Sagittal plane slab fractures of the third carpal bone in 45 racing Thoroughbred horses.

This study investigates the rate of return to racing for UK Thoroughbred horses who suffered sagittal slab fractures of the third carpal bone, comparing outcomes of horses treated surgically versus those managed conservatively. Findings indicate that both treatment approaches facilitate the horse’s return to training and racing, with a higher improvement rate in horses that received surgical treatment.

Study Methodology and Criteria

• The researchers conducted a single centre retrospective study over a 15-year period.
• The study focused exclusively on Thoroughbred racehorses with a simple sagittal slab fracture of the third carpal bone, an injury common in racehorses. Horses with more complex fractures were not included.
• The main criteria for measuring the success of the treatment methods was the time taken from intervention to the next race.
• Another parameter was the proportion of horses that improved their Racing Post Rating (RPR) after the injury.
• Statistical tests including Fisher’s Exact Test and Mann-Whitney U Test were used to compare the success rates of the treatment options.

Study Findings

• Out of 47 horses with 49 fractures, 60% successfully raced after the injury, with a median time to first start of 251 days.
• 16 fractures were managed conservatively, with 47% of horses racing again after a median of 240 days, following the injury.
• 30 horses underwent surgery which involved placement of a 3.5-mm lag screw under arthroscopic guidance. 67% of these horses raced again after a median of 264 days following surgery.
• A significant proportion of horses managed surgically improved their RPR after the injury compared to those managed conservatively.

Conclusions and Limitations

• The researchers concluded that both arthroscopic repair (surgery) and conservative management allow horses to return to training and racing after a sagittal slab fracture of the third carpal bone.
• However, the study had a small sample size, especially for horses managed conservatively.
• Also, the treatment was not randomly assigned, so some factors like subsequent retirement for breeding after conservative management, could influence the results.