Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.

The research studies the survival rates of horses with fractures in the radius bone, excluding certain types of fractures. The factors influencing survival rates were examined, including age, fracture type, surgical method, surgery duration, time in hospital, implant failure rate, and surgical site infection rate. The key findings include lower survival rates in cases with complications such as surgical site infections or severe fractures, and higher survival rates for young horses and those with minimally displaced incomplete fractures.

Objectives and Methods

• The purpose of this study was twofold: firstly, to investigate the survival to discharge rates of horses with radial fractures, specifically excluding osteochondral fragmentation of the distal aspect of the radius and stress fractures; and secondly, to identify the risk factors that affect the survival rate, both in horses that were managed conservatively and those that underwent surgical intervention.
• The researchers conducted a case series study, where medical records and radiographs of 54 horses admitted with radial fractures between 1990 and June 2012 were carefully examined. The criteria for inclusion did not involve horses with osteochondral fragmentation of the distal aspect of the radius or stress fractures.
• Several risk factors were evaluated, including age, fracture configuration, type of surgical repair, duration of surgery, hospitalization time, and rates of implant failure and surgical site infection (SSI).

Results

• Out of 54 horses, the overall survival to discharge rate was 50%. However, 13 horses (24%) were euthanized on admission due to severe fractures, open fractures, or financial constraints.
• Fourteen horses (26%) with minimally displaced incomplete fractures were managed conservatively, with 12 of them (86%) surviving to discharge.
• Twenty-seven horses (50%) underwent surgery through open reduction and internal fixation (ORIF), with a survival to discharge rate of 56%.
• Open fractures were significantly linked to a higher likelihood of developing SSI, which in turn increased the rate of implant failure by 17 times. Of the 8 horses with an open fracture that were treated surgically, only 2 survived to discharge.
• The age of the horse (older horses had lower survival rates) and duration of surgery (surgeries longer than 168 minutes had lower survival rates) were also significant factors influencing the outcome.
• There was a trend towards lower survival rates in horses that developed a surgical site infection, but this was not statistically significant.

Conclusions

• Overall, the survival prognosis for horses with minimally displaced incomplete fractures is good. Younger horses that undergo ORIF have a higher survival rate than adult horses that undergo the same procedure.
• Open fractures and surgical site infections are linked to a significantly higher risk of catastrophic implant failure and poor survival rates.
• The study provides valuable insights for equine veterinarians to make informed treatment decisions and prognoses for horses with radial fractures.