Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age < 2 years: 151 cases (1989--2002).
Authors: Schnabel L V, Bramlage L R, Mohammed H O, Embertson R M, Ruggles A J, Hopper S A
Journal: Equine veterinary journal
Summary
# Editorial Summary: Racing Prognosis Following Arthroscopic Treatment of Apical Sesamoid Fractures in Immature Thoroughbreds Apical proximal sesamoid fractures represent a significant orthopaedic challenge in young racehorses, yet evidence regarding long-term racing outcomes after arthroscopic fragment removal in weanlings and yearlings has been limited until now. Schnabel and colleagues retrospectively analysed 151 immature Thoroughbreds (age <2 years) that underwent arthroscopic removal of apical sesamoid fracture fragments, cross-referencing post-operative outcomes against race records and comparing performance metrics with maternal siblings to control for genetic and environmental variables. The vast majority of fractures (92%) occurred in the hindlimbs, and critically, location significantly influenced prognosis: hindlimb-fractured horses achieved an 86% probability of racing with performance equivalent to unaffected siblings, whereas forelimb fractures yielded substantially poorer results at only 55% racing incidence, with medial forelimb fractures carrying the worst outlook. Overall, 84% of the surgically treated cohort returned to racing with comparable performance statistics to their uninjured maternal siblings (78% of whom raced), indicating that arthroscopic intervention in hindlimb cases carries an excellent prognosis for future athletic function. For veterinarians, farriers and studs managing young Thoroughbreds, these findings provide quantifiable prognostic data essential for clinical decision-making and establishing yearling values, whilst highlighting the considerably more guarded prognosis when forelimb involvement is present.
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Practical Takeaways
- •Arthroscopic removal of apical sesamoid fracture fragments in young Thoroughbreds has an excellent prognosis for racing when the fracture is in the hindlimbs (86% return rate), allowing confident decisions on yearling valuations at sale
- •Forelimb fractures, particularly medial fractures, have substantially reduced racing prospects (55% return rate), requiring different prognostic counseling and commercial decisions
- •Post-operative racing performance in successful cases matches that of non-surgical siblings, validating the surgical intervention as an effective treatment option for early intervention in immature horses
Key Findings
- •92% of apical sesamoid fractures in horses <2 years occurred in hindlimbs versus 8% in forelimbs
- •84% of surgically treated horses raced post-operatively with performance similar to maternal siblings
- •Horses with hindlimb fractures had 86% probability of racing compared to 55% for forelimb fractures
- •Medial forelimb fractures carried the worst prognosis for return to racing