Veterinary care in horses encompasses the medical and preventive measures taken to maintain and improve the health and well-being of equine patients. It includes a wide range of practices such as routine health examinations, vaccinations, dental care, parasite control, and management of injuries and diseases. Veterinary care also involves diagnostic procedures, surgical interventions, and therapeutic treatments tailored to the specific needs of horses. This page gathers peer-reviewed research studies and scholarly articles that explore various aspects of equine veterinary care, including advancements in diagnostic techniques, treatment protocols, and health management strategies to support the well-being and performance of horses.
Sylvia L, West E, Blackburn AM, Gupta C, Bui E, Mahoney T, Duncan G, Wright EC, Lejeune S, Spencer TJ.Equine-assisted activities and therapies (EAATs) have been a growing adjunctive integrative health modality, as they allow participants to practice mindfulness, emotional regulation, and self-mastery or self-esteem building skills. Preliminary evidence suggests that these programs may be helpful in reducing posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms. The current study examines the acceptability of integrating an EAAT program as part of a two-week, intensive clinical program for veterans with PTSD and/or traumatic brain injury (TBI). Methods: A family member or suppo...
Durie I, van Galen G.This case report describes the clinical presentation, and the diagnostic and therapeutic approaches of a 4-year-old gelding presented with severe polyuria and polydipsia. The horse was diagnosed with central diabetes insipidus. After diagnosis, different therapeutic regimens with intraocular desmopressin acetate (Minirin, Ferring GmbH, Kiel, Germany) (a synthetic arginine vasopressin analog) were tested, but without success. Only the subcutaneous injection of desmopressin acetate (Minirin, Ferring GmbH) led to an increase in urine specific gravity and a decrease in water intake and urine outpu...
Mirra A, Birras J, Diez Bernal S, Spadavecchia C.Epidural administration of morphine has been shown to be an effective analgesic strategy in horses; however, the possible occurrence of side effects limits its usage. In order to decrease their frequency, it is important to target the minimal effective plasma concentration and avoid overdosing. As to date species-specific pharmacokinetics data are not available for epidural morphine, the dosing regimen is usually established on the basis of clinical reports and personal experience. In certain physiological conditions, like gestation, the outcome of an empirical dosing scheme can be unpredictab...
Hudson BJ, Chicken C, Blishen A, Todhunter KH, Begg AP, Chan L, Karagiannis T, Raymond B, Bogema D, Adkins AR, O'Sullivan CB, O'Rourke BA....We describe three cases of osteoarticular infection (OAI) in young thoroughbred horses in which the causative organism was identified by MALDI-TOF as . The pattern of OAI resembled that reported with infection in humans. Analysis by 16S rRNA PCR enabled construction of a phylogenetic tree that placed the isolates closer to and , rather than . Average nucleotide identity (ANI) comparison between the new isolate and and however revealed low probability that the new isolate belonged to either of these species. This preliminary analysis suggests the organism isolated is a previously unrecognis...
Stokol T.This article uses a case-based approach, complemented with diagnostic algorithms and images, to highlight hematologic changes of pathologic relevance in horses, namely, marked erythrocytosis, anemia or leukocytosis, inflammatory leukograms, lymphocytosis in adult horses, thrombocytopenia, and pancytopenia. These hematologic abnormalities occur with certain diseases and their identification can help clinicians narrow to down differential diagnostic lists. This article highlights the importance of blood smear examination, particularly, but not only, when numerical red flags are identified on aut...
Schellenberg LM, Bonicelli J, Hochheim I, Regenthal R, Abraham G.The β-adrenergic receptor (β-AR) plays an important role in regulating a variety of cell and organ functions in different animal species and is an important target in asthma pathogenesis and therapy. The β-AR expression and function in equine bronchial epithelial cells (EBEC) were not known but innervation and significant decrease in receptor level were reported in the equine bronchial tissues from asthmatic horses. I-iodocyanopindolol (ICYP) binding studies were undertaken in primary freshly isolated and cultured EBEC to identify the presence of the β-ARs. The receptor distribution was as...
Lynden J, Hollands T, Ogden J.There is an evidence base in human and small animal veterinary health care contexts which understands how practitioners engage in partnership working with patients and owners to support adherence to treatment/care plans. However, as yet, it is believed there is no similar evidence base for how practitioners in equine health care contexts work with equine owners. It is argued that this is essential for understanding complex equine practitioner-owner interaction involving the prevention and management of laminitis. The aim of this study was to explore farrier-client interaction where risk manage...
Gough S, Hallowell G, Rendle D.Equine squamous gastric disease (ESGD) is a highly prevalent disease in horses, particularly in elite athletes. Some horses respond slowly, or fail to respond, to the licensed treatment, oral omeprazole (ORLO). To compare rates of ESGD healing and improvement between ORLO and a long-acting injectable omeprazole preparation (LAIO). Retrospective clinical study. The case records and gastroscopy images of horses presenting to Rainbow Equine Hospital over a 12-month period were reviewed, with images being reviewed blind by one of the authors (David Rendle). Treatment responses were compared betwe...
Hirsch E.Medical diagnosis is typically an iterative process guided by integration and synthesis of data into a model of disease. However, facts are not the only inputs into this process. A case of medical mis-diagnosis is presented, in which systematic cognitive bias is considered to have played a role in generating error. Specific cognitive biases are cited, and measures that can be taken to minimize their negative impact are reviewed.
Conceição ML, Alonso JM, Alves ALG, Hussni CA, Rodrigues CA, Watanabe MJ.Dorsal displacement of the soft palate (DDSP) usually occurs in athletic adult horses. Congenital DDSP in foals secondary to the persistent frenulum of the epiglottis is rarely observed. The aim of this report was to describe a case of a seven-day-old female neonate Quarter Horse presenting dysphagia, milk reflux through the nostrils and mouth, and expiratory dyspnea since 4 days. Thoracic auscultation was indicative of aspiration pneumonia. Diagnosis of DDSP associated with local inflammation was made after endoscopic examination of upper respiratory tract. Radiographic examination was perfo...
Giacchi A, Marcatili M, Withers J, Knottenbelt D.A 12-year-old Warmblood mare was presented with an acute onset left hindlimb lameness associated with generalised soft tissue swelling of the entire limb and medial saphenous vein (MSV) thrombophlebitis. A presumptive diagnosis of extremity compartment syndrome (ECS) was made. Due to the clinical deterioration, emergency fasciotomy of the crural fascia and biopsy was performed. Histological and immunohistochemical examination of the samples confirmed a diagnosis of leiomyosarcoma likely originating from the tunica media of the MSV. This report is the first to describe an unique combination of ...
Husso A, Jalanka J, Alipour MJ, Huhti P, Kareskoski M, Pessa-Morikawa T, Iivanainen A, Niku M.The establishment of the intestinal microbiota is critical for the digestive and immune systems. We studied the early development of the rectal microbiota in horse, a hindgut fermenter, from birth until 7 days of age, by qPCR and 16S rRNA gene amplicon sequencing. To evaluate initial sources of the foal microbiota, we characterised dam fecal, vaginal and oral microbiotas. We utilised an amplicon sequence variant (ASV) pipeline to maximise resolution and reproducibility. Stringent ASV filtering based on prevalence and abundance in samples and controls purged contaminants while preserving intest...
Ruocco NA, Luedke LK, Fortier LA, Ducharme NG, Reesink HL.The most common pathologic manifestation of , a gram-positive, facultative intracellular bacterium, is pyogranulomatous pneumonia in foals and weanlings. Hematogenous spread of bacteria may subsequently occur, resulting in joint sepsis, osteomyelitis, or subcutaneous abscessation. Medical records from horses presenting to the Cornell University Equine Hospital from 1998 to 2018 were reviewed for cases diagnosed with joint and/or bone infection, and information about case progression and outcome were analyzed. We hypothesized that, despite advances in diagnostic imaging, antimicrobials and ant...
Panzuti P, Rocafort Ferrer G, Mosca M, Pin D.Equine pastern vasculitis is an uncommon disorder in horses. Underlying causes are difficult to assess, especially bacterial infections. Conclusions: A 13-year-old French saddle gelding horse presented for evaluation of a six weeks history of pastern dermatitis. Histopathological examination of skin biopsy samples revealed small vessel vasculitis. A pure growth of a multidrug-resistant Pseudomonas aeruginosa (MRPA) was obtained from a deep skin biopsy. Clinical remission was observed after a six week course of enrofloxacin and lesions did not recur. Conclusions: To the best of the authors' kno...
Khusro A, Aarti C, Rivas-Caceres RR, Barbabosa-Pliego A.Equine herpesvirus-1 (EHV-1) is one of the most common and ubiquitous viral pathogens infecting equines, particularly horses worldwide. The EHV-1 is known to induce not only humoral but also cellular immune responses in horses. Respiratory distress, abortion in pregnant mares, neurological disorders, and neonatal foal deaths represent EHV-1 infection. Despite the limited success of inactivated, subunit, live, and DNA vaccines, over the past few decades, vaccination remains the prime preventive option to combat EHV-1 infection in horses. However, current vaccines lack the potentiality to protec...
Pu Y, Zhang Y, Zhang T, Han J, Ma Y, Liu X.As a nutrient sensor, the placenta plays a key role in regulating fetus growth and development. Long non-coding RNAs (lncRNAs) have been shown to regulate growth-related traits. However, the biological function of lncRNAs in horse placentas remains unclear. To compare the expression patterns of lncRNAs in the placentas of the Chinese Ningqiang (NQ) and Yili (YL) breeds, we performed a transcriptome analysis using RNA sequencing (RNA-seq) technology. NQ is a pony breed with an average adult height at the withers of less than 106 cm, whereas that of YL is around 148 cm. Based on 813 million high...
Asadollahpour Nanaei H, Ayatollahi Mehrgardi A, Esmailizadeh A.The primary objective of most horse breeding operations was to maximize reproductive efficiency and minimize the cost of producing live foals. Here, we compared individual horses from the Thoroughbred population (n = 17), known as a horse breed with poor reproductive performance, with other six horse populations (n = 28), to detect genomic signatures of positive selection underlying of reproductive traits. A number of protein-coding genes with significant (p-value <.01) higher F values (616 genes) and a lower value for nucleotide diversity (π) (310 genes) were identified. The results of o...
Deng L, Shi S, Li J, Tang C, Liao Q, Xie P.It is important to assess the reproductive efficiency and improve the reproductive management to promote the donkey population development. The overall foaling-related parameters of jennies under smallholder farm conditions in China were hardly under investigation. A cross-sectional survey of randomly selected 694 smallholder farms was conducted in 40 villages in the north, east, and south areas of Western Liaoning Province and Eastern Inner Mongolia Autonomous Region between March and July, 2017. Foaling-related parameters were assessed such as the mean age at first foaling, foaling rate and ...
Qi M, Ji X, Zhang Y, Wei Z, Jing B, Zhang L, Lin X, Karim MR, Wang H, Sun M.Giardia duodenalis is a zoonotic intestinal parasite infecting humans and mammals worldwide. In this study, we evaluated the prevalence of G. duodenalis in racehorses in China and genetically characterized it. In total, 621 fecal samples were collected from racehorses at 17 equestrian clubs in 15 cities in China. Forty-eight (7.7%) animals from 11 equestrian clubs were positive for G. duodenalis of assemblages A (n = 10), B (n = 36), and E (n = 2), based on the small subunit ribosomal RNA (SSU rRNA) gene. Statistically significant differences in the prevalence of this parasite were...
Fotschki J, Wróblewska B, Fotschki B, Kalicki B, Rigby N, Mackie A.Horse milk is a valuable raw material and a very attractive alternative for scientific research to address the issue of cow milk (CM) allergy due to its protein profile. A decrease in immunoreactive properties can be achieved by thermal, enzymatic, and hydrolytic processing. Therefore, the aim of this study was to explore the possibility of reducing the immunoreactivity of horse milk proteins by microbial transglutaminase (TG) polymerization. To determine how TG linking alters immunoreactivity under simulated digestion of the examined milk, analyses were performed before, during, and after dig...
Orr KE, Baker WT, Lynch TM, Hughes FE, Clark CK, Slone DE, Fogle CA, Gonzalez LM.To determine the prognostic value of (1) colonic venous lactate or peripheral lactate values obtained before and after manual correction of a large colon volvulus and (2) a combination of variables including pelvic flexure biopsy. Methods: Prospective clinical study. Methods: Forty adult horses in which large colon volvulus was diagnosed intraoperatively. Methods: Colonic venous, peripheral venous, and arterial blood samples were collected to measure lactate values before and after manual correction. Mucosal biopsy samples were obtained in cases that underwent enterotomy or colonic resection a...
Brown KA, Davidson EJ, Ortved K, Ross MW, Stefanovski D, Wulster KB, Levine DG.To report the long-term outcome of horses treated with interspinous ligament desmotomy (ISLD) for pain associated with overriding dorsal spinous processes (ORDSP) and determine the influence of preoperative diagnostic analgesia on long-term outcome. Methods: Retrospective study. Methods: Eighteen horses. Methods: Data were collected from horses presenting for ISLD to the University of Pennsylvania New Bolton Center between January 2013 and May 2018. Follow-up of ≥3 months postsurgically was obtained from the owner, trainer, or referring veterinarian. Long-term improvement was compared betw...
Podico G, Ellerbrock RE, Curcio BR, Cheong SH, Lima FS, Canisso IF.Urospermia is a major ejaculatory dysfunction affecting stallions. It has been thought that urine-contaminated semen should not be cryopreserved; however, on select cases, urine contamination of semen cannot be avoided. A recent study suggested that urospermic semen can be cryopreserved after cushion centrifugation and extension. Thus, this study aimed to assess the use of single-layer colloid centrifugation (SLC) to process frozen-thawed urine-contaminated stallion semen. Raw ejaculates (n = 55) from eight stallions were split into three groups: no urine, low (20%), or high (50%) urine conta...
Ayala-Valdovinos MA, Galindo-García J, Sánchez-Chiprés D, Duifhuis-Rivera T, Anguiano-Estrella R.The 'Gait keeper' mutation in the DMRT3 gene alters locomotion and gait patterns in horses. This mutation (C>A) has been found in all gaited breeds of horses analyzed but is absent in most non-gaited breeds. We developed a new mutagenically separated polymerase chain reaction (MS-PCR) based method for simple detection of horse DMRT3 genotype. Our method was applied in a preliminary study to determine DMRT3 allele frequencies in 78 Azteca horses (AZ) and 53 Costa Rican Saddle Horses (CRSH). We found a wild-type C allele frequency of 100% in the AZ horses. For the CRSH, the wild-type C freque...
de Souza AF, Paretsis NF, De Zoppa ALDV.A systematic review was conducted to investigate evidence to support or refute the use of hyaluronic acid and polyacrylamide hydrogel as intra-articular therapy in equines, which are frequent treatment options in the routine of veterinarians of equines in cases of osteoarthritis. In total, 19 studies were included, among clinical and in vitro studies, as well as a retrospective series of cases. The outcomes of the included studies provided fragile evidence supporting the recommendation for intra-articular use of hyaluronic acid. No study was included showing any clinical outcome in diseased s...
May ML, Nolen-Walston RD, Utter ME, Boston RC.During hospitalization, horses typically undergo frequent blood sampling for diagnostic testing and monitoring. The need for numerous samples in hospitalized horses makes acquisition from an intravenous catheter (IVC) both convenient and less stressful to the patient. Objective: We hypothesized that there would be no significant difference in the plasma chemistry and CBC variables from blood samples obtained from a jugular catheter as compared with direct jugular venipuncture. Methods: Fifty adult hospitalized horses; 25 receiving constant rate crystalloid therapy, and 25 receiving low volume ...
Frisbie DD.Osteoarthritis is one of the most economically important diseases facing equine practitioners. The loss of use associated with joint disease is a leading problem in the equine industry. Although osteoarthritis in all species is believed to be a multifactorial disease that is not well understood, significant advances are being made. This article presents areas of research that are relatively well developed but have not made it to commercialization or routine clinical practice and looks at new applications being investigated for peo-ple that may have an equine application.
Campbell ML.Embryo transfer (ET) is an accepted and successful technique for obtaining foals from mares without interrupting their competition careers. Recent research, however, suggests that the potential of factors including heat, exercise, repeated embryo flushing and repeated manipulation of the reproductive cycle using exogenous hormones to have a negative impact on fertility may have been underestimated. This paper reviews the evidence base for involvement of these factors in repeated failures to recover embryos from nongeriatric competition mares without obvious clinical or pathological indications...
Laverty S, Pascoe JR, Ling GV, Lavoie JP, Ruby AL.Medical records of 68 horses with urolithiasis were examined. Calculi were in the bladder in 47 horses, urethra in 11 horses, kidneys in 15 horses, and ureter in two horses. They occurred at several sites in six horses. Common clinical signs included hematuria, altered micturition (pollakiuria, dysuria, urinary incontinence), and tenesmus. Weight loss, possibly attributable to chronic renal failure and colic, was associated more commonly with renal and ureteral calculi. Weight loss also occurred in 13% of horses with cystic calculi only. In male horses, most cystic calculi were removed by peri...
Krueger K, Esch L, Byrne R.Anecdotal reports of horses opening fastened doors and gates are an intriguing way of exploring the possible scope of horses' problem-solving capacities. The species' natural environment has no analogues of the mechanisms involved. Scientific studies on the topic are missing, because the rate of occurrence is too low for exploration under controlled conditions. Therefore, we compiled from lay persons case reports of horses opening closed doors and gates. Additionally, we collected video documentations at the internet platform YouTube, taking care to select raw data footage of unedited, clearly...
Glass K, Watts AE.Despite differences in etiology and diagnostics, the mainstay of therapy in the foal is similar to the adult: local lavage and/or debridement and local antimicrobial therapy. When musculoskeletal infection is concurrent with neonatal sepsis, the prognosis for survival is fair. When musculoskeletal infection is the primary problem, the prognosis is fair to good for survival of synovial, bony, and physeal infections with appropriate and aggressive local therapy. Recent literature may indicate that prognosis for survival and potential athleticism in foals that are treated expediently with local t...
McGowan CM.In laminitis occurring in the field, as opposed to laminitis occurring during hospitalization or severe illness, endocrinopathic laminitis is the predominant form of laminitis. Prevalent causes of endocrinopathic laminitis are ECS and EMS. Exclusion of inflammatory or weight bearing causes of laminitis and focussing on the identification and treatment of underlying endocrine conditions will improve laminitis management strategies.
Filby M, Jackson C, Turner M.The horseracing training industry has largely been ignored in terms of active occupational health research. Objective: To provide baseline statistics on the specific nature and type of accidents that occurred in English horseracing stables during 2008. Methods: All 716 training yards/stables registered with the British Horseracing Authority were contacted in April/May 2009 to complete the Racing Injury Accident Statistical Survey. The survey asked respondents to detail all recorded accidents and injuries during 2008. Results: Two hundred and fifty-six yards (36%) provided usable responses. The...
Wickens C, Brooks SA.Behavior is a valuable quantitative trait in the horse because of its impact on performance, work, recreation, and prerequisite close interactions with humans. This article reviews what is known about the genetics of behavior in horses with an emphasis on the genetic basis for temperament traits, neuroendocrine function, and stereotypic behavior. The importance of using modern molecular genetic techniques to the study of equine behavior and recommendations for future research are also discussed. Ultimately, these studies enhance the understanding of the biology of behavior in the horse, improv...
Andrews FM, Frank N, Sommardahl CS, Buchanan BR, Elliott SB, Allen VA.The study was performed to evaluate the efficacy of omeprazole powder in sterile water, administered intravenously, on gastric juice pH in adult horses with naturally occurring gastric ulcers. Omeprazole (0.5 mg/kg, IV) was administered once daily for 5 days to 6 adult horses with gastric ulcers. Gastric juice was aspirated through the biopsy channel of an endoscope and pH was measured before and 1 hour after administration of omeprazole on day 1, and then before and after administration of omeprazole on day 5. Gastric ulcer scores were recorded on day 1 before administration of omeprazole and...
Matthews S, Dart AJ, Dowling BA, Hodgson JL, Hodgson DR.To review the clinical findings, diagnosis and treatment of 51 horses with peritonitis attributed to Actinobacillus equuli. Methods: Retrospective study of clinical cases. Methods: Breed, age and gender of horse, history, physical examination findings, treatment and outcome were determined from the hospital records of 51 horses in which a diagnosis of peritonitis attributed to A. equuli was made between January 1993 and June 1999. Results of abdominal fluid cytology and bacteriology, antimicrobial sensitivity patterns, haematology and faecal egg counts, when performed, were also retrieved. Res...
Rendle DI, Durham AE, Hughes KJ, Lloyd D, Summerhays GE.Five horses with sabulous cystitis were managed for up to three years. They were treated by emptying the bladder through a urinary catheter and saline lavage with cytoscopic guidance to remove residual sabulous material. The cystitis was treated with antimicrobial and anti-inflammatory medications, and bethanechol chloride was also administered. Frequent catheterisation and emptying of the bladder was an alternative to regular cystoscopic examination with saline lavage but it resulted in the development of a urethral stricture in one case. Four of the horses returned to work and one was retire...
Bennet ED, Cameron-Whytock H, Parkin TDH.Eventing is an equestrian sport that tests athletes' and horses' skill over three phases: dressage, jumping and cross-country. Falls during the cross-country phase can have very serious outcomes up to and including death for both horse and athlete. Therefore, understanding risk factors associated with falls is essential for improving equine and human welfare. Objective: To provide descriptive statistics and identify risk factors at the horse-, athlete- and course-level affecting horses competing in Fédération Equestre Internationale (FEI) events worldwide. Methods: Retrospective cohort study...
Parks A.The list of possible diagnoses derived from matching anatomic structures or tissues to pathologic processes is inevitably broad in nature. Understanding and observation of distal limb function, conformation, and balance is the basis of identifying where the greatest abnormal stresses within the distal limb are likely to occur. This is key to focusing the diagnostic process and, in some instances, to treating the horse when a definitive diagnosis cannot be achieved.
Bröjer JT, Parsons DA, Linder KE, Peregrine AS, Dobson H.An 8-year-old, Arabian mare presented with acute progressive ataxia and a firm swelling over the right mandible. Radiographs revealed multiple radiolucent areas on the mandibles. The mare's neurological signs progressed, she was consequently euthanized. Postmortem examination revealed mandibular granulomatous reactions and meningoencephalitis due to the nematode Halicephalobus gingivalis.
Hill EW, Eivers SS, McGivney BA, Fonseca RG, Gu J, Smith NA, Browne JA, MacHugh DE, Katz LM.The role of molecular signalling pathways in the phenotypic adaptation of skeletal muscle to different exercise stimuli in the Thoroughbred horse has not been reported previously. Objective: To examine CKM, COX4I1, COX4I2 and PDK4 gene expression following high intensity sprint and moderate intensity treadmill exercise stimuli in skeletal muscle of Thoroughbred horses. Methods: Two groups of trained 3-year-old Thoroughbred horses participated. Group A (n = 6 females, n = 3 males) participated in an incremental step test (moderate intensity) to fatigue or HR(max) on a Sato high speed treadmill ...
Prange T, Derksen FJ, Stick JA, Garcia-Pereira FL, Carr EA.Despite modern medical diagnostic imaging, it is not possible to identify reliably the exact location of spinal cord compression in horses with cervical vertebral stenotic myelopathy (CVSM). Vertebral canal endoscopy has been successfully used in man and a technique for cervical vertebral canal endoscopy (CVCE) has been described in equine cadavers. Objective: To determine the feasibility and safety of CVCE in healthy mature horses. Methods: Six healthy mature horses were anaesthetised. A flexible videoendoscope was subsequently introduced via the atlanto-occipital space into the epidural spac...
Parkin TD.The management and prevention of racehorse injuries have been
studied for many years but it is only in the last decade that
quantitative epidemiological techniques have been applied to
racehorse injury and fatality (Estberg et al. 1995, 1996, 1998a,b;
Kane et al. 1996; Bailey et al. 1997, 1998, 1999; Cohen et al.
1997, 2000; Carrier et al. 1998; Hernandez et al. 2001, 2005; Hill
et al. 2001, 2003; Wood et al. 2001; Pinchbeck et al. 2002, 2003;
Parkin et al. 2004a,b, 2005, 2006; Takahashi et al. 2004; Perkins
et al. 2005a,b; Verheyen et al. 2005, 2006; Cogger et al. 2006;
Boden et al. ...
Oikawa M, Kusunose R.The purpose of this report is to describe the results of epidemiological surveys of racing-related fractures in Thoroughbred horses in Japan. In the period 1987-2000, a total of 10,203 fractures were diagnosed in 556,705 runners, resulting in an overall incidence of 1.83%. The annual incidence of fractures in flat racing during the 14-year period fluctuated between 1.44% and 2.19%. The majority of fractures affected the forelimbs. We found significant effects of track condition on injury incidence. The incidence of fractures decreased as track conditions on turf became softer and increased as ...