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.
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...
Fackelman GE, von Rechenberg B, Fetter AW.The need for early postoperative weight bearing following fracture repair in the horse has led to investigation of various means of expediting the healing process. Bone grafting represents one means of accomplishing this, and the transplantation of autologous tissues has proven to be most useful in equine orthopedics. Acid-decalcified, frozen, allogeneic bone for grafting is easy to prepare, readily contoured, osteogenic, and elicits no obvious immune or rejection response. The most compelling reason for the use of the substance is the elimination of the need of a harvesting operation on a pat...
Valdez H, Rook JS.A 10-year-old gelding was operated on for a depression fracture involving the frontal, lacrimal, and nasal bones. The fracture had been sustained 4 months prior to surgery and was healed. Fluorocarbon polymer and carbon fiber was implanted subperiosteally to reconstruct the defect, giving the animal a more cosmetic appearance.
Easley KJ, Schneider JE.In 9 horses, osteotomies were performed to simulate accessory carpal bone fractures. Screw fixation, aided by a large C-clamp, was performed on 6 of the 9 horses. Three were treated conservatively, as controls, with fractures not repaired; they remained clinically lame throughout the 6-month study. Fibrocartilaginous nonunion developed in each of the 3 controls. At 150 days, the principals were free of lameness, with evidence of bony union. The results of clinical, radiographic, and pathologic evaluations showed surgical repair to be superior to prolonged rest in treating equine accessory carp...
Baker JR, Ellis CE.The causes of death recorded in 480 consecutive post mortem examinations of horses performed at the department of pathology, Veterinary Field Station, University of Liverpool, between February 1958 and February 1980, are reported. The alimentary, locomotor and nervous systems were those most frequently diseased. The most common specific entities were those associated with grass sickness, fractures and endoparasitism.
Baker JR, Ellis CE.Disease processes not directly related to the cause of death recorded in 480 consecutive post mortem examinations of horses performed at the department of pathology, Veterinary Field Station, University of Liverpool, between February 1958 and February 1980 are reported. The alimentary, cardiovascular, respiratory and locomotor systems were those most frequently diseased. The most common specific entities were those associated with endoparasitism and its associated vascular lesions, pneumonia and fractures.
Campbell MD, Bellamy JE, Searcy GP.The microhematocrit heat-precipitation methods of Millar et al (1971) and Schalm et al (1975) were compared with the reference clottable protein method of Ratnoff and Menzie (1951) in the measurement of plasma fibrinogen concentration in horses. The millar et al method was more precise and accurate and showed better positive correlation with the reference method than did the Schalm et al method. There was no significant difference in the plasma fibrinogen concentration between healthy Thoroughbreds and healthy horses of other breeds. Horses with bacterial pneumonia and abscesses had significan...
Bramlage LR, Gabel AA, Hackett RP.Five horses with avulsion fractures of the proximal origin of the suspensory ligament were examined for lameness. The horses in the series each had lameness of acute onset; four were severely lame, and one was moderately lame. The condition was difficult to diagnose because commonly used local anesthetic blocks did not result in improvement during the routine examination. Local infiltration of the area with local anesthetic returned the horses to soundness. After a period of rest, varying from a few weeks in the acute injury to 6 months in the chronic injuries, the horses were returned to raci...
Auer J.Degenerative joint disease is the most frequently diagnosed problem of the carpus. Horses afflicted with this disease should not be injected with corticosteroids, but should be rested for several months. Swimming exercise and intra-articular injections of hyaluronic acid during this time help to restore the integrity of the involved joints. Chip fractures of the various carpal bones and the distal radius are commonly diagnosed as the cause of the lameness. Not all horses with carpal fractures are candidates for surgery. It is important that the severity of the problem be realized and that the ...
Murch KM.Clinical findings, surgical repair and postsurgical care of a unilateral fracture of the mandible of a bull and of a bilateral mandibular fracture in a horse are described. Compression plating limited the pain suffered by the animals and resulted in a quick return to function of the mandibles.
Stick JA, Wilson T, Kunze D.Of three horses with basilar skull fractures, two died within 48 hours. The remaining horse was euthanatized because of a locomotion deficit. Clinical signs included epistaxis followed by ataxia. In each case, the basi-occipital bone and ventral portion of the calvarium were involved in the fracture. Diagnosis was based on clinical signs or radiographic appearance of guttural pouches, or both.
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.
Fackelman GE, von Rechenberg B, Fetter AW.The need for early postoperative weight bearing following fracture repair in the horse has led to investigation of various means of expediting the healing process. Bone grafting represents one means of accomplishing this, and the transplantation of autologous tissues has proven to be most useful in equine orthopedics. Acid-decalcified, frozen, allogeneic bone for grafting is easy to prepare, readily contoured, osteogenic, and elicits no obvious immune or rejection response. The most compelling reason for the use of the substance is the elimination of the need of a harvesting operation on a pat...
Cervantes C, Madison JB, Miller GJ, Casar RS.The biomechanical characteristics of a 4-ring circular multiplanar fixator applied to equine third metacarpal bones with a 5 mm mid-diaphyseal osteotomy gap were studied. Smooth Steinmann pins, either 1/8 inch, 3/16 inch, or 1/4 inch, were driven through pilot holes in the bone in a crossed configuration and full pin fashion and fastened to the fixator rings using cannulated fixation bolts. The third metacarpal bone fixator constructs were tested in three different modes (cranial-caudal four-point bending, axial compression, and torsion). Loads of 2,000 N were applied in bending and axial comp...
Bindler D, Koch C, Gendron K, Ferguson SJ, Kaposi AD, Papp M, Bodó G.Mechanical evaluation of a novel screw position used for repair in a type III distal phalanx fracture model and assessment of solar canal penetration (SCP). Methods: Experimental study. Methods: Disarticulated equine hooves (n = 24) and 24 isolated distal phalanges. Methods: Hooves/distal phalanges cut in a sagittal plane were repaired with 1 of 2 different cortical screw placements in lag fashion. In group 1 (conventional screw placement), the screw was inserted halfway between the proximal border of the solar canal (SC) and the subchondral bone surface on a line parallel to the dorsal co...
Piccot-Crézollet C, Cauvin ER.To report an unusual 2nd carpal bone (C2) slab fracture and its treatment, using an ultrasonographically assisted, minimally invasive arthrotomy technique, for fragment removal. Methods: Case report. Methods: An 11-year-old crossbred Warmblood gelding. Methods: A bone fragment, spanning the height of C2, identified on the palmaromedial aspect of C2 was demarcated intraoperatively using ultrasonographically guided needles and removed by arthrotomy. Results: Fracture fragment removal was achieved using a small, ultrasonographically guided arthrotomy. The horse has become sound after treatment an...
Lutter JD, Cary JA, Stephens RR, Potts LB.Determine the relative stiffness of 3 bandage/splint constructs intended for emergency fracture stabilization. Methods: Experimental model. A single plane free end deflection model was developed to simulate the forces placed on a bandage/splint construct during stabilization of a complete mid-metacarpal bone fracture. The total deflection of the model in one plane was measured following application of 3 different bandage/splint combinations including a classic, 3 layered Robert Jones Bandage (RJB) with a splint placed on the outside of the bandage (RJB-3), an RJB with splint placed after the f...
Raschka C, Feuerbach L.Using an online questionnaire, the injuries of 649 acrobats on horseback were recorded (636 female, 13 male, average age 20.8 years, average sports time 12.1 years). 64% of the athletes practised their sport in the upper and 34% in the lower performance classes. 62.7% of the athletes hurt themselves on vaulting at least once during their sports time. Most injuries occured at the lower limbs (57.5%), particularly on foot (31.2%) and knee (22.2%). At the upper limbs (26.1%), injuries were most often registered at hands (8.4%) and shoulders (6.0%). 16.4% of the athletes hurt themselves on trunk, ...
Schade SM, Arnoczky SP, Bowker RM.To describe the intra-osseous microvasculature of the distal phalanx of the equine forelimb with regard to its potential clinical relevance. Methods: Eleven clinically normal equine forelimbs were used from six adult horses (range: 4 to 18 years old) euthanatized for reasons unrelated to lameness. In each limb the median artery was catheterized at the level of the carpus and India ink was injected under constant manual pressure. The limbs were frozen and 5 mm thick sections of the foot were cut in the sagittal, coronal, or transverse planes on a band saw. The sections were fixed in 10% formali...
