Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006).
Authors: Ahern Benjamin J, Richardson Dean W, Boston Raymond C, Schaer Thomas P
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Between 1990 and 2006, researchers reviewed 192 horses treated surgically for fractures of the long bones (metacarpals, metatarsals, radius, ulna, humerus, tibia, and femur) or arthrodeses using internal fixation, examining postoperative infection rates and associated risk factors through retrospective case analysis. Postoperative infection developed in 53 horses (28%), significantly impacting outcomes—horses without infection were 7.25 times more likely to be successfully discharged from hospital. Closed fractures proved substantially more resilient than open fractures, with approximately 4.2-fold greater resistance to infection and 4.6-fold improved discharge rates, whilst closed reduction techniques reduced infection risk 2.5-fold compared with open reduction approaches. Female horses showed a notable trend toward higher infection rates relative to colts and stallions (though not geldings), and surgical duration emerged as an additional risk factor requiring consideration. These findings emphasise that fracture classification, reduction technique, and patient sex should inform prognostic counselling and postoperative management protocols, with particular vigilance warranted for open fractures, extended surgical procedures, and female patients where infection risk is materially elevated.
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Practical Takeaways
- •Expect approximately 1 in 4 horses with long bone fracture fixation to develop postoperative infection; plan owner communication and follow-up accordingly
- •Prioritize closed reduction techniques when feasible—they substantially reduce infection risk compared to open approaches
- •Female horses show increased infection risk compared to colts and stallions; consider this in prognosis discussion and postoperative monitoring protocols
Key Findings
- •Overall postoperative infection rate was 28% (53/192 horses), with 59% of infected horses still discharged
- •Closed fractures were 4.23 times more likely to remain uninfected than open fractures
- •Closed reduction and internal fixation was associated with 2.5-fold reduction in infection rate compared to open reduction
- •Fracture classification, repair method, gender, and surgical duration were significant risk factors for postoperative infection