FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Characteristics of complete tibial fractures in California r...
Equine veterinary journal2020; 53(5); 911-922; doi: 10.1111/evj.13375

Characteristics of complete tibial fractures in California racehorses.

Abstract: Tibial fractures cause ~3% of racehorse deaths. Pre-existing stress fractures have been associated with multiple racing and training fractures, but not complete tibial fractures. Objective: To describe racehorse tibial fractures and compare signalment and exercise histories of affected and control racehorses. Methods: Retrospective analysis of necropsy reports. Methods: Racehorses that had a complete tibial fracture (1990-2018) were retrospectively reviewed. Signalment and exercise histories of affected horses were compared to 1) racehorses that died because of non-tibial musculoskeletal injuries or 2) non-musculoskeletal cause and 3) age, sex, event-matched control racehorses. Tibial fracture prevalence was described relative to California racehorses that had at least one official work or race. Age, sex and limb distributions were compared between affected and control horses (Chi-square, Fisher's Exact test). Exercise history data were reduced to counts and rates of official high speed works, races and layups (periods without an official high speed work or race >60 days). Variables were compared among groups using matched logistic regression (P ≤ .05). Results: Tibial fractures in 115 horses (97% unilateral; 50% left, 47% right) occurred most commonly during training (68%) and in 2- to 3-year-old horses (73%). Fractures were predominantly comminuted (93%), diaphyseal (44%) and oblique (40%). Of 61 cases examined for callus, 64% had periosteal callus associated with fracture, most commonly in proximal (65%) and distal diaphyseal (27%) locations. Of 28 racehorses with known exercise history, 57% never raced and 36% had a layup. Affected horses had fewer official-timed works and events (official high speed works and races), number of active days and accumulated less distance in events and works (P < .05) than control horses. Conclusions: Retrospective review of necropsy reports by multiple pathologists over 28 years. Conclusions: Tibial fractures were associated with pre-existing stress fracture early in career. Most fractures were associated with proximolateral stress fractures.
© 2020 EVJ Ltd.
Get Full Text
Publication Date: 2020-11-27 PubMed ID: 33119186DOI: 10.1111/evj.13375Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

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.

This study focuses on understanding the characteristics of tibial fractures in racehorses in California, comparing the age, sex, exercise histories and other factors of horses affected by this injury with a control group. The researchers found that tibial fractures, which represent about 3% of racehorse deaths, were commonly linked with pre-existing stress fractures, observed primarily during training and in horses aged 2-3 years.

Research Methodology

  • The researchers carried out a retrospective analysis of necropsy reports, covering a 28-year period from 1990 to 2018.
  • This involved reviewing cases of racehorses that had a complete tibial fracture.
  • These horses’ exercise histories and signalment (a term that refers to the details outlining a horse’s breed, age, sex, and color) were then compared with three control groups: racehorses that died because of non-tibial musculoskeletal injuries, those that died of non-musculoskeletal causes, and racehorses of the same age, sex, and type of event that did not suffer such injuries.
  • The prevalence of tibial fractures was then calculated and compared with the total number of racehorses in California that had raced or worked at least once.
  • The researchers used Chi-square and Fisher’s Exact tests to examine and compare the age, sex, and limb distributions between affected and control horses.

Research Findings

  • The research unveiled tibial fractures in 115 horses, with 97% of them being unilateral, either on the left (50%) or right (47%) side.
  • These injuries predominantly occured during training (68%) and affected 2- to 3-year-old horses (73%) more frequently.
  • The fractures were mainly comminuted (broken into several pieces, 93%), diaphyseal (in the main or mid section of the tibia, 44%) and oblique (diagonal, 40%).
  • Of the 61 cases reviewed for callus formation – a sign of healing in bones, 64% showed periosteal callus (a layer of new bones) associated with the fracture, particularly located in proximal (near the middle section, 65%) and distal diaphyseal (near the end of the bone, 27%) locations.
  • The analysis of exercise history revealed that 57% of the 28 racehorses with known exercise history had never raced and 36% had an interruption in their training period.
  • The horses with tibial fractures showed less activity — they had fewer official-timed works and events, fewer active days, and accumulated less distance in events and works, which was significantly less (P < .05) than that of control horses.

Research Conclusions

  • The research postulates that tibial fractures were associated with pre-existing stress fractures early in the horse’s career.
  • It highlights that most fractures were linked with proximolateral stress fractures—those that occur on the upper and outer side of the bone.

Cite This Article

APA
Samol MA, Uzal FA, Hill AE, Arthur RM, Stover SM. (2020). Characteristics of complete tibial fractures in California racehorses. Equine Vet J, 53(5), 911-922. https://doi.org/10.1111/evj.13375

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 5
Pages: 911-922

Researcher Affiliations

Samol, Monika A
  • California Animal Health and Food Safety Laboratory System, San Bernardino Branch, University of California Davis, Davis, CA, USA.
Uzal, Francisco A
  • California Animal Health and Food Safety Laboratory System, San Bernardino Branch, University of California Davis, Davis, CA, USA.
Hill, Ashley E
  • California Animal Health and Food Safety Laboratory System, Davis Branch, University of California Davis, Davis, CA, USA.
Arthur, Rick M
  • School of Veterinary Medicine, University of California Davis, Davis, CA, USA.
Stover, Susan M
  • Department of Surgical and Radiological Sciences, University of California Davis, Davis, CA, USA.

MeSH Terms

  • Animals
  • Fractures, Bone / epidemiology
  • Fractures, Bone / veterinary
  • Fractures, Stress / veterinary
  • Horse Diseases
  • Horses
  • Logistic Models
  • Retrospective Studies
  • Sports
  • Tibial Fractures / epidemiology
  • Tibial Fractures / veterinary

References

This article includes 55 references
  1. Johnson BJ, Stover SM, Daft BM, Kinde H, Read DH, Barr BC. Causes of death in racehorses over a 2 year period.. Equine Vet J 1994;26:327-30.
  2. Sarrafian TL, Case JT, Kinde H, Daft BM, Read DH, Moore JD. Fatal musculoskeletal injuries of Quarter Horse racehorses: 314 cases (1990-2007).. J Am Vet Med Assoc 2012;241:935-42.
  3. Estberg L, Stover SM, Gardner IA, Johnson BJ, Case JT, Ardans A. Fatal musculoskeletal injuries incurred during racing and training in thoroughbreds.. J Am Vet Med Assoc 1996;208:92-6.
  4. Estberg L, Stover SM, Gardner IA, Johnson BJ, Jack RA, Case JT. Relationship between race start characteristics and risk of catastrophic injury in thoroughbreds: 78 cases (1992).. J Am Vet Med Assoc 1998;212:544-9.
  5. Verheyen KLR, Wood JLN. Descriptive epidemiology of fractures occurring in British Thoroughbred racehorses in training.. Equine Vet J 2004;36:167-73.
  6. Verheyen KLP, Newton JR, Price JS, Wood JLN. 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;74:21-35.
  7. Cohen ND, Mundy GD, Peloso JG, Carey VJ, Amend NK. Results of physical inspection before races and race-related characteristics and their association with musculoskeletal injuries in Thoroughbreds during races.. J Am Vet Med Assoc 1999;215:654-61.
  8. 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;49:789-94.
  9. Pilsworth RC, Shepherd MC. Stress fractures.. Current Therapy in Equine Medicine 1997;pp 104-12.
  10. Arthur RM, Constantinide D. Results of 428 nuclear scintigraphic examinations of the musculoskeletal system at a Thoroughbred racetrack.. Proc Am Ass Equine Practnrs 1995;41:84-7.
  11. 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;222:491-8.
  12. Vallance SA, Spriet M, Stover SM. Catastrophic scapular fractures in Californian racehorses: Pathology, morphometry and bone density: Catastrophic scapular fractures: pathology, morphometry and bone density.. Equine Vet J 2011;43:676-85.
  13. Stover SM, Johnson BJ, Daft BM, Read DH, Anderson M, Barr BC. An association between complete and incomplete stress fractures of the humerus in racehorses.. Equine Vet J 1992;24:260-3.
  14. Gray SN, Spriet M, Garcia TC, Uzal FA, Stover SM. Preexisting lesions associated with complete diaphyseal fractures of the third metacarpal bone in 12 Thoroughbred racehorses.. J VET Diagn Invest 2017;29:437-41.
  15. Collar EM, Zavodovskaya R, Spriet M, Hitchens PL, Wisner T, Uzal FA. Caudal lumbar vertebral fractures in California Quarter Horse and Thoroughbred racehorses: Caudal lumbar vertebral fractures in racehorses.. Equine Vet J 2015;47:573-9.
  16. Haussler KK, Stover SM. Stress fractures of the vertebral lamina and pelvis in Thoroughbred racehorses.. Equine Vet J 1998;30:374-81.
  17. Dimock AN, Hoffman KD, Puchalski SM, Stover SM. Humeral stress remodelling locations differ in Thoroughbred racehorses training and racing on dirt compared to synthetic racetrack surfaces: Humeral stress remodelling on dirt compared to synthetic racetrack surfaces.. Equine Vet J 2013;45:176-81.
  18. Whitton RC, Walmsley EA, Wong ASM, Shannon SM, Frazer EJ, Williams NJ. Associations between pre-injury racing history and tibial and humeral fractures in Australian Thoroughbred racehorses.. The Vet J 2019;247:44-9.
  19. Hasegawa M, Kaneko M, Oikawa M, Yoshihara T, Wada R. Pathological Studies on Distal Third Tibial Fractures on the Plantar Side in Racehorses.. Bulletin of Equine Research Institute 1988;1988:6-14.
  20. Hill AE, Gardner IA, Carpenter TE, Stover SM. Effects of injury to the suspensory apparatus, exercise, and horseshoe characteristics on the risk of lateral condylar fracture and suspensory apparatus failure in forelimbs of Thoroughbred racehorses.. Am J Vet Res 2004;65:1508-17.
  21. Anthenill LA, Stover SM, Gardner IA, Hill AE. Risk factors for proximal sesamoid bone fractures associated with exercise history and horseshoe characteristics in Thoroughbred racehorses.. Am J Vet Res 2007;68:760-71.
  22. Vallance SA, Case JT, Entwistle RC, Kinde H, Barr BC, Moore J. Characteristics of Thoroughbred and Quarter Horse racehorses that sustained a complete scapular fracture: Catastrophic scapular fractures in Thoroughbred and Quarter Horse racehorses.. Equine Vet J 2012;J.44:425-31.
  23. Mackey VS, Trout DR, Meagher DM, Hornof WJ. Stress fractures of the humerus, radius, and tibia in horses: Clinical Features and Radiographic and/or Scintigraphic Appearance.. Vet Radiol 1987;28:26-31.
  24. Spike DL, Bramlage LR, Embertson RM, Hance SR. Tibial fractures in 51 racehorses.. Proc Am Ass Equine Practnrs 1996;42(280-281):25.
  25. Haynes PF, Watters JW, McClure JR, French D. Incomplete tibial fractures in three horses.. J Am Vet Med Assoc 1980;177:1143-5.
  26. 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 1988;20:60-5.
  27. Ramzan PHL, Newton JR, Shepherd MC, Head MJ. The application of a scintigraphic grading system to equine tibial stress fractures: 42 cases.. Equine Vet J 2010;35:382-8.
  28. Valdés-Martínez A, Seiler G, Mai W, Bolt DM, Mudge M, Dukti SA. Quantitative analysis of scintigraphic findings in tibial stress fractures in Thoroughbred racehorses.. Am J Vet Res 2008;69:886-90.
  29. Worden P, Peloso J, Legg R. How to Radiograph and Diagnose Fractures of the Tibia in the Field.. Proc Am Ass Equine Practnrs 2013;59:403-9.
  30. Moreira CA, Bilezikian JP. Stress fractures: concepts and therapeutics.. J Clin Endocrinol Metabolism 2016;2016-720.
  31. Centre for Microscopy and Analysis, Trinity College Dublin, Dublin 2, Ireland, Dooley C, Cafferky D, Lee T, Taylor D. Fatigue failure of osteocyte cellular processes: implications for the repair of bone.. eCM 2014;27:39-49.
  32. Wu AC, Kidd LJ, Cowling NR, Kelly WL, Forwood MR. Osteocyte expression of caspase-3, COX-2, IL-6 and sclerostin are spatially and temporally associated following stress fracture initiation.. BoneKEy Reports 2014;3.
  33. Simon AM, Manigrasso MB, O’Connor JP. Cyclo-Oxygenase 2 Function Is Essential for Bone Fracture Healing.. J Bone Miner Res 2002;17:963-76.
  34. Zhang X, Schwarz EM, Young DA, Puzas JE, Rosier RN, O’Keefe RJ. Cyclooxygenase-2 regulates mesenchymal cell differentiation into the osteoblast lineage and is critically involved in bone repair.. J Clin Invest 2002;109:1405-15.
  35. Aspenberg P. Drugs and fracture repair.. Acta Orthop 2005;76:741-8.
  36. Allen HL, Wase A, Bear WT. Indomethacin and Aspirin: Effect of Nonsteroidal Anti-Inflammatory Agents on the Rate of Fracture Repair in the Rat.. Acta Orthop Scand 1980;51:595-600.
  37. Altman RD, Latta LL, Keer R, Renfree K, Hornicek FJ, Banovac K. Effect of Nonsteroidal Antiinflammatory Drugs on Fracture Healing: A Laboratory Study in Rats.. J Orthop Trauma 1995;9:392-400.
  38. Elves MW, Bayley I, Roylance PJ. The Effect of Indomethacin Upon Experimental Fractures in the Rat.. Acta Orthop Scand 1982;53:35-41.
  39. Høgevold HE, Grøgaard B, Reikerås O. Effects of short-term treatment with corticosteroids and indomethacin on bone healing: A mechanical study of osteotomies in rats.. Acta Orthop Scand 1992;63:607-11.
  40. Wheeler P. Do non-steroidal anti-inflammatory drugs adversely affect stress fracture healing? A short review.. Br J Sports Med 2005;39:65-9.
  41. Dirikolu L, Woods WE, Boyles J, Lehner AF, Harkins JD, Fisher M. Nonsteroidal anti-inflammatory agents and musculoskeletal injuries in Thoroughbred racehorses in Kentucky.. J Vet Pharmacol Ther 2009;32:271-9.
  42. McLellan J. Science-in-brief: Bisphosphonate use in the racehorse: Safe or unsafe?. Equine Vet J 2017;49:404-7.
  43. Soto SA, Chiappe Barbará A. Bisphosphonates: Pharmacology and Clinical Approach to Their Use in Equine Osteoarticular Diseases.. J Equine Vet Sci 2014;34:727-37.
  44. Sloan AV, Martin JR, Li S, Li J. Parathyroid hormone and bisphosphonate have opposite effects on stress fracture repair.. Bone 2010;47:235-40.
  45. Bellido T, Plotkin LI. Novel actions of bisphosphonates in bone: Preservation of osteoblast and osteocyte viability.. Bone 2011;49:50-5.
  46. Kim S, Seiryu M, Okada S, Kuroishi T, Takano-Yamamoto T, Sugawara S. Analgesic effects of the non-nitrogen-containing bisphosphonates etidronate and clodronate, independent of anti-resorptive effects on bone.. Eur J Pharmacol 2013;699:14-22.
  47. Groshar D, Lam M, Even-Sapir E, Israel O, Front D. Stress fractures and bone pain: are they closely associated?. Injury 1985;16:526-8.
  48. Milgrom C, Giladi M, Stein M, Kashtan H, Margulies JY, Chisin R. Stress fractures in military recruits. A prospective study showing an unusually high incidence.. J Bone Joint Surg Br 1985;67:732-5.
  49. Mantyh PW. The neurobiology of skeletal pain.. Eur J Neurosci 2014;39:508-19.
  50. Mattia C. Bone pain mechanism in osteoporosis: a narrative review.. ccmbm 2016.
  51. Martin CD, Jimenez-Andrade JM, Ghilardi JR, Mantyh PW. Organization of a unique net-like meshwork of CGRP+ sensory fibers in the mouse periosteum: Implications for the generation and maintenance of bone fracture pain.. Neurosci Lett 2007;427:148-52.
  52. Julius D, Basbaum AI. Molecular mechanisms of nociception.. Nature 2001;413:203-10.
  53. Nagae M, Hiraga T, Wakabayashi H, Wang L, Iwata K, Yoneda T. Osteoclasts play a part in pain due to the inflammation adjacent to bone.. Bone 2006;39:1107-15.
  54. 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;209:634-7.
  55. Vaughan B, McKerney ER, Wollenberger C, Cloninger A, Spriet M, Galuppo L. Ultrasonographic diagnosis of humeral stress fractures in racehorses.. Proc Am Ass Equine Practnrs 2018;64:447-8.

Citations

This article has been cited 2 times.
  1. Bowers K, Weinhandl JT, Anderson DE. A review of equine tibial fractures.. Equine Vet J 2023 Mar;55(2):171-181.
    doi: 10.1111/evj.13599pubmed: 35569040google scholar: lookup
  2. Samol MA, Uzal FA, Blanchard PC, Arthur RM, Stover SM. Sudden death caused by spinal cord injury associated with vertebral fractures and fetlock failure in a Thoroughbred racehorse.. J Vet Diagn Invest 2021 Jul;33(4):788-791.
    doi: 10.1177/10406387211018289pubmed: 34041971google scholar: lookup
Subscribe to our newsletter
Join 99,344 horse owners like you who receive our email updates on horse health and nutrition.