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Equine veterinary journal2011; 44(1); 64-70; doi: 10.1111/j.2042-3306.2011.00371.x

Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the third metacarpal bone in 55 horses.

Abstract: Previous descriptions of incomplete longitudinal fractures and fatigue injury of the proximopalmar aspect of the third metacarpal bone (McIII) have focused on diagnostic imaging findings, especially in racehorses. Objective: To document the case details, clinical features, response to diagnostic analgesia, diagnostic imaging findings and follow-up data in a large group of horses with an incomplete longitudinal fracture or fatigue injury of the proximopalmar medial aspect of the McIII. Methods: Horses were included in the study if pain was localised to the proximopalmar aspect of the metacarpal region, with radiological evidence of an incomplete longitudinal fracture or generalised increased radiopacity in the proximopalmar medial aspect of the McIII, or focal increased radiopharmaceutical uptake (IRU) in the proximopalmar aspect of the McIII. Age, breed, gender, height, bodyweight, work discipline, work history, duration of lameness, clinical signs and responses to diagnostic analgesia were recorded. Radiographic and scintigraphic images were assessed subjectively and objectively. Results: There were 55 horses representing a broad spectrum of ages and work disciplines, 73% of which had radiological abnormalities. The majority had no localising clinical signs, although 73% of horses with radiological abnormalities showed a characteristic pattern of lameness. Lameness was generally worse in straight lines than in circles. Increased radiopharmaceutical uptake ranged from mild to intense in the lame limb; 14% of nonlame limbs had mild IRU. Of horses for which long-term follow-up was available, 98% returned to full athletic function. Conclusions: Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the McIII may occur in horses of many types and sports disciplines, and are not confined to immature performance horses. They should be considered an important differential diagnosis for proximal metacarpal region pain.
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Publication Date: 2011-08-04 PubMed ID: 21812806PubMed Central: PMC7199480DOI: 10.1111/j.2042-3306.2011.00371.xGoogle 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 provides an in-depth exploration of incomplete longitudinal fractures and fatigue injury, commonly referred to as stress fractures, in the third metacarpal bone of horses. The data gathered suggest horses from various ages and work disciplines can suffer from these types of injuries, not just immature athletic horses as previously thought. Most horses with radiological evidence of these conditions demonstrate characteristic patterns of lameness.

Study Methodology and Criteria

For a horse to be included in the study, it had to experience pain localized to a specific region of the metacarpal (the proximopalmar aspect). Furthermore, there had to be radiological proof of either an incomplete longitudinal fracture or an generalized increased in radiopacity, indicating the presence of bone abnormalities, in that same proximopalmar medial aspect of the third metacarpal bone (McIII). Another inclusion criteria was the identification of a focal increased radiopharmaceutical uptake (IRU) in the same region as a sign of an active remodeling process in the bone which often results from a stress reaction or fracture.

  • The study took into account a horse’s age, breed, gender, height, body weight, type of employment (work discipline), employment history, duration of the associated lameness, and the clinical signs observed.
  • The horses’ responses to diagnostic analgesia, a technique used to localize the source of pain and verify diagnoses, were also meticulously recorded.
  • Subjective and objective assessments of their radiographic (X-ray) and scintigraphic (bone scan) images were carried out.

Findings of the Study

The study incorporated a sample of 55 horses from a broad range of ages and work disciplines.

  • 73% of the horses presented with radiological abnormalities, however, most of these horses did not exhibit localizing signs such as swelling or heat in the affected area.
  • A “characteristic pattern of lameness,” was, however, present in the same percentage of horses (73%) with these radiological abnormalities. It was noticeable that the lameness was generally worse when the horse moved in straight lines rather than in circles.
  • The study found that IRU, which indicates bone remodeling, varied from mild to intense in the lame limbs of horses under investigation.
  • A surprising finding was that 14% of the non-lame limbs also showed mild IRU, suggesting some degree of subclinical bone stress.
  • Encouragingly, where long-term follow-up data was available, 98% of the horses were able to return to full athletic function, implying successful management and recovery from these incomplete fractures and fatigue injuries.

Conclusion of the Study

As the research concludes, these incomplete longitudinal fractures and fatigue injuries in the third metacarpal bone of horses can affect more than just young athletic horses, which was the common belief. Any horse engaged in physical activities, regardless of age, breed or work discipline, may suffer these injuries. Therefore, they should be an essential consideration when diagnosing metacarpal region pain in horses.

Cite This Article

APA
Morgan R, Dyson S. (2011). Incomplete longitudinal fractures and fatigue injury of the proximopalmar medial aspect of the third metacarpal bone in 55 horses. Equine Vet J, 44(1), 64-70. https://doi.org/10.1111/j.2042-3306.2011.00371.x

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 44
Issue: 1
Pages: 64-70

Researcher Affiliations

Morgan, R
  • Centre for Equine Studies, Animal Health Trust, Newmarket, UK.
Dyson, S

    MeSH Terms

    • Animals
    • Female
    • Forelimb / diagnostic imaging
    • Forelimb / pathology
    • Fractures, Bone / diagnostic imaging
    • Fractures, Bone / pathology
    • Fractures, Bone / therapy
    • Fractures, Bone / veterinary
    • Horse Diseases / diagnostic imaging
    • Horse Diseases / pathology
    • Horse Diseases / therapy
    • Horses
    • Male
    • Physical Conditioning, Animal
    • Radiography
    • Ultrasonography

    Conflict of Interest Statement

    No conflicts of interest have been declared.

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    Citations

    This article has been cited 3 times.
    1. Miyakoshi D, Watanabe A, Ikeda H, Mizuguchi Y. Arthroscopic guided repair of a slab fracture of the fourth carpal bone in an 8-month-old thoroughbred horse. J Equine Sci 2021 Dec;32(4):143-146.
      doi: 10.1294/jes.32.143pubmed: 35023992google scholar: lookup
    2. Baird A, Lindsay T, Everett A, Iyemere V, Paterson YZ, McClellan A, Henson FMD, Guest DJ. Osteoblast differentiation of equine induced pluripotent stem cells. Biol Open 2018 May 10;7(5).
      doi: 10.1242/bio.033514pubmed: 29685993google scholar: lookup
    3. MacEoin F, Robinson P. Repetitive stress-related injury of the proximal metacarpus in a seven-year old Thoroughbred racehorse with emphasis on diagnostic analgesia of the proximopalmar metacarpus. Ir Vet J 2014;67(1):26.
      doi: 10.1186/2046-0481-67-26pubmed: 25937918google scholar: lookup
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