Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.
Abstract: To determine (1) survival to discharge of horses with radial fractures (excluding osteochondral fragmentation of the distal aspect of the radius and stress fractures); and (2) risk factors affecting survival to hospital discharge in conservative and surgically managed fractures. Methods: Case series. Methods: Horses (n = 54). Methods: Medical records (1990-June 2012) and radiographs of horses admitted with radial fracture were reviewed. Horses with osteochondral fragmentation of the distal aspect of the radius or stress fractures were excluded. Evaluated risk factors were age, fracture configuration, surgical repair method, surgical duration, hospitalization time, implant failure rate, and surgical site infection (SSI) rate. Results: Of 54 horses, overall survival to discharge was 50%. Thirteen (24%) were euthanatized on admission because of (1) fracture severity; (2) presence of an open fracture; or (3) financial constraints. Fourteen (26%) horses with minimally displaced incomplete fractures were conservatively managed and 12 (86%) survived to discharge. Twenty-seven (50%) horses had surgical treatment by open reduction and internal fixation (ORIF) and 15 (56%) survived to hospital discharge. Open fractures were significantly more likely to develop SSI (P = .008), which also resulted in a 17-fold increase in implant failure (P < .005). Six of 8 surgically managed horses with an open fracture did not survive to discharge. Outcome was also adversely affected by age (P 168 minutes (P < .027). Presence of SSI trended toward a decreased survival rate (P = .09). Conclusions: Prognosis for survival to discharge with minimally displaced incomplete fractures is good. Young horses have a good prognosis survival to discharge for ORIF, whereas ORIF in adult horses has a poor prognosis and SSI strongly correlates with catastrophic implant failure.
© Copyright 2015 by The American College of Veterinary Surgeons.
Publication Date: 2015-10-12 PubMed ID: 26455917DOI: 10.1111/vsu.12412Google Scholar: Lookup
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- Journal Article
Summary
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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.
Cite This Article
APA
Stewart S, Richardson D, Boston R, Schaer TP.
(2015).
Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.
Vet Surg, 44(8), 1036-1041.
https://doi.org/10.1111/vsu.12412 Publication
Researcher Affiliations
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania.
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania.
MeSH Terms
- Animals
- Horse Diseases / mortality
- Horse Diseases / therapy
- Horses
- Pennsylvania / epidemiology
- Prognosis
- Radius Fractures / mortality
- Radius Fractures / therapy
- Radius Fractures / veterinary
- Risk Factors
Citations
This article has been cited 2 times.- Ribitsch I, Oreff GL, Jenner F. Regenerative Medicine for Equine Musculoskeletal Diseases.. Animals (Basel) 2021 Jan 19;11(1).
- Fielding CL, Mayer JR, Dechant JE, Epstein KL, Magdesian KG. Clinical and biochemical factors associated with survival in equids attacked by dogs: 28 cases (2008-2016).. J Vet Intern Med 2021 Jan;35(1):532-537.
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