The On-going Effort to Minimise the Rate and Impact of Fractures

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Published in European Trainer, January - March 2018, issue 60.

In thoroughbred racing, musculoskeletal injury is a major safety concern and is the leading reason for days lost to training.  Musculoskeletal injury is the greatest reason for horse turnover in racing stables, with financial implications for the owner and the racing industry. Injuries, particularly on race day, have an impact on public perception of racing.  

Upper limb and pelvis fractures are less common than lower limb fractures, but they can lead to fatalities. Reducing the overall prevalence of fractures is critical and, at the very least, improving the rate of detection of fractures in their early stages so the horse can be withdrawn from racing with a recoverable injury will be a big step forwards in racehorse welfare. Currently, we lack information on the outcomes following fracture, and an article recently published in the Equine Veterinary Journal (EVJ) from the veterinary team at the Hong Kong Jockey Club (HKJC) addressed this important knowledge gap.

Hong Kong Fracture Outcome Study

The HKJC veterinary team is in a unique position to carry out this work because their centralised and computerised database of clinical records, together with racing and retirement records, allows them to document follow-up, which is all but impossible elsewhere in the world. Dr Leah McGlinchey, working with vets in Hong Kong and researchers from the Royal Veterinary College, London, reviewed clinical records from 2003 to 2014 to identify racehorses that suffered a fracture or fractures to the bones of the upper limb or the pelvis during training or racing, confirmed by nuclear scintigraphy, radiography, ultrasonography, or autopsy....

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Gallery

The arrow in this bone scan identifies a 'hot spot' indicating a humeral fracture towards the lower end of the bone, just above the elbow.

The arrow in this bone identifies increased radionucleotide uptake indicating a radial stress fracture.

Oblique view of the ilium of the pelvis showing a linear pattern of increased bone activity consistent with stress fracture pathology.

Arrow indicates a marked focus of increased radionucleotide uptake in the upper tibia, associated with a tibial stress fracture.

Example of a bone scan pattern indicative of pelvic stress fracture pathology shown this time from above to readily compare both sides of the pelvis.

Scapular fractures are particularly catastrophic. This CT image, made during an autopsy shows a comminuted fracture with multiple bone fragments. 

This autopsy specimen shows a comminuted scapular fracture.

A close up shows how the scapular fracture extends into the shoulder joint.

These plots show the complex relationships between depth and stiffness of the cushion when the virtual horse gallops on surfaces laid over harrowed dirt (A), consolidated dirt (B), harrowed synthetic (C), and consolidated synthetic (D). The red zones illustrate degrees of fetlock movement in the leading forelimb that places the horse at risk of injury. Very compliant surfaces (blue zones) require the horse to exert more energy to gallop as well as reducing damping within the limbs, propogate vibrations and damage bone. Reproduced, with permission, Equine Veterinary Journal Vloume 49, Issue 5, pages 681-687, 2017 DOI: 10.1111/evj.12672.

Does nutrition factor in injury, repair and recovery?

First published in European Trainer issue 58 - July - September 2017

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Lost training days through injury or infection are problematic for trainers, both practically and commercially. It is a stark fact that 50% of thoroughbred foals, bred to race, may never reach the racecourse.

Lost training days through injury or infection are problematic for trainers, both practically and commercially. It is a stark fact that 50% of thoroughbred foals, bred to race, may never reach the racecourse.  In young thoroughbreds, musculoskeletal problems have been cited as the most common reason for failure to race and this appears to continue to be a major issue for horses in training.  

An early study carried out in 1985 in the UK reported that lameness was the single biggest contributor to lost days of training, and subsequent research 20 years later found that this was still the case, with stress fractures, which involve normal bone being exposed to abnormal stress, being cited as a significant underlying cause.  Perhaps not surprisingly, two-year-olds were more susceptible to injury than three-year-olds.  Whilst there are of course many other reasons – including muscular issues such as tying up, respiratory problems, and viral infection – why horses may fail to train, in this survey medical issues accounted for only 5% of the total training days lost.

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Standing fracture repair - an important step forward in fracture repair

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