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Equine veterinary journal2022; 55(2); 171-181; doi: 10.1111/evj.13599

A review of equine tibial fractures.

Abstract: 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 the reported risk factors. Both impact and fatigue fracture propagation are dependent on the magnitude of force applied and on the local composition/alignment of mineralised collagen in the tibial lamella. Extensive research has characterised the pattern of strain distribution and stress remodelling within the equine tibia, but in vivo measurement of load and angular moments are currently not feasible. Further research is warranted to correlate biomechanical theory of tibia fatigue fracture propagation with current histopathological data. Preventative measures for fatigue fractures aim to optimise diagnostic efficiency, reduce the interval between injury and diagnosis and modify racing and training conditions to reduce non-specific fracture risk. Treatment options for complete tibial fractures in adult horses are limited, but with careful case selection, successful outcomes have been reported after open reduction and internal fixation. On the other hand, tibial stress fractures and minimally displaced incomplete fractures are typically treated conservatively and have good prognosis for athletic recovery. This review aims to describe the current literature regarding tibial fracture aetiology, prevalence, risk factors, fracture biomechanics, treatment, prognosis and prevention.
© 2022 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
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Publication Date: 2022-06-15 PubMed ID: 35569040PubMed Central: PMC10084381DOI: 10.1111/evj.13599Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The study examines equine tibial fractures, their cause, treatment, and prevention strategies. The paper states that while these fractures aren’t frequent, they pose a challenge due to their high mortality rate and limited treatment options.

Aetiology and Prevalence of Equine Tibial Fractures

  • Equine tibial fractures are not common in horses involved in both racing and non-racing sports. However, when they do occur, they result in a relatively high mortality rate due to the challenges in treating such fractures.
  • The reasons for these fractures are generally split into two categories: traumatic impact and fatigue failure. The latter, also known as fatigue fractures or tibial stress fractures, ranks second in terms of common stress fractures in racing Thoroughbreds.
  • The occurrence of these fractures is influenced by factors such as the animals’ youth, the early stage of their race training, and the start of their training after a period of rest.

Biomechanical Factors and Strain Distribution

  • The spread of both impact and fatigue fractures depends on the extent of the force applied and the local composition or alignment of mineralised collagen in the tibial lamella.
  • Several research studies have detailed the pattern of strain distribution and stress remodelling within the equine tibia. However, in vivo measurement of the load and angular moments is not currently feasible.
  • Further research is necessary to associate the biomechanical theory of tibia fatigue fracture spread with the existing histopathological data.

Preventative Measures and Treatment Options

  • Precautionary strategies for fatigue fractures focus on enhancing diagnostic efficiency, shortening the time between the injury and diagnosis, and adjusting racing and training conditions to decrease the risk of non-specific fracture.
  • Treatment options for complete tibial fractures in adult horses are limited. However, successful outcomes have been achieved following open reduction and internal fixation in selected cases.
  • On the contrary, tibial stress fractures and slightly displaced incomplete fractures are generally treated conservatively and have a good prognosis for athletic recovery.

Cite This Article

APA
Bowers K, Weinhandl JT, Anderson DE. (2022). A review of equine tibial fractures. Equine Vet J, 55(2), 171-181. https://doi.org/10.1111/evj.13599

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 55
Issue: 2
Pages: 171-181

Researcher Affiliations

Bowers, Kristin
  • Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA.
Weinhandl, Joshua T
  • Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, Tennessee, USA.
Anderson, David E
  • Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA.

MeSH Terms

  • Horses
  • Animals
  • Fractures, Stress / diagnosis
  • Fractures, Stress / veterinary
  • Physical Conditioning, Animal / adverse effects
  • Tibial Fractures / veterinary
  • Tibial Fractures / epidemiology
  • Tibial Fractures / etiology
  • Sports
  • Prognosis
  • Horse Diseases / therapy

References

This article includes 40 references
  1. Johnson BJ, Stover SM, Daft BM, Kinde H, Read DH, Barr BC, Anderson M, Moore J, Woods L, Stoltz J. Causes of death in racehorses over a 2 year period.. Equine Vet J 1994 Jul;26(4):327-30.
    doi: 10.1111/j.2042-3306.1994.tb04395.xpubmed: 8575402google scholar: lookup
  2. Estberg L, Stover SM, Gardner IA, Johnson BJ, Case JT, Ardans A, Read DH, Anderson ML, Barr BC, Daft BM, Kinde H, Moore J, Stoltz J, Woods LW. Fatal musculoskeletal injuries incurred during racing and training in thoroughbreds.. J Am Vet Med Assoc 1996 Jan 1;208(1):92-6.
    pubmed: 8682713
  3. Watkins JP, Sampson SN. Fractures of the tibia. Equine Fracture Repair. Hoboken, NJ: Wiley‐Blackwell; 2019. p. 648–63.
  4. Levine DG, Aitken MR. Physeal Fractures in Foals.. Vet Clin North Am Equine Pract 2017 Aug;33(2):417-430.
    doi: 10.1016/j.cveq.2017.03.008pubmed: 28687098google scholar: lookup
  5. Ramzan PH, Newton JR, Shepherd MC, Head MJ. The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases.. Equine Vet J 2003 Jun;35(4):382-8.
    doi: 10.2746/042516403776014253pubmed: 12880006google scholar: lookup
  6. Ruggles AJ, Moore RM, Bertone AL, Schneider RK, Bailey MQ. Tibial stress fractures in racing standardbreds: 13 cases (1989-1993).. J Am Vet Med Assoc 1996 Aug 1;209(3):634-7.
    pubmed: 8755986
  7. O'Sullivan CB, Lumsden JM. Stress fractures of the tibia and humerus in Thoroughbred racehorses: 99 cases (1992-2000).. J Am Vet Med Assoc 2003 Feb 15;222(4):491-8.
    doi: 10.2460/javma.2003.222.491pubmed: 12597423google scholar: lookup
  8. Samol MA, Uzal FA, Hill AE, Arthur RM, Stover SM. Characteristics of complete tibial fractures in California racehorses.. Equine Vet J 2021 Sep;53(5):911-922.
    doi: 10.1111/evj.13375pubmed: 33119186google scholar: lookup
  9. McGlinchey L, Hurley MJ, Riggs CM, Rosanowski SM. Description of the incidence, clinical presentation and outcome of proximal limb and pelvic fractures in Hong Kong racehorses during 2003-2014.. Equine Vet J 2017 Nov;49(6):789-794.
    doi: 10.1111/evj.12696pubmed: 28480574google scholar: lookup
  10. Verheyen KL, Wood JL. Descriptive epidemiology of fractures occurring in British Thoroughbred racehorses in training.. Equine Vet J 2004 Mar;36(2):167-73.
    doi: 10.2746/0425164044868684pubmed: 15038441google scholar: lookup
  11. Verheyen KL, Newton JR, Price JS, Wood JL. A case-control study of factors associated with pelvic and tibial stress fractures in Thoroughbred racehorses in training in the UK.. Prev Vet Med 2006 Apr 17;74(1):21-35.
    doi: 10.1016/j.prevetmed.2006.01.004pubmed: 16473420google scholar: lookup
  12. Johnston AS, Sidhu ABS, Riggs CM, Verheyen KLP, Rosanowski SM. The effect of stress fracture occurring within the first 12 months of training on subsequent race performance in Thoroughbreds in Hong Kong.. Equine Vet J 2021 May;53(3):460-468.
    doi: 10.1111/evj.13324pubmed: 32698239google scholar: lookup
  13. Markel MD. Fracture biomechanics. Equine Fracture Repair. Hoboken, NJ: Wiley‐Blackwell; 2019. p. 12–23.
  14. Fuerst AE, Oswald S, Jäggin S, Piskoty G, Michel S, Auer JA. Fracture configurations of the equine radius and tibia after a simulated kick.. Vet Comp Orthop Traumatol 2008;21(1):49-58.
    doi: 10.3415/vcot-07-03-0022pubmed: 18288344google scholar: lookup
  15. Piskoty G, Jäggin S, Michel SA, Weisse B, Terrasi GP, Fürst A. Resistance of equine tibiae and radii to side impact loads.. Equine Vet J 2012 Nov;44(6):714-20.
    doi: 10.1111/j.2042-3306.2012.00560.xpubmed: 22432596google scholar: lookup
  16. Donati B, Fürst AE, Hässig M, Jackson MA. Epidemiology of fractures: The role of kick injuries in equine fractures.. Equine Vet J 2018 Sep;50(5):580-586.
    doi: 10.1111/evj.12819pubmed: 29441693google scholar: lookup
  17. Riggs CM, Vaughan LC, Evans GP, Lanyon LE, Boyde A. Mechanical implications of collagen fibre orientation in cortical bone of the equine radius.. Anat Embryol (Berl) 1993 Mar;187(3):239-48.
    pubmed: 8470824doi: 10.1007/bf00195761google scholar: lookup
  18. Reznikov N, Chase H, Brumfeld V, Shahar R, Weiner S. The 3D structure of the collagen fibril network in human trabecular bone: relation to trabecular organization.. Bone 2015 Feb;71:189-95.
    doi: 10.1016/j.bone.2014.10.017pubmed: 25445457google scholar: lookup
  19. Ferguson VL. Deformation partitioning provides insight into elastic, plastic, and viscous contributions to bone material behavior.. J Mech Behav Biomed Mater 2009 Aug;2(4):364-74.
    doi: 10.1016/j.jmbbm.2009.01.004pubmed: 19627843google scholar: lookup
  20. Creel JA, Stover SM, Martin RB, Fyhrie DP, Hazelwood SJ, Gibeling JC. Compliance calibration for fracture testing of anisotropic biological materials.. J Mech Behav Biomed Mater 2009 Oct;2(5):571-8.
    doi: 10.1016/j.jmbbm.2008.11.005pubmed: 19627864google scholar: lookup
  21. Evans FG, Vincentelli R. Relation of collagen fiber orientation to some mechanical properties of human cortical bone.. J Biomech 1969 Mar;2(1):63-71.
    doi: 10.1016/0021-9290(69)90042-6pubmed: 16335113google scholar: lookup
  22. Halley SE, Bey MJ, Haladik JA, Lavagnino M, Arnoczky SP. Three dimensional, radiosteriometric analysis (RSA) of equine stifle kinematics and articular surface contact: a cadaveric study.. Equine Vet J 2014 May;46(3):364-9.
    doi: 10.1111/evj.12127pmc: PMC3864602pubmed: 23802689google scholar: lookup
  23. Lanovaz JL, Khumsap S, Clayton HM, Stick JA, Brown J. Three-dimensional kinematics of the tarsal joint at the trot.. Equine Vet J Suppl 2002 Sep;(34):308-13.
    doi: 10.1111/j.2042-3306.2002.tb05438.xpubmed: 12405706google scholar: lookup
  24. Schneider RK, Milne DW, Gabel AA, Groom JJ, Bramlage LR. Multidirectional in vivo strain analysis of the equine radius and tibia during dynamic loading with and without a cast.. Am J Vet Res 1982 Sep;43(9):1541-50.
    pubmed: 7149401
  25. Hartman W, Schamhardt HC, Lammertink JL, Badoux DM. Bone strain in the equine tibia: an in vivo strain gauge analysis.. Am J Vet Res 1984 May;45(5):880-4.
    pubmed: 6732018
  26. Schamhardt HC, Hartman W, Lammertink JL. In vivo bone strain in the equine tibia before and after transection of the peroneus tertius muscle.. Res Vet Sci 1985 Sep;39(2):139-44.
    doi: 10.1016/S0034-5288(18)31736-3pubmed: 4070783google scholar: lookup
  27. Martig S, Chen W, Lee PV, Whitton RC. Bone fatigue and its implications for injuries in racehorses.. Equine Vet J 2014 Jul;46(4):408-15.
    doi: 10.1111/evj.12241pubmed: 24528139google scholar: lookup
  28. Fleck C, Eifler D. Deformation behaviour and damage accumulation of cortical bone specimens from the equine tibia under cyclic loading.. J Biomech 2003 Feb;36(2):179-89.
    doi: 10.1016/S0021-9290(02)00364-0pubmed: 12547355google scholar: lookup
  29. Peloso JG, Watkins JP, Keele SR, Morris EL. Bilateral stress fractures of the tibia in a racing American quarter horse.. J Am Vet Med Assoc 1993 Sep 15;203(6):801-5.
    pubmed: 8226232
  30. Nunamaker DM, Butterweck DM, Provost MT. Fatigue fractures in thoroughbred racehorses: relationships with age, peak bone strain, and training.. J Orthop Res 1990 Jul;8(4):604-11.
    doi: 10.1002/jor.1100080417pubmed: 2355300google scholar: lookup
  31. Pilsworth RC, Webbon PM. The use of radionuclide bone scanning in the diagnosis of tibial 'stress' fractures in the horse: a review of five cases.. Equine Vet J Suppl 1988 Sep;(6):60-5.
    doi: 10.1111/j.2042-3306.1988.tb04649.xpubmed: 9079064google scholar: lookup
  32. Faillace V, Tambella AM, Fratini M, Paggi E, Dini F, Laus F. Use of autologous platelet-rich plasma for a delayed consolidation of a tibial fracture in a young donkey.. J Vet Med Sci 2017 Mar 23;79(3):618-622.
    doi: 10.1292/jvms.16-0400pmc: PMC5383186pubmed: 28190827google scholar: lookup
  33. Curtiss AL, Stefanovski D, Richardson DW. Surgical site infection associated with equine orthopedic internal fixation: 155 cases (2008-2016).. Vet Surg 2019 Jul;48(5):685-693.
    doi: 10.1111/vsu.13216pubmed: 30993777google scholar: lookup
  34. Whitton RC, Walmsley EA, Wong ASM, Shannon SM, Frazer EJ, Williams NJ, Guerow JF, Hitchens PL. Associations between pre-injury racing history and tibial and humeral fractures in Australian Thoroughbred racehorses.. Vet J 2019 May;247:44-49.
    doi: 10.1016/j.tvjl.2019.03.001pubmed: 30971350google scholar: lookup
  35. MacKinnon MC, Bonder D, Boston RC, Ross MW. Analysis of stress fractures associated with lameness in Thoroughbred flat racehorses training on different track surfaces undergoing nuclear scintigraphic examination.. Equine Vet J 2015 May;47(3):296-301.
    doi: 10.1111/evj.12285pubmed: 24762263google scholar: lookup
  36. Keiper RR. Social structure.. Vet Clin North Am Equine Pract 1986 Dec;2(3):465-84.
    doi: 10.1016/S0749-0739(17)30701-0pubmed: 3492240google scholar: lookup
  37. Huguet EE, Porter EG, Chapman KA, Saunders FC, Davis B, Berry CR. Radiographic anatomy of the equine distal tibia.. Vet Radiol Ultrasound 2020 Sep;61(5):497-506.
    doi: 10.1111/vru.12875pubmed: 32602266google scholar: lookup
  38. Porter SM, Dailey HL, Hollar KA, Klein K, Harty JA, Lujan TJ. Automated measurement of fracture callus in radiographs using portable software.. J Orthop Res 2016 Jul;34(7):1224-33.
    doi: 10.1002/jor.23146pmc: PMC5166988pubmed: 26714245google scholar: lookup
  39. Hoskinson JJ. Equine nuclear scintigraphy. Indications, uses, and techniques.. Vet Clin North Am Equine Pract 2001 Apr;17(1):63-74.
    doi: 10.1016/S0749-0739(17)30075-5pubmed: 11488046google scholar: lookup
  40. Valdés-Martínez A, Seiler G, Mai W, Bolt DM, Mudge M, Dukti SA, Hubert JD. Quantitative analysis of scintigraphic findings in tibial stress fractures in Thoroughbred racehorses.. Am J Vet Res 2008 Jul;69(7):886-90.
    doi: 10.2460/ajvr.69.7.886pubmed: 18593240google scholar: lookup

Citations

This article has been cited 1 times.
  1. Ji X, Zhao D, Xin Z, Feng H, Huang Z. The predictive value of stress-induced hyperglycemia parameters for delayed healing after tibial fracture post-surgery. J Orthop Surg Res 2024 Oct 16;19(1):666.
    doi: 10.1186/s13018-024-05138-4pubmed: 39415173google scholar: lookup
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