Rib fractures in adult horses as a cause of poor performance; diagnosis, treatment and outcome in 73 horses.
Authors: Hall Suzy, Smith Roger, Ramzan Peter H L, Head Marcus, Robinson Natalie, Parker Russell
Journal: Equine veterinary journal
Summary
# Editorial Summary: Rib Fractures in Adult Horses Rib fractures remain an underreported cause of poor performance and resistance in ridden horses, prompting this retrospective analysis of 73 cases across three referral centres over 15 years. The majority of affected horses presented with performance issues (n=41) or lameness (n=21), though clinical palpation successfully localised the injury in fewer than 40% of cases, highlighting the diagnostic challenge these injuries pose. Ultrasonography proved the most reliable imaging modality, confirming fractures in 98% of cases (58/59), whilst scintigraphy identified all fracture sites examined (59/59), whereas radiography confirmed only 42% (10/24); most horses were managed conservatively, with only six requiring surgical intervention. Of the 55 horses tracked for over one year, just over half (51%) returned to their previous level of exercise, though notably three euthanasia cases were directly attributable to the rib fracture itself. Whilst relatively uncommon, rib fractures warrant consideration in cases of unexplained poor performance or ridden resistance, and a combination of ultrasonographic and scintigraphic imaging offers the best diagnostic certainty when clinical examination proves inconclusive.
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Practical Takeaways
- •Consider rib fractures in horses presenting with poor performance or resistance to work, not just after obvious trauma—clinical palpation alone is unreliable for diagnosis
- •Use ultrasonography as first-line imaging after scintigraphy for confirming rib fractures; radiography has poor sensitivity (42%) and should not be relied upon alone
- •Most rib fractures can be managed conservatively with good outcomes (51% return to previous level); surgery is reserved for non-healing fractures with persistent clinical signs
Key Findings
- •Rib fractures presented as poor performance/resistance (56%), lameness (29%), or trauma (10%) in 73 adult horses over 15 years
- •Ultrasonography confirmed rib fractures in 98% of cases (58/59), while radiography only confirmed 42% (10/24) and palpation localized injury in only 38% (18/47)
- •51% of horses (28/55 with follow-up >1 year) returned to previous exercise level; 3 euthanized due to rib fracture
- •Six horses required surgery for non-healing fractures with ongoing clinical signs; conservative management was successful in most cases