Retrospective performance-indexed analysis of Thoroughbred racehorses undergoing surgical management of proximal sesamoid bone fractures.
Authors: Yeomans A, Cramp P, Carpenter R, Bladon B
Journal: Equine veterinary journal
Summary
# Proximal Sesamoid Bone Fractures: Updated Surgical Outcomes in Racehorses Proximal sesamoid bone fractures remain a significant challenge in equine practice, with limited recent data on long-term racing outcomes following surgical repair. Yeomans and colleagues analysed 168 Thoroughbred racehorses treated surgically between 2008–2022, comparing pre- and post-operative racing performance using a standardised performance index and matching cases against age- and sex-matched controls. Overall, 51% of horses returned to racing post-operatively; however, success was heavily influenced by fracture location and surgical approach—apical and abaxial fractures managed via fragment removal achieved return-to-racing rates of 56–61%, whilst mid-body fractures and those requiring screw fixation showed markedly poorer outcomes (16% and 17% respectively). Forelimb injuries were substantially less likely to race again compared with hindlimb cases (42% versus 66%), and whilst post-operative racers maintained comparable longevity to control animals, their per-start performance indices were reduced relative to pre-injury levels. These findings should guide both pre-operative counselling regarding realistic prognosis and surgical decision-making, particularly in valuing fragment removal over internal fixation where anatomically feasible, though the retrospective design and data loss warrant cautious interpretation of the results.
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Practical Takeaways
- •Fracture location and surgical approach significantly influence return-to-racing prognosis; fragment removal for apical/abaxial fractures offers better outcomes than internal fixation
- •Forelimb PSBF carries a poorer prognosis for racing return than hindlimb injury, which should inform owner counselling and treatment decisions
- •Horses that do return to racing post-operatively maintain good longevity and number of starts, though expect reduced performance metrics per race
Key Findings
- •51.2% of horses with surgical PSBF repair returned to racing, with 50.4% return rate among pre-operatively racing horses
- •Forelimb fractures had significantly lower post-operative racing rates (42.3%) compared to hindlimb fractures (65.6%)
- •Fragment removal surgery was associated with better post-operative racing outcomes (56.6%) compared to screw-fixation (17.4%)
- •Post-operative racers showed reduced performance index per start compared to pre-operative performance, though number of starts and longevity were maintained