Outcome following standing fracture repair in 245 horses

Outcome and racing performance following standing fracture repair in 245 horses
Equine Vet J. 2023 Oct 6. doi: 10.1111/evj.14016. Online ahead of print.
Authors
Victoria A Colgate 1 , Natalie Robinson 2 , Timothy P Barnett 1 , Andrew P Bathe 1 , Matthew O D Coleridge 1 , Lewis C R Smith 1 , Richard J Payne 1
Affiliations

1 Rossdales Equine Hospital, Suffolk, UK.
2 VetPartners Ltd, York, UK.

PMID: 37803880
DOI: 10.1111/evj.14016

Abstract

Background: Repair of sagittal proximal phalanx (P1) and parasagittal metacarpal/metatarsal III (MC/MTIII) fractures has evolved over recent decades from a procedure carried out solely under general anaesthesia, to one commonly performed under standing sedation. To date, standing fracture repair has not been evaluated for large cohorts.

Objectives: To determine short-term (survival to discharge) and long-term (return to racing) outcomes of horses undergoing standing repair of MC/MTIII and P1 fractures, and to compare pre-surgical and post-surgical racing performance.

Study design: Single-centre retrospective cohort study.

Methods: Retrospective clinical record review of 245 cases undergoing standing repair of MC/MTIII or P1 fractures, 1 January 2007-30 June 2021. Data on signalment, fracture configuration and complications were collected and full race records were retrieved from the Racing Post Database (wwww.racingpost.com). Chi-squared and Mann-Whitney U tests were used to determine any difference in variables between horses that raced after surgery compared to those that did not. McNemar change and Wilcoxon signed-rank tests were used to compare pre- and post-surgical racing performance, p ≤ 0.05.

Results: Ninety-eight percent [95% confidence interval (CI): 96.2%-99.7%] of horses survived hospital discharge, and 75.1% (95% CI: 68.9%-81.4%) raced after surgery, a median of 241 days later. Horses that raced post-surgery were significantly less likely to have suffered from complications during hospitalisation than those that did not race again [17.3% (95% CI: 11%-24%) vs. 36.5% (95% CI: 23%-50%), p = 0.005]. Comparing pre- and post-operative racing performance, there was no significant difference in earnings per start [median £628.00, interquartile range (IQR) 115.90-1934.80 vs. £653.20, 51.00-1886.40, p = 0.7] or proportion of horses winning [51% (95% CI: 41%-61%) vs. 54% (95% CI: 44%-64%), p = 0.8] or being placed first-third [77% (95% CI: 68%-85%) vs. 71% (95% CI: 62%-80%, p = 0.5] in at least one race.

Main limitations: Retrospective nature of study with reliance on clinical records and public databases, limiting data available for analysis.

Conclusions: Standing fracture repair is a viable treatment option for MC/MTIII or P1 fractures that returns horses to the racetrack within an acceptable time frame and is capable of restoring pre-surgical athletic ability.

Keywords: condylar; fissure; fracture; horse; phalangeal; standing repair.

© 2023 EVJ Ltd.