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.
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...
Spurlock GH, Gabel AA.One-hundred and nine apical fractures of the proximal sesamoid bones were diagnosed in Standardbred racehorses at the Ohio State University Veterinary Hospital during a 5-year period ending December 1978. Lateral sesamoids of the hindlimbs accounted for 61 of the 109 fractures, which was a significantly (P less than 0.05) greater proportion than that for fractures in all other sesamoid bones. Two- and three-year-old horses accounted for 73 of the 109 apical sesamoid fractures. The remaining 36 apical sesamoid fractures were in horses 4 to 9 years old. The apical fragment was removed in 80 of t...
Tulamo RM, Bramlage LR, Gabel AA.The case histories and follow-up data for 11 horses with slab fractures of the central or 3rd tarsal bones were examined for information pertaining to the diagnosis, which was difficult to identify, treatment, which was proven ineffective, and the prognosis, which was shown to be poor for return to racing. The purpose of the study was to define the results that could be obtained by nonoperative methods, in an attempt to determine whether surgical treatment was advisable. Nine of the horses were Standardbreds and 2 were Thoroughbreds; all horses were 2 to 4 years old and were being exercised at...
Bernhang AM, Winslett G.In brief: It has always been assumed that participants in equestrian sports are at high risk of serious injury and that minor injuries are common. This study of American Horse Shows Association and United States Pony Clubs horse shows tried to determine if shows are as safe as or safer than other sports, what the accident rate is for horse shows, if any factors influence the accident rate, and what types of accidents and injuries occur. There were 290 reported injuries and two deaths in the 984 responding shows. The accident rate per entry was 0.0003. There was no statistically significant rel...
Yovich JV, Hilbert BJ, McGill CA.Nineteen cases of fracture of the distal phalanx in horses are reviewed. This represented 1.1% of the total number of horses seen at Murdoch University Veterinary Hospital (MUVH) over a 32-month period. All horses were managed conservatively. Eight horses made a complete recovery. Three are being trained again and are not lame. Four horses made a limited recovery. Two horses are still resting and one horse was killed humanely when it still showed lameness after 2 years. One horse was killed humanely after the fracture was first diagnosed.
Dewes HF.Fractures of the central tarsal and/or third tarsal bones involving both limbs of six foals are described. Five of the subjects were born either premature or of twin pregnancies. Fractures occurred in the neonatal period and coincided with disablement. Features of behaviour, posture and gait are described, together with gross radiographic findings, bone ash determination and blood chemistry. Lesions observed on the articular faces of tarsal bones recovered from adult horses may have originated during the neonatal-period.
Schneider RK, Milne DW, Gabel AA, Groom JJ, Bramlage LR.Rosette strain gauges were applied to the equine radius and tibia. Three sites were examined on each bone on separate occasions (proximal metaphysis, middiaphysis, and distal metaphysis). At each site, 4 rosette gauges were applied around the bone (ie, cranial, caudal, medial, and lateral). Strain recordings were made while walking the horse with and without a full-limb plaster cast. The principal axis of tensile strain was on the craniolateral aspect of the radius. Distally, on the radius, the largest strains were torsional. The cast changed the principal axis of tensile strain on the radius ...
White NA, Blackwell RB, Hoffman PE.Salter-Harris type II proximal tibial fractures were repaired in two 1-month-old foals, using a dynamic compression plate. The plate was placed on the medial aspect of the tibia, and a single cancellous bone screw was used to reduce the proximal fragment displacement. The plate provided fixation during healing and functioned as a transphyseal bridge, which induced a disparity in growth and corrected a slight lateral angulation of the limb. Limb growth after plate removal was normal.
Bramlage LR, Hanes GE.A 3-year-old Thoroughbred mare was examined because of hindlimb lameness from incomplete fracture of the tibia, which became a complete diaphyseal fracture during the examination. The fracture was repaired by open reduction and internal fixation with lag screws and 2 neutralization plates. A cranial approach was used and the plates were placed craniolateral and medial on the tibia. At 18 months after surgery, there was no evidence of complications resulting from the fracture or its repair. It was concluded that a cranial approach with craniolateral and medial plate placement allows easier inse...
Jakovljevic S, Gibbs C, Yeats JJ.The clinical features, radiographic findings, management and outcome in 13 cases of traumatic fracture of the hock joint are reported. The principal fracture sites were the distal tibial malleoli (5 cases), the fibular tarsal bone (4 cases), the tibial tarsal bone (3 cases) and the proximal end of metatarsal IV (one case). An additional small chip fracture of the central tarsal was noted in 2 cases. Three horses were destroyed immediately after diagnosis, 2 failed to recover following surgical intervention and one remained lame and was destroyed after 3 months' rest. Seven horses recovered com...
Jeffcott LB, Kold SE.The clinical and radiological characteristics of stifle lameness in 86 horses are described. The majority of these cases had been lame for some weeks before referral. The most frequent diagnoses made were osteochondrosis dissecans (13 per cent) and subchondral bone cyst (38 per cent). Both of these conditions were seen principally in Thoroughbreds at or before the onset of training. The other bone lesions encountered were osteoarthritis (3 per cent), fractures (4 per cent) and "epiphysitis" (1 per cent). The commonest soft tissue condition was an atypical or partial upward fixation of the pate...
Lindsay WA, McMartin RB, McClure JR.Five cases of fracture of the third tarsal bone in racehorses are reported. A method of surgical correction employing a cortical bone screw is described in 2 cases. Healing of the fractures was followed radiographically. Surgical repair permitted both horses to return to competition. The 3 cases treated conservatively suffered a prolonged healing time and excessive new bone formation. They were unable to return to training due to persistent lameness.
Lindsay WA, Horney FD.During a 6-year period, carpal arthrotomies were performed on 89 horses with carpal fractures. Fifty-two percent of the fractures involved the left forelimb; the 3rd carpal bone was most often involved (42%), followed by the radial carpal bone (30%). The effect of surgery on the performance of a subgroup of 48 thoroughbreds was evaluated by comparing the number of starts, level of racing (claiming value), and earnings for the 12 months of racing preceding and following arthrotomy. The data indicated that carpal arthrotomy in the Thoroughbred carries with it a favorable prognosis inasmuch as 80...
Sherlock CE, Eggleston RB, Howerth EW.A 7-year-old Quarter Horse gelding was evaluated because of sudden onset of severe left forelimb lameness of 4 days' duration. Results: Clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. Radiography revealed a transverse fracture of the distal phalanx of the left forelimb. Results: The horse was treated conservatively with stall rest and stabilization of the hoof with fiberglass cast material and an elevated heel support. These treatments improved the lameness considerably. Over the following 4 months, the horse was exerci...
Sasaki N, Takakuwa J, Yamada H, Mori R.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...
Allen D, White NA.Twenty-five cases of fractures of the second and fourth metacarpal and metatarsal (splint) bones were reviewed. Fourteen fractures involved a thoracic limb and 11 involved a pelvic limb. Fractures of the proximal one-third of splint bones are reported in one of two forms: fractures that are closed, or fractures with a permanent or intermittent draining sinus. Thirteen of the fractures presented were closed fractures and the remaining 12 were open. All of the closed fractures were managed by surgical excision of the distal fragment and the exostosis at the fracture site, followed by primary sur...
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...
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...
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...
Durket E, Kersh K, Dembek K, Riedesel E, Silverstone A, Kraus KH.To determine the influence of plate fixation (locking or dynamic compression) and the site of application (ventral [V] or ventrolateral [VL]) on the resistance to bending of transverse mandibular fractures. Methods: Ex vivo, simple randomized study. Methods: Mandibles harvested from adult equine cadavers (n = 18). Methods: Bilateral osteotomies were created 1 cm caudal to the mental foramen and perpendicular to the long axis of each mandible. Mandibles were fixed with 1 of 3 methods: (1) VL dynamic compression plate (DCP), (2) V-DCP, or (3) VL locking compression plating (LCP). Construct...
Wright IM, Smith MR.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...
Henninger RW, Bramlage LR, Schneider RK, Gabel AA.Case records of 25 horses with transverse fractures of the proximal sesamoid bone were reviewed to evaluate the success of treatment. All fractures were repaired by use of lag screw fixation and an autogenous cancellous bone graft because the fracture fragments were considered too large for surgical removal and reconstruction of the suspensory apparatus was necessary. Radiography was performed in all cases, and the fractures were classified into 3 types: (1) proximal midbody fractures, which included all fractures in the proximal aspect of the sesamoid bone that resulted in fragments involving...
Joss R, Baschnagel F, Ohlerth S, Piskoty G, Fürst A, Bischofberger AS. The aim of this study was to compare the potential of an unshod and shod hoof to cause an orbital fracture in the event of a kick. Methods: Thirty-four equine cadaveric orbitae were exposed to a steel or horn impactor in a dropping test set-up. An impactor velocity of 7 m/s was used for both materials. Testing was repeated on the same orbit at a velocity of 10 m/s with the horn impactor if no damage occurred. A high-speed camera was used to analyse the impact process. Physical parameters (peak force and impact duration) were calculated based on quantitative video-tracking. Computed tomog...
Rubio-Martínez LM, Redding WR, Bladon B, Wilderjans H, Payne RJ, Tessier C, Geffroy O, Parker R, Bell C, Collingwood FA.Fractures of the medial intercondylar eminence of the tibia (MICET) are scarcely reported in horses. Objective: To report the clinical and diagnostic findings, surgical treatment and outcome in a series of horses presented with MICET fracture and treated with arthroscopic fragment removal. Methods: Multicentre retrospective case series. Methods: Case records of horses diagnosed with MICET fractures that had undergone surgical treatment were reviewed. Follow-up information was obtained from re-examination visits and/or owners. Results: Twenty-one cases were identified at 9 equine hospitals betw...
Southwood LL, Trotter GW, McIlwraith CW.To determine the outcome of horses after arthroscopic removal of abaxial fracture fragments of the proximal sesamoid bone and association of fracture grade with outcome. Methods: Retrospective study. Methods: 47 horses. Methods: Information obtained from dorsopalmar and dorsoplantar radiographic views of metacarpophalangeal and metatarsophalangeal joints was used to classify fractures as grade 1 ( 25 mm long) and type 1 (abaxial) and type 2 (apical-abaxial). Outcome was determined by whether the horse returned to its intended use, raced in the same class or higher (racehorses), or performed sa...
Nunamaker DM, Nash RA.To report development, configuration, application, and results of a tapered-sleeve transcortical pin external skeletal fixation device (TSP ESFD) for use on fractures of the distal aspect of the equine limb. Methods: Optimization analysis of a TSP ESFD was carried out with mechanical testing and review of clinical case outcomes. Methods: Cadaveric adult third metacarpal bones (MC3) for mechanical testing; horses (n=7) with severely comminuted proximal (6; P1) or second (1) phalanx fractures. Methods: Mechanical testing of methods for attachment of TSP to the sidebars were tested as well as opt...
Galuppo LD, Simpson EL, Greenman SL, Dowd JP, Ferraro GL, Meagher DM.To report clinical evaluation of headless compression screws for repair of metacarpal/metatarsal (MC/MT3) condylar fractures in horses. Methods: Retrospective case study. Methods: Racing Thoroughbreds (n=16) with nondisplaced lateral condylar fractures of MC/MT 3. Methods: Medical records (1999-2004) of horses with nondisplaced longitudinal fractures of the lateral condyle of MC/MT3 were reviewed. Pre-operative variables retrieved were: patient age, gender, limb involvement, injury occurrence, fracture length, and width, evidence of palmar comminution and degenerative joint disease, number of ...
Henderson B, Bramlage LR, Koenig J, Monteith G.To assess the influence of humeral stress fracture location on the time to return to racing and postinjury performance of thoroughbred racehorses. Methods: Retrospective study (1992-2015). Methods: Thoroughbred racehorses (n = 131) that presented for lameness with the sole diagnosis of humeral stress fractures in the lame limb, as determined by scintigraphy or radiology. Methods: Sex, fracture site, age, starts, earnings, and average earnings per race were examined for differences in pre-stress and post-stress fracture diagnosis for the entire population as well as individual stress fracture l...
Denny HR.Methods of treating fractures of the olecranon in the horse are reviewed. A further 4 cases are recorded in which the fracture was treated by open reduction and fixation with a heavy duty Venable's plate placed on the caudal aspect of the ulna. Three cases had an oblique fracture through the semilunar notch; this was complicated in one by a fracture of the lateral half of the radial head which resulted in subluxation of the radio-humeral joint. The fracture of the radial head was treated by open reduction and fixation with a lag screw. The fourth case had an oblique fracture of the olecranon j...
Palmer SE.Five horses with apical and abaxial fractures of the proximal sesamoid bones were treated arthroscopically. Ipsilateral and contralateral triangulation were used to remove abaxial fragments; apical fragments were removed by ipsilateral triangulation. Excellent visibility of the fracture fragments was obtained with each method. Dissection and removal of fragments was accomplished with standard arthroscopic instruments, tendon-splitting knives, and curved scissors. Excellent functional and cosmetic results were achieved in all cases.
Barker WH, Wright IM.A technique for minimally invasive repair of slab fractures of the third tarsal bone has not previously been reported. Results of third tarsal bone slab fracture repair in Thoroughbred racehorses are lacking. Objective: To report the outcomes of repair of uniplanar frontal slab factures of the third tarsal bone using a single 3.5 mm cortex screw in lag fashion. Methods: Retrospective case series. Methods: Case records of horses that had undergone this procedure were reviewed. Results: Seventeen horses underwent surgery. Eighteen percent of cases had wedge shaped third tarsal bones. A point mid...
O'Brien T, Hunt RJ.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...
Smanik LE, Stefanovski D, Reilly PT, Richardson DW.Type II distal phalanx (P3) fractures are a well-described cause of lameness in horses. Reports on outcome following internal fixation of type II P3 fractures are lacking, and with little emphasis on complications. Objective: To describe a technique for internal fixation of type II P3 fractures, and evaluate whether specific variables influenced post-operative complications or a horse's ability to return to work. Methods: Retrospective case series. Methods: Medical records of 51 horses with CT-guided internal fixation of type II P3 fractures were reviewed. Outcome data were acquired from race ...
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...
Muñiz Fontán M, Moure González JD, Mirás Veiga A, Rodríguez Núñez A.Children's equestrian activities in the domestic, play activities, sports and educational areas are relatively frequent, and are not exempt from risks. Nevertheless, there is a lack of data on horse-related injuries, their circumstances and the key points for their prevention. Methods: Retrospective and descriptive study of pediatric equestrian injuries admitted to Hospital between July 1997 and September 2008. Results: A total of 17 patients with ages between 4 and 17 years were analyzed. There were 14 accidental falls, 2 kicks and 1 bite, and 8 patients had lost consciousness after the accid...
Lumsden JM, Caron JP, Stickle RL.Bilateral radiographically persistent proximal third metatarsal physes and concurrent cuboidal bone immaturity were identified in a foal. Repair of a Salter type-II fracture of the left proximal third metatarsal physis was accomplished by use of lag screw fixation. A 6-day-old Arabian foal, intended for use as a show horse, was referred because of severe unilateral hind limb lameness and valgus deformity. A Salter type-II fracture of the proximal portion of the third metacarpal bone was identified radiographically and repaired by use of cancellous lag screws. The fractured limb was further sup...
Kraus BM, Richardson DW, Nunamaker DM, Ross MW.To report the outcome of surgical treatment of comminuted fractures of the proximal phalanx in horses. Methods: Retrospective study. Methods: 64 horses. Methods: Medical records and radiographs were reviewed to obtain information regarding signalment, fracture classification, and treatment. Follow-up information was obtained by telephone conversation or evaluation of production records. Results: Thirty-eight horses had moderately comminuted fractures of the proximal phalanx. Two horses were euthanatized immediately. Fractures of the proximal phalanx in 36 horses were repaired with open reducti...
Swor TM, Watkins JP, Bahr A, Honnas CM.Previous olecranon fracture reports contain a small proportion of type 1b fractures, with only a few repaired by tension band plate fixation. Objective: To evaluate subject details, history, clinical findings and outcome of type 1b olecranon fractures in a large group of horses treated by tension band plate fixation. Methods: Medical records of 77 horses diagnosed with an olecranon fracture were reviewed. Twenty-four horses (31%) were classified as having type 1b olecranon fractures. Clinical details and follow-up results (4-128 months post operatively) were recorded. Results: Treatment includ...
Gardelle O, Feige K, Geissbühler U, Geyer H, Schmucker N, Sydler T, Kaser-Hotz B.For the past 2 years computed tomography is used at the Veterinary School, University of Zürich. This new imaging modality enables the detection of abnormalities occurring in small and large animals which were previously not visible with imaging techniques. Subjects of this study were a foal and a small pony, both with suspected head trauma. Routine radiography could not explain any of the neurological deficiencies. In the first case a basilar skull fracture along with a focal brain hemorrhage was detected, in the second case multiple basilar skull fractures were seen. The computed tomographi...
Wright IM, Smith MR.To report the technique, observations on fracture configurations and results of treatment by fixation lag screw following the fracture plane determined by an approach to the third metacarpal/metatarsal bone (MC3/MT3) that begins laterally over the metacarpo(metatarso)phalangeal joint and extends dorsally over the diaphysis of the bone. Methods: Case series. Methods: Thoroughbred horses (n=18) with propagating fractures of the medial condyle of MC3/MT3. Methods: Retrospective analysis of case records of horses with fractures of the medial condyle of MC3/MT3 that propagated sagittaly or in a spi...
Bertoni L, Seignour M, de Mira MC, Coudry V, Audigie F, Denoix JM.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...
Sato F, Endo Y, Horiuchi N, Tominari M, Murase H, Ishimaru M, Korosue K.Although radiographic findings at the apical portion of the proximal sesamoid bone (PSB) are often observed in young Thoroughbred foals, conflicting findings, either fractures or apparent secondary ossifications centers, have been reported. Three cases (aged 2, 5, and 7 weeks) were identified in 30 necropsied foals (0-31 weeks old). Histopathologically, the subchondral trabecular woven bone was fractured and exhibited focal necrosis of woven bone, fibrin exudate, and/or fibrosis within the foci. In the 7-week-old case, proliferations of chondrocytes were also observed. These findings suggest t...
Hickman J.Sir Frederick Hobday's service as a Veterinary Officer in the Army Veterinary Corps during the Great War 1914-1918 is recorded. This is followed by a description of the fractures of the distal forelimb which can be treated satisfactorily by surgery, and includes fractures of the carpal, the small metacarpal, the proximal sesamoid bones, the first phalanx and the extensor process of the third phalanx.
