Scanning electron microscopic examination of third metacarpal/third metatarsal bone failure surfaces in thoroughbred racehorses with condylar fracture

OBJECTIVE : To examine the fracture failure surfaces from Thoroughbred horses that had sustained a catastrophic condylar fracture. SAMPLE POPULATION : Bone specimens from the failure surface were obtained from 12 Thoroughbred racehorses with catastrophic injury and 2 non-racing horses with accidental long bone fracture. METHODS : Bone specimens from the failure surface of each fracture were incubated with gold microspheres to label microcracks before examination at x50 to x60,000 using scanning electron microscopy. Microcracking at the failure surface was assessed using a visual analog scale. RESULTS : Branching arrays or clusters of microcracks were seen over a range of magnifications in adapted subchondral bone in the distal end of the MC3/MT3 bone from racing Thoroughbreds with a catastrophic displaced condylar fracture. In the palmar/plantar region, microcracking was associated with the formation of an array of macroscopic cracks in the condylar groove. A different pattern of microcracking was seen in specimens of bone from distal metaphyseal and diaphyseal MC3/MT3 failure surfaces from Thoroughbred racehorses with catastrophic fracture and non-racing horses with an accidental diaphyseal long bone fracture. Few microcracks were seen and typically did not form branching arrays. CONCLUSION : These data suggest that propagation of condylar fracture in Thoroughbred racehorses is initiated by the formation of nanoscale microcracks in adapted subchondral bone that form during exercise-induced bone adaptation. CLINICAL RELEVANCE : Accumulation and coalescence of branching microcracks into arrays or clusters appears to eventually lead to the development of macroscopic subchondral cracks in the condylar groove and initiation of a condylar fracture.     

Macroscopic changes in the distal ends of the third metacarpal and metatarsal bones of Thoroughbred racehorses with condylar fractures

OBJECTIVE: To determine changes in the distal ends of the third metacarpal and metatarsal bones (MCIII and MTIII) of Thoroughbred racehorses that had sustained a catastrophic condylar fracture during high-speed exercise. SAMPLE POPULATION: Fractured and contralateral MCIIIs and MTIIIs from 11 Thoroughbred racehorses that sustained a displaced condylar fracture during racing, both MCIIIs from 5 Thoroughbred racehorses euthanatized because of a catastrophic injury other than a condylar fracture, and both MCIIIs from 5 horses of other breeds that had not been professionally trained or raced. PROCEDURE: Macroscopic observations were made of the distal ends of the bones before and after digestion of the articular cartilage with NaOH. RESULTS: In all 11 racehorses with a displaced condylar fracture, the fracture was associated with a branching array of cracks in the condylar groove. In this region, fracture margins were smooth, and there was loss of subchondral bone. Comminution of the dorsal cortex was also seen. Parasagittal linear wear lines in the articular cartilage, erosions in the articular cartilage of the condyles, loss of the underlying subchondral bone, and cracking of condylar grooves were all more severe in the Thoroughbred racehorses than in the horses that had not been professionally trained or raced. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that condylar fractures in horses are pathologic fatigue or stress fractures that arise from a preexisting, branching array of cracks in the condylar groove of the distal end of MCIII or MTIII.     

Comparison of visual lameness scores to gait asymmetry in racing Thoroughbreds during trot in-hand

Regular monitoring of movement asymmetry with inertial measurement units (IMUs) to aid in the diagnosis of the underlying cause of a lameness is feasible. Normal ranges for specific groups of horses may be required, with consideration of expert veterinary opinions for both asymmetry screening and lameness assessment. The aim of this study was to determine movement asymmetry values compared with expert lameness scores to enable screening for lameness in Thoroughbreds in race training. IMU gait assessment during in-hand trot-up was performed in 25 racehorses undergoing routine gait analysis or lameness examination at the Singapore Turf Club. Video recordings were graded numerically (0–5) for lameness by six experienced racehorse veterinarians. Inter-observer agreement and consistency were determined. Median lameness scores were used to calculate sensitivity and specificity for head, withers and pelvic movement asymmetry. Guideline values for aligning movement asymmetry values with expert opinions about forelimb and hindlimb lameness were determined from receiver operating characteristics (ROC). Inter-observer agreement was poor to fair, inter-observer consistency was good (intraclass correlation coefficient: 0.667 for forelimbs and 0.617 for hindlimbs). ROCs indicated higher discriminative power for hindlimb lameness using pelvic asymmetry (90% sensitivity, 93% specificity) compared with forelimb lameness using head asymmetry (69% sensitivity, 89% specificity) or withers asymmetry (44% sensitivity, 89% specificity). When compared to expert lameness scores from videos of a limited number of Thoroughbred racehorses, preliminary guideline values for movement asymmetry screening for forelimb lameness (>|14.5 mm|) and hindlimb lameness (>|7.5 mm|) are higher than previously reported clinical thresholds of >|7 mm| for head movement and >|4 mm| for pelvic movement asymmetry.     

Occurrence of Unilateral Posterior Polyneuritis in an 8-year-old Crossbred Mare

An 8-year-old Thoroughbred Turkoman crossbred mare was examined for right pelvic limb paresis and ataxia. The signs had been progressing through time. Neurological examinations revealed a gait deficit, right pelvic limb gluteal muscles atrophy, skin hypalgesia around the tail, perineum, and right pelvis. Hyperesthesia was found in the margins of anesthetic areas. Hypotonic anal sphincter and flaccid tail were also evident. Fecal and urinary retention were revealed by rectal palpation. At necropsy, the affected nerve roots in right lumbar, sacral vertebrae, as well as cauda equina were found to be significantly thickened and fibrotic with adhesions to the related vertebral bodies. Histopathological examinations confirmed the diagnosis of polyneuritis in this mare.     

Femoral asymmetry in the Thoroughbred racehorse

OBJECTIVE: To investigate the occurrence of geometrical asymmetries in the macro-architecture of left and right femurs from Thoroughbred racehorses previously used in competitive training and racing in New South Wales, Australia. METHODS: Detailed postmortem measurements were made of 37 characteristics of left and right femurs from eleven Thoroughbred racehorses euthanased for reasons unrelated to the study. Measurements focused on articulating surfaces and sites of attachment of muscles and ligaments known to be associated with hindlimb locomotion. RESULTS: Five measurements were significantly larger in left compared to right femurs (P < 0.05). The regions showing significant differences between left and right limbs were proximal cranial and overhead medio-lateral widths, greater trochanter depth, depth of the fovea in the femoral head and distal inter-epicondylar width. CONCLUSION: The left-right differences in femoral morphology were associated with sites of muscle and ligament attachment known to be involved with hindlimb function in negotiating turns. These differences may be the result of selection pressure for racing performance on curved race tracks and/or adaptations related to asymmetrical loading of the outside hindlimb associated with repeated negotiation of turns on such tracks.     

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002)

REASONS FOR PERFORMING STUDY: Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. METHODS: Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. RESULTS: Sixty-four percent of fractures occurred in the hindlimbs and 36% in the forelimbs. Horses with forelimb fractures had a reduced probability of return to racing (67%) compared to those with hindlimb fractures (83%), but the majority (77%) of treated horses recovered to return to race post operatively. Horses with medial forelimb fractures raced at only a 47% rate; those with suspensory desmitis at 63%. Unlike Standardbreds, there was no difference in probability of racing post operatively between horses that had, and had not, raced preoperatively. CONCLUSIONS: Data show that arthroscopic removal of apical proximal sesamoid fracture fragments is successful at restoring ability to race in skeletally mature TB horses without evidence of severe suspensory ligament damage. Prognosis for return to racing is excellent (83%) in horses with hindlimb fractures and good (67%) in those with forelimb fractures. Medial fractures of the forelimb have the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis for differing sites in TB racehorses should increase knowledge of apical proximal sesamoid bone fractures and improve communication from veterinarian to owner, and trainer, on the potential for arthroscopic restoration of the ability to race.     

Pathologic changes in the lumbosacral vertebrae and pelvis in Thoroughbred racehorses

OBJECTIVE: To describe the prevalence, characteristics, and severity of soft-tissue and osseous lesions in the caudal portion of the thoracic and lumbosacral vertebral column and pelvis in Thoroughbred racehorses. ANIMALS: 36 Thoroughbred racehorses that died or were euthanatized at California racetracks between October 1993 and July 1994. PROCEDURE: Lumbosacral and pelvic specimens were collected and visually examined for soft-tissue and osseous lesions. RESULTS: Acute sacroiliac joint injury was observed in 2 specimens. Signs of chronic laxity or subluxation of the sacroiliac joint were not observed in any specimens. Impingement of the dorsal spinous processes and transverse processes was observed in 92 and 97% of specimens, respectively. Thoracolumbar articular processes had variable degrees of degenerative change in 97% of specimens. Degenerative changes were observed at lumbar intertransverse joints and sacroiliac articulations in all specimens. Some degenerative changes were widespread and severe. CONCLUSIONS: Numerous degenerative changes affected vertebral processes, intervertebral articulations, and sacroiliac joints in these Thoroughbred racehorses. CLINICAL RELEVANCE: Various types of vertebral and pelvic lesions need to be considered during clinical evaluation of the back and pelvis in horses. Undiagnosed vertebral or pelvic lesions could be an important contributor to poor performance and lameness in athletic horses.     

Prevalence of pharyngeal and laryngeal abnormalities in Thoroughbreds racing in Australia, and their association with performance

REASONS FOR PERFORMING STUDY: Little information is available regarding the prevalence of abnormalities of the upper airway and their association with performance in the general population of Thoroughbred racehorses. OBJECTIVES: To describe the prevalence of selected abnormalities of the upper airway and their association with performance in Thoroughbred racehorses in Australia. HYPOTHESIS: That abnormalities of the upper airway of Thoroughbred racehorses are associated with poor race performance. METHODS: Rhinolaryngoscopy was performed after racing and presence and characteristics of abnormalities of the larynx and pharynx were recorded in a prospective cross-sectional study of Thoroughbred horses racing in Victoria, Australia. RESULTS: Rhinolaryngoscopy was performed once on each of 744 horses over 35 months. Fifty abnormalities of the upper airway were detected in 47 horses (6.3%, 95% confidence interval [CI] 4.7-83%). Epiglottic entrapment was detected in 7 horses (0.9%, 95% CI 0.4-1.9%) and was significantly (P = 0.015) associated with superior performance. Grade 2 asymmetry (4 grade scale) of the left arytenoid cartilage was detected in 9 horses (1.2%, 95% CI 0.5-2.4%) and was also associated with superior performance (P<0.001). Ulceration or erosion of the mucosa of the axial surface of one or both arytenoids was detected in 18 horses (2.4%, 95% CI 13-3.8%) and was not associated with alterations in exercise performance (P = 0.31). CONCLUSIONS: Epiglottic entrapment, Grade 2 laryngeal asymmetry and mucosal erosions detected in Thoroughbred racehorses were not associated with impaired performance; therefore, surgical correction and concern over laryngeal function in horses with Grade 2 asymmetry may not be necessary in individuals performing to expectation.     

Effect of controlled exercise on middle gluteal muscle fibre composition in Thoroughbred foals

REASONS FOR PERFORMING STUDY: Most racehorses are trained regularly from about age 18 months; therefore, little information is available on the effect of training in Thoroughbred foals. HYPOTHESIS: Well-controlled exercise could improve muscle potential ability for endurance running. METHODS: Thoroughbred foals at age 2 months were separated into control and training (treadmill exercise) groups and samples obtained from the middle gluteal muscle at 2 and 12 months post partum. Muscle fibre compositions were determined by histochemical and electrophoretical techniques and succinic dehydrogenase (SDH) activity was analysed in each fibre type. RESULTS: All fibre types were hypertrophied with growth and type I and IIA fibres were significantly larger in the training than the control group at age 12 months. A significant increase of SDH activity was found in type IIX muscle fibres in the training group. CONCLUSIONS: Training in young Thoroughbred horses can facilitate muscle fibre hypertrophy and increase the oxidative capacity of type IIX fibres, which could potentially enhance stamina at high speeds. POTENTIAL RELEVANCE: To apply this result to practical training, further studies are needed to determine more effective and safe intensities of controlled exercise.     

Characteristics of Thoroughbred and Quarter Horse racehorses that sustained a complete scapular fracture

Reasons for performing study: To determine if scapular fractures occur in racehorses with distinctive characteristics. Objectives: To test the hypothesis that Thoroughbred (TB) and Quarter Horse (QH) racehorses with a scapular fracture have similar characteristics that are different from those of their respective racetrack populations. Methods: Necropsy findings, case details, last race information and career earnings for TB and QH racehorses that had a scapular fracture in California between 1990 and 2008 were retrospectively compared between breeds. Horse signalment, career earnings, career starts and race characteristics were obtained for all California racehorses. Comparisons were made between affected horses, other racehorses that died, and all horses that raced, in California during the 19 year period. Results: Seventy‐three TB and 28 QH racehorses had a similar, complete comminuted scapular fracture with an articular component, and right forelimb predilection. The QHs had a higher incidence of scapular fracture incurred during racing than TBs (0.98 vs. 0.39/1000 starters). The TB and QH incident rates for musculoskeletal deaths incurred racing were 20.5 and 17.5/1000 starters, respectively; however, a greater proportion of TB musculoskeletal deaths occurred training (40% vs. 8%). Horses with a scapular fracture were more likely to be male and aged 2 or ≥5 years than the racetrack population. Most affected QHs (64%) were 2‐year‐olds; most TBs (74%) were aged ≥3 years. Scapular fractures occurred more commonly during racing in QHs (70%) than TBs (44%). Race‐related scapular fracture was more likely to occur in a Maiden race than in a non‐Maiden race. Horses with a scapular fracture had fewer career starts than the racetrack population. Conclusions and potential relevance: Despite breed differences for signalment and exercise distances, both breeds incur a complete scapular fracture that is more likely to occur in the right scapula of young and older, male racehorses, early in their race career or after few races. Quarter Horses sustain a catastrophic scapular fracture more frequently than TBs.     

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age < 2 years: 151 cases (1989--2002)

REASONS FOR PERFORMING STUDY: Studies on arthroscopic removal of apical proximal sesamoid fracture fragments in Thoroughbred (TB) horses age > or = 2 years have reported a high success rate. However, there are no reports documenting the racing prognosis of TB horses that undergo such surgery as weanlings or yearlings. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in immature TB horses, age < 2 years and determine probability and quality of racing performance after arthroscopic removal of such fractures in 151 TB weanlings and yearlings. METHODS: The medical records of TB horses age < 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. Follow-up information was obtained from race records. Student's t tests were used to compare performance variables of operated racehorses to that of their maternal siblings. RESULTS: Ninety-two percent (139/151) of fractures occurred in the hindlimbs and 8% (11/151) in the forelimbs (fracture of both fore- and hindlimb, n = 1). Horses with forelimb fractures had a greatly reduced probability of racing (55%) compared to those with hindlimb fractures (86%). Overall, 84% of the horses raced post operatively and had performance records similar to that of their maternal siblings, 78% (787/1006) of which raced. CONCLUSIONS: Arthroscopic removal of apical proximal sesamoid fracture fragments in TB weanlings and yearlings carries an excellent prognosis for racing in horses with hindlimb fractures and a reduced prognosis in those with forelimb fractures. Medial fractures of the forelimb carry the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis increases knowledge on apical sesamoid bone fractures and potential for arthroscopic restoration of the ability to race; and enables the value of yearlings for subsequent sale to be established.     

Clinical evaluation of the locking compression plate for fetlock arthrodesis in six thoroughbred racehorses

Objective— To report use of a locking compression plate (LCP) for fetlock arthrodesis in Thoroughbred racehorses after catastrophic disruption of the suspensory apparatus.
Study Design— Retrospective case study.
Animals— Racing Thoroughbreds (n=6) with a catastrophic breakdown injury of the suspensory apparatus.
Methods— Medical records (2004–2006) of horses that had fetlock arthrodesis using an LCP were reviewed. Preoperative recorded variables were: age, gender, affected limb, injury type and occurrence, limb support used and time to surgery. Recorded surgical variables were: implants used and cost, surgery time, and anesthetic recovery method. Postoperative recorded variables included: treatment, physical status, complications, and outcome.
Results— Of 6 Thoroughbred racehorses that had LCP arthrodesis, 4 were sound for breeding purposes the next year and 2 horses were euthanatized (1 at 16 days, 1 at 68 days) because of proximal interphalangeal joint (PIJ) luxation. No surgical complications were associated with implant application. Postoperative complications were similar to those reported for other arthrodesis techniques.
Conclusions— LCP is a viable option for fetlock arthrodesis in Thoroughbred racehorses after catastrophic suspensory apparatus disruption.
Clinical Relevance— Adequate fetlock stability can be achieved with an LCP, and although the repair is likely more stable it is ∼3 times more expensive than using a limited contact dynamic compression plate (LC-DCP) with cortical screws.     

Humeral stress remodelling locations differ in Thoroughbred racehorses training and racing on dirt compared to synthetic racetrack surfaces

Reasons for performing study: Veterinarians have observed a putative change in the location of humeral stress remodelling in Thoroughbred racehorses with change from dirt to synthetic racetrack surfaces. Objectives: To determine whether the location and severity of humeral stress remodelling differs between Thoroughbred racehorses exercising on dirt and synthetic racetrack surfaces, the potential significance of different locations of stress remodelling, and the potential usefulness of scintigraphy for prevention of complete humeral fracture. Methods: Scintigraphic images of humeri from 841 Thoroughbred racehorses at 3 racetracks during 2 years before and after conversion from dirt to synthetic surfaces were evaluated for location and severity of lesions. The effects of surface on lesion distributions were examined using Chi‐square or Fisher's exact tests. Archived fractured humeri were examined to determine the location and severity of stress remodelling associated with complete fracture. Databases were queried to determine whether racehorses with scintigraphic lesions suffered humeral fracture and whether racehorses with a complete humeral fracture had had a scintigraphic examination. Results: Horses at synthetic racetracks had a greater proportion of distal humeral lesions, whereas horses at dirt racetracks had a greater proportion of caudoproximal lesions (P<0.001). Proximal lesions were more likely to be severe than distal lesions (P<0.001). Most complete fractures were associated with caudoproximal lesions, which were more often severe than distal lesions (P = 0.002). None of the horses with a scintigraphic lesion had a complete humeral fracture. None of the horses with a complete humeral fracture underwent scintigraphic examination. Conclusions: Race surface affected humeral scintigraphic lesion location and hence the location of stress remodelling. Lesion severity was associated with lesion location. Complete humeral fracture was associated with caudoproximal stress remodelling and lack of scintigraphic examination. Potential relevance: Risk for complete humeral fracture may be lower on synthetic surfaces than on dirt surfaces, and, by inference, for horses examined using scintigraphy.     

Magnetic resonance imaging‐detected adaptation and pathology in the distal condyles of the third metacarpus,associated with lateral condylar fracture in Thoroughbred racehorses

Reasons for performing the study: Lateral condylar (LC) fractures of the third metacarpus (McIII) are a common reason for euthanasia in racehorses, and may be the result of repetitive overloading or cumulative pathological change. Magnetic resonance imaging (MRI) allows monitoring of bone and cartilage to detect pathological and adaptive changes that may be precursors of fracture. Objectives: To describe bone and cartilage MRI features in the distal condyles of McIII of Thoroughbred racehorses, with and without condylar fracture. Hypotheses: 1) A greater degree of bone and cartilage adaptation or pathology will be seen in fractured McIIIs compared with their respective contralateral McIIIs. 2) Contralateral McIIIs will have a greater degree of bone and cartilage adaptation or pathology than McIIIs from control horses that did not sustain a LC fracture. Methods: The McIIIs from 96 horses subjected to euthanasia at racecourses were divided into 3 groups: Group 1: nonfractured bones from horses without LC fracture; Group 2: nonfractured bones from horses with unilateral LC fracture; and Group 3: fractured bones from horses with unilateral LC fracture. The MR images were examined and graded for bone and cartilage changes. Results: Nine percent of Group 1 (n = 9) and 11% of Group 2 bones (n = 5) had incomplete LC fractures. Focal palmar necrosis was most frequently detected in bones from Group 1 (12%) compared with Groups 2 (9%) and 3 (4%). The prevalence of bone and/or cartilage abnormalities tended to increase from Group 1 to Group 2 to Group 3. Conclusions: Magnetic resonance imaging is able to detect cartilage and bone changes that may be associated with LC fracture. There was no significant difference in bone/cartilage changes between bones from Groups 1 and 2, despite increased pathology in Group 2 bones. Potential relevance: Periodic monitoring of bone and/or cartilage changes in distal McIII of Thoroughbred racehorses may help to prevent catastrophic LC fractures.     

Catastrophic scapular fractures in Californian racehorses: pathology, morphometry and bone density

Reasons for performing study: To enhance understanding of the nature and pathogenesis of scapular fractures in racehorses. Hypothesis: Scapular fractures in racehorses have a consistent configuration related to sites of pre‐existing stress modelling and remodelling. Methods: Fractured and intact scapulae collected post mortem were examined visually and with computed tomography (CT). Scapular fracture configuration, bone modelling changes and standardised CT morphometry and density measurements were recorded. Statistical comparisons were made between fractured, nonfractured contralateral and control scapulae. Results: Thirty‐nine scapulae from 10 Thoroughbred (TB) and 10 Quarter Horse (QH) racehorses were obtained. All 14 fractured scapulae (from 12 horses) had a consistent comminuted fracture configuration. A complete fracture coursed transversely through the neck of the scapula at the level of the distal aspect of the spine (8.9 ± 0.9 cm proximal to the lateral articular margin of the glenoid cavity). The distal fragment of 13 fractured scapulae was split into 2 major fragments by a fracture in the frontal plane that entered the glenoid cavity (2.8 ± 0.4 cm caudal to the cranial articular margin). Focal areas of periosteal proliferation and/or radiolucency were present in the distal aspect of the scapular spine of all fractured and intact contralateral scapulae, but less commonly (P<0.01) in intact scapula from horses without a scapular fracture. Fractured scapulae had 7–10% lower mean density and 46–104% greater density heterogeneity in the spine adjacent to the transverse fracture compared to control scapulae (P<0.03). Conclusions and clinical relevance: Thoroughbred and QH racehorses have a characteristic scapular fracture configuration that is associated with pre‐existing pathology of the distal aspect of the spine. This location is consistent with scapular stress fractures diagnosed in lame TB racehorses. Catastrophic fracture is the acute manifestation of a more chronic process. Consequently, there are opportunities for early detection and prevention of fatalities.     

Low-field standing magnetic resonance imaging findings of the metacarpo/metatarsophalangeal joint of racing Thoroughbreds with lameness localised to the region: a retrospective study of 131 horses

Reasons for performing study: The metacarpo/metatarsophalangeal (MCP/MTP) joint is a common site of lameness in the Thoroughbred racehorse. Radiographs may fail to show pathology consistent with the degree of lameness. With a high incidence of stress fractures occurring in the distal third metacarpal/metatarsal (MC3/MT3) condyles and proximal phalanx, a definitive diagnosis as to the nature of the pathology is essential. Objective: To describe the low‐field magnetic resonance imaging (MRI) findings in Thoroughbred racehorses with MCP/MTP joint pain scanned under standing sedation. Methods: The MR images and clinical records of all Thoroughbred racehorses undergoing MRI of the MCP/MTP joint between October 2006 and August 2010 were reviewed. A total of 168 joints from 131 horses were selected for inclusion. The MRI finding considered most significant in the lame (or lamest) limb was noted. Results: Diagnostic quality images were obtainable in 97.8% of horses. The most common finding was palmar/plantar osteochondral disease in MC3/MT3 (54.9% of horses). Incomplete condylar fracture was diagnosed in 19.8% of horses, with the lateral condyle predominating. An incomplete sagittal fracure of P1 was diagnosed in 14.5% of horses and 11.4% were diagnosed with ‘dorsal joint disease’. Other findings included transverse MC3 stress fractures (1.5%), soft tissue injuries (12.2%) and proximal phalangeal ‘contusions’ (3.8%). No significant bone/soft tissue injury was detected in 5.4% of cases. Conclusions: Standing MRI can detect a spectrum of disease within the MCP/MTP joints of racehorses. The procedure is well tolerated and may lead to a definitive diagnosis where radiographic imaging is inconclusive. Potential relevance: A total of 35.8% of cases had MRI findings consistent with fracture pathology, which could not be confirmed radiographically at the time of the MRI examination. This has important therapeutic and prognostic implications and may help to prevent catastrophic injury.     

Effect of track maintenance on mechanical properties of a dirt racetrack: A preliminary study

When Thoroughbred racehorses experience catastrophic injuries, the track surface is often discussed as a factor. The present study investigated the mechanical properties of the surface and found that significant changes in a track occur during routine maintenance. Questions regarding the relative importance of track variability and hardness require further investigation.     

Lag screw fixation of dorsal cortical stress fractures of the third metacarpal bone in 116 racehorses

Reasons for performing study: The effectiveness and best method to manage dorsal cortical stress fractures is not clear. This study was performed to evaluate the success of lag screw fixation of such fractures in a population of Thoroughbred racehorses. Hypothesis: Lag screw fixation of dorsal cortical stress fractures is an effective surgical procedure allowing racehorses to return to their preoperative level of performance. Methods: The records of 116 racehorses (103 Thoroughbreds) admitted to Equine Medical Centre, California between 1986 and 2008 were assessed. Information obtained from medical records included subject details, limb(s) affected, fracture configuration, length of screw used in repair and presence of concurrent surgical procedures performed. Racing performance was evaluated relative to these factors using Fisher's exact test and nonparametric methods with a level of significance of P<0.05. Results: Of 92 Thoroughbred horses, 83% raced preoperatively and 83% raced post operatively, with 63% having ≥5 starts. There was no statistically significant association between age, gender, limb affected, fracture configuration or presence of concurrent surgery and likelihood of racing post operatively or of having 5 or more starts. The mean earnings per start and the performance index for the 3 races following surgery were lower compared to the 3 races prior to surgery; however, 29 and 45% of horses either improved or did not change their earnings per start and performance index, respectively. Conclusions and potential relevance: Data show that lag screw fixation is successful at restoring ability to race in horses suffering from dorsal cortical stress fractures.     

Severe acute rhabdomyolysis associated with Streptococcus equi infection in four horses

Four Quarter Horses (9 months to 7 years of age) with submandibular lymphadenopathy and firm muscles (palpation of which elicited signs of pain) were evaluated; in general, the horses had a stiff gait, and 3 horses became recumbent. Streptococcus equi was cultured from aspirates of lymph nodes or samples of purulent material collected from the auditory tube diverticula. Once the horses were recumbent, their condition deteriorated rapidly despite aggressive antimicrobial and antiinflammatory treatment, necessitating euthanasia within 24 to 48 hours. One horse did not become recumbent and recovered completely. Among the 4 horses, common clinicopathologic findings included neutrophilia, hyperfibrinogenemia, and high serum activities of creatine kinase and aspartate aminotransferase. Necropsies of the 3 euthanatized horses revealed large, pale areas most prominent in the semimembranosus, semitendinosus, sublumbar, and gluteal muscles that were characterized histologically by severe acute myonecrosis and macrophage infiltration of necrotic myofibers. Streptococcus equi was identified in sections of affected muscle by use of immunofluorescent stains for Lancefield group C carbohydrate and S. equi M protein. In the 4 horses of this report, acute severe rhabdomyolysis without clinical evidence of muscle atrophy or infarction was associated with S. equi infection; rhabdomyolysis was attributed to either an inflammatory cascade resembling streptococcal toxic shock or potentially direct toxic effects of S. equi within muscle tissue.     

A case-control study of factors associated with pelvic and tibial stress fractures in Thoroughbred racehorses in training in the UK

Few epidemiological studies have investigated risk factors for musculoskeletal injury occurring in Thoroughbred racehorses during training, although it is the major cause of wastage in the racing industry. We recently conducted a large-scale epidemiological study to estimate the incidence of fracture in racehorses in training in the UK and to identify associated risk factors. Thirteen racehorse trainers provided data on horses in their care, with daily recording of training information and provision of details on any fractures incurred. Data were collected for 2 years, including two consecutive flat racing seasons (1999 and 2000). This paper describes findings from a nested case-control study investigating factors associated with the occurrence of pelvic and tibial stress fractures in our study population. Cases were identified from the main study and defined as horses with a pelvic or tibial stress fracture, confirmed through routine diagnostic imaging. Randomly selected controls were matched on date of fracture in the case. Age and gender of the horse, its exercise history and training surfaces were examined as explanatory variables. Exercise was quantified as cumulative distances cantered and worked at high speed in 30- and 60-day periods prior to date of fracture in the case. Conditional logistic regression was used to construct multivariable models for the 30- and 60-day periods, respectively. We hypothesised that larger cumulative exercise distances would be associated with an increased risk of pelvic or tibial stress fracture and that different training surfaces would be associated with differences in fracture risk. In the 30-day period, when adjusting for trainer, the risk of pelvic or tibial stress fracture increased with increasing distance cantered, reaching a peak at around 50 km, after which the risk reduced. This trend was not obvious in the 60-day period, with no significant association between exercise distances and risk of stress fracture. Predominant use of one particular sand-based all-weather surface was related to an increased risk of pelvic or tibial stress injury, although this finding should be interpreted with caution. Surface maintenance and construction may play a role; variables that were not considered in the current analyses, which were based on a relatively small number of cases. Trainer was associated with differences in stress fracture risk after adjusting for exercise distances and surface but age and gender were not.