment spinning, and irritation of dorsal soft tissue structures. A novel, headless, cannulated screw with interlocking threads the Headless Compression Screw Fastener (HCSF) has been developed to resist multidirectional forces and bending moments; however, it has not been applied in the horse. Simulated C3 frontal plane slab fractures were created in...
Ultrasonographic diagnosis of femoral fractures in large animals.
Journal of the American Veterinary Medical Association    July 28, 2022   Volume 260, Issue 13 1675-1682 doi: 10.2460/javma.22.02.0081
Jones SA, Whitcomb MB, Vaughan B, Goorchenko G, Busch R, Kilcoyne I, Spriet M.Femoral fractures are often catastrophic in large animals. Radiographic diagnosis is limited by patient size and feasibility, especially in ambulatory settings. Ultrasonography is widely available and may provide an alternative to radiography for definitive diagnosis. 12 large animals (6 horses, 5 cattle, and 1 elephant). Retrospective analysis of large animal patients diagnosed with femoral fracture by use of femoropelvic ultrasonography (2000 to 2019). 5 of 12 cases were ≤ 1 year of age. The remaining 7 cases were 2 to 33 years of age (median, 13 years). All patients developed severe acute...
Caecal dysfunction following standing surgical procedures.
Veterinary medicine and science    July 27, 2022   Volume 8, Issue 5 1930-1935 doi: 10.1002/vms3.882
Gough RL, McGovern KF, Bladon BM, Carmichael LA.The aim of this study is to report cases of caecal dysfunction following surgical procedures in the standing horse. The study design is retrospective. Six client-owned horses developed caecal dysfunction following a variety of surgical procedures undertaken in the standing sedated horse. Medical records were reviewed for caecal dysfunctions that had occurred in horses within 2 weeks of standing surgical procedures. Signalment, details of the original standing surgery and medications administered were recorded. Short-term outcome was obtained from clinical records. Long-term outcome was obtain...
Palmar/plantar oblique projections improve radiographic detection of fractures of the palmar/plantar processes of the equine distal phalanx. Fairburn AJ, Sherlock CE, Mair TS.Radiography is a standard diagnostic test for horses with suspected fractures of the palmar/plantar processes (PP) of the distal phalanx, however published studies evaluating the diagnostic utility for radiography are currently lacking. The objectives of this retrospective, diagnostic case-control study were to determine the sensitivity of radiographs for the detection of PP fractures, and determine the diagnostic utility of the palmar/plantar oblique projections of the PP for the identification of PP fractures compared to standard radiographic series. The medical records of horses undergoing...
Simulated Kick Injury to the Mandible in Horses: Study of Fracture Configurations and Physical Parameters of the Impact.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    July 15, 2022   Volume 35, Issue 4 255-262 doi: 10.1055/s-0042-1748878
Gfrerer L, Michel S, Fürst AE, Piskoty G, Weisse B, Montavon S, Jackson MA. The goal of this study was to generate mandibular fractures in three regions of the diastema using a metal impactor to simulate a kick from a horse and to determine the mean deceleration in the initial phase of the impact event, the maximum contact force, the impact energy necessary to create a fracture and the duration of the impact. Methods:  Thirty heads of horses aged between 5 and 20 years and euthanatized for various reasons were used. The heads were attached to a steel bar at the occiput at an axial angle of 45 degrees so that the body of the mandible was positioned horizontally ...
Catastrophic Musculoskeletal Injuries in Thoroughbred Racehorses in Uruguay, 2011-2017.
Journal of equine veterinary science    July 9, 2022   Volume 117 104074 doi: 10.1016/j.jevs.2022.104074
Bimson NH, Morrice-West AV, Wong ASM, Hitchens PL, Rocca MR, Whitton RC.Catastrophic musculoskeletal injuries (CMI) pose a major welfare concern to horses and their riders, yet limited data are available describing their occurrence in South America. Using a retrospective cohort and case-control design, the objective of the study was to determine the incidence of CMI for Thoroughbreds in training and racing, and associated horse-level risk factors in Uruguay. Seventy-seven Thoroughbreds sustained a CMI, 37 of which were age- and sex-matched to 111 control horses in the same race. Training and racing data from 2011 to 2017 were collected. Incidence of race day CMI p...
Is the Use of Bisphosphonates Putting Horses at Risk? An Osteoclast Perspective.
Animals : an open access journal from MDPI    July 3, 2022   Volume 12, Issue 13 doi: 10.3390/ani12131722
Vergara-Hernandez FB, Nielsen BD, Colbath AC.Osteoclasts are unique and vital bone cells involved in bone turnover. These cells are active throughout the individual's life and play an intricate role in growth and remodeling. However, extra-label bisphosphonate use may impair osteoclast function, which could result in skeletal microdamage and impaired healing without commonly associated pain, affecting bone remodeling, fracture healing, and growth. These effects could be heightened when administered to growing and exercising animals. Bisphosphonates (BPs) are unevenly distributed in the skeleton; blood supply and bone turnover rate determ...
An in vitro model for discovery of osteoclast specific biomarkers towards identification of racehorses at risk for catastrophic fractures.
Equine veterinary journal    June 19, 2022   Volume 55, Issue 3 534-550 doi: 10.1111/evj.13600
Malek G, Richard H, Beauchamp G, Laverty S.Focal bone microcracks with osteoclast recruitment and bone lysis, may reduce fracture resistance in racehorses. As current imaging does not detect all horses at risk for fracture, the discovery of novel serum biomarkers of bone resorption or osteoclast activity could potentially address this unmet clinical need. The biology of equine osteoclasts on their natural substrate, equine bone, has never been studied in vitro and may permit identification of specific biomarkers of their activity. Objective: (1) Establish osteoclast cultures on equine bone, (2) Measure biomarkers (tartrate resistant ac...
A review of equine tibial fractures.
Equine veterinary journal    June 15, 2022   Volume 55, Issue 2 171-181 doi: 10.1111/evj.13599
Bowers K, Weinhandl JT, Anderson DE.Equine tibial fractures are relatively infrequent in racing and non-racing sport horses, but limitations in successful treatment of tibial fractures in adult horses result in relatively high mortality compared with other musculoskeletal injuries. The aetiology of tibial fracture can be classified into two general categories: traumatic impact or fatigue failure. Tibial stress fractures, also known as fatigue fractures, are often rated as the second most common stress fracture in racing Thoroughbreds; young age, early stage in race training, and initiation of training after a period of rest are ...
Proximal sesamoid bone microdamage is localized to articular subchondral regions in Thoroughbred racehorses, with similar fracture toughness between fracture and controls.
Veterinary surgery : VS    June 7, 2022   Volume 51, Issue 6 952-962 doi: 10.1111/vsu.13816
Luedke LK, Ilevbare P, Noordwijk KJ, Palomino PM, McDonough SP, Palmer SE, Basran PS, Donnelly E, Reesink HL.To determine whether proximal sesamoid bone (PSB) microdamage and fracture toughness differ between Thoroughbred racehorses sustaining PSB fracture and controls. Methods: Cadaveric case-control. Methods: Twenty-four Thoroughbred racehorses (n = 12 PSB fracture, n = 12 control). Methods: Proximal sesamoid bones were dissected, and gross pathological changes and morphological measurements were documented. High-speed exercise history data were evaluated. Microdamage was assessed in fracture, fracture-contralateral limb (FXCL) and control PSBs using whole bone lead uranyl acetate (LUA) stainin...
Surgical management of a Salter-Harris type I proximal physeal fracture of the tibia in a foal: a case report.
BMC veterinary research    May 16, 2022   Volume 18, Issue 1 183 doi: 10.1186/s12917-022-03285-6
Mazaheri-Khameneh R, Azizi S, Davoodi F, Gooran MM.One of the traumatic fractures occurring in the hindlimb of the foals is physeal fractures of the tibia. The most common type of proximal tibial fracture in foals is reported to be Salter-Harris type II. Methods: This case report describes the history, clinical signs, radiographic findings, and surgical management of a proximal physeal fracture of the tibia due to the kick trauma in a 2-weeks-old Kurdish female foal, with signs of left pelvic limb lameness, valgus deviation with non-weight-bearing, non-mobility in stifle region and crepitation in the affected area. In this case, radiography wa...
Predicting return to racing after repair of fractures of the metacarpal/metatarsal condyles in Thoroughbred racehorses.
Veterinary surgery : VS    May 8, 2022   Volume 51, Issue 5 753-762 doi: 10.1111/vsu.13820
Young N, Corletto F, Wright I.To identify prognostic factors for return to racing after lag screw repair of condylar fractures and develop a predictive model for return to racing. Methods: Retrospective cohort study. Methods: A total of 356 horses referred to a single referral hospital in the UK with a third metacarpal/metatarsal condylar fracture between January 1999 and December 2018. Methods: Age, sex, fracture site, fracture characteristics, surgery related variables and complications were retrieved from case records. Data were divided into two sets for model training and model validation. Univariable analyses were per...
Preoperative computed tomographic evaluation of neonatal foals with rib fractures.
Veterinary surgery : VS    May 2, 2022   Volume 51, Issue 5 816-826 doi: 10.1111/vsu.13817
Garrett KS, Embertson RM, Hopper SA, Woodie JB, McQuerry KJ.To compare ultrasonographic and computed tomographic findings in neonatal foals prior to surgical repair of rib fractures as well as postoperative outcomes in foals with and without preoperative thoracic computed tomography (CT). Study design Retrospective cohort study. Sample population 43 neonatal foals undergoing surgical treatment of rib fractures between 2013 and 2021. Methods: Medical records were reviewed for age, sex, delivery method, comorbidities, presurgical anesthetic time, surgical time, number and location of fractured ribs identified with ultrasound and CT, number and location o...
Race-Level Reporting of Incidents during Two Seasons (2015/16 to 2016/17) of Thoroughbred Flat Racing in New Zealand.
Animals : an open access journal from MDPI    April 15, 2022   Volume 12, Issue 8 doi: 10.3390/ani12081033
Gibson MJ, Bolwell CF, Gee EK, Legg KA, Rogers CW.The objective of this study was to describe the incident and non-incident reports of Thoroughbred flat racing in New Zealand. Retrospective stipendiary stewards' reports of race day events during the 2015/2016 and 2016/2017 racing season were examined. The primary injury and reporting outcomes were analysed to assess the horse- and race-level risk factors associated with the occurrence of incident and non-incident reports. The number of incident and non-incident events and binomial exact 95% confidence intervals were calculated per 1000 horse starts. Most reports were for non-incidents and exa...