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Diagnosis and management of stress fractures and fatigue injuries in horses

02 March 2024
Clinical
13 mins read
02 March 2024
Volume 8 · Issue 2
Figure 1. Flexed dorsopalmar/plantar radiographic views of the metacarpophalangeal joint showing (a) a typical, complete, minimally displaced lateral condylar fracture and (b) a typical incomplete medial condylar fracture with a spiralling configuration extending into the proximal diaphysis. Soft tissue swelling of the metacarpophalangeal joint is evident in both cases. The lateral aspect is to the left of both images.
Figure 1. Flexed dorsopalmar/plantar radiographic views of the metacarpophalangeal joint showing (a) a typical, complete, minimally displaced lateral condylar fracture and (b) a typical incomplete medial condylar fracture with a spiralling configuration extending into the proximal diaphysis. Soft tissue swelling of the metacarpophalangeal joint is evident in both cases. The lateral aspect is to the left of both images.

Abstract

Fractures are relatively common in equine practice and their aetiology can broadly be divided into three categories: fractures as a result of repetitive stress injury, traumatic fractures and pathological fractures. Stress fractures and fatigue injuries are most commonly seen in performance horses, in particular racehorses. Traumatic fractures can occur in all types of horses at many different anatomical sites. These fractures are frequently seen following a kick injury. Pathological fractures are less common, but may be seen secondary to osteomyelitis or neoplasia. This article will focus on the aetiopathogenesis, diagnosis, treatment and prognosis of stress fractures and fatigue injuries in horses.

Wolff's law states that bone will respond to the mechanical load placed on it. This can occur through modelling, which leads to a change in shape and volume of the bone to reduce stresses, or through remodelling, which involves a change to the internal structure of the bone. During remodelling, bone will be laid down by osteoblasts in areas of increased stress and resorbed by osteoclasts in areas of reduced stress. This allows for the repair of fatigued bone which has been subjected to repeated cyclical loading (Whitton et al, 2010; Markel, 2019; Logan and Nielson, 2021). Stress fractures occur during continued repetitive loading when the rate of accumulation of microdamage within the bone is greater than the ability for repair through remodelling (Whitton et al, 2018). Stress fractures can vary from subclinical microcracks to complete, catastrophic fractures.

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stress fracture
fatigue injury
imaging
pelvic fracture