Lag screw fixation of dorsal cortical stress fractures of the third metacarpal bone in 116 racehorses.
Authors: Jalim S L, McIlwraith C W, Goodman N L, Anderson G A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Lag Screw Fixation for Dorsal Cortical Stress Fractures in Racehorses Dorsal cortical stress fractures of the third metacarpal bone present a common but challenging injury in racing Thoroughbreds, yet evidence-based guidance on optimal surgical management has been limited. Jalim and colleagues retrospectively analysed 116 racehorses (predominantly Thoroughbreds) treated with lag screw fixation between 1986 and 2008, examining whether horses could return to racing and competitive performance levels post-operatively. Among 92 Thoroughbreds with preoperative racing records, 83% resumed racing after surgery, with 63% achieving five or more subsequent starts—a notably positive outcome regardless of age, gender, affected limb, fracture configuration, or concurrent procedures. Whilst mean earnings per start and performance indices did decline in the three races immediately following surgery compared to the three races prior, nearly one-third of horses either improved or maintained their pre-injury earnings, suggesting substantial variability in individual recovery trajectories. For practitioners managing dorsal cortical stress fractures, these findings support lag screw fixation as a viable technique with realistic expectations: most horses can return to racing, though a recovery period with initially reduced performance should be anticipated before some individuals return to their previous competitive level.
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Practical Takeaways
- •Lag screw fixation offers a reliable surgical option for managing dorsal cortical stress fractures in racehorses, with success rates around 83% for return to racing
- •Surgical outcomes are consistent across different horse ages, genders, and fracture presentations, suggesting standardized surgical protocols work reliably
- •Post-surgical performance expectations should be conservative initially, as many horses show reduced earnings and performance in early races, though some improve substantially
Key Findings
- •83% of 92 Thoroughbred racehorses returned to racing post-operatively after lag screw fixation, matching preoperative racing rate
- •63% of horses that raced postoperatively had 5 or more starts, indicating sustained racing ability
- •No statistically significant associations found between age, gender, limb affected, fracture configuration, or concurrent surgery and postoperative racing success
- •Mean earnings per start and performance index decreased in the 3 races following surgery compared to 3 races prior, but 29-45% of horses improved or maintained performance