Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 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
# Apical Sesamoid Fractures in Mature Thoroughbreds: Surgical Outcomes and Racing Prognosis Arthroscopic removal of apical proximal sesamoid fracture fragments offers a viable pathway back to racing for mature Thoroughbreds, though success rates vary significantly by fracture location and limb involvement. This retrospective analysis of 84 cases (1989–2002) revealed that 77% of treated horses returned to racing, with substantially better outcomes for hindlimb fractures (83% return rate) compared to forelimb involvement (67%), and notably poor prognosis for medial forelimb fractures at just 47%. Concurrent suspensory ligament damage further compromised racing prospects, with horses presenting suspensory desmitis achieving only a 63% return rate, suggesting that cartilage and soft tissue involvement at the time of surgery should inform prognostic discussions. Unlike in Standardbreds, previous racing history did not predict post-operative success in Thoroughbreds, indicating that skeletally mature horses with these injuries warrant consideration for arthroscopic intervention regardless of their prior track record. For equine practitioners communicating with owners and trainers, these location-specific findings provide evidence-based guidance: whilst hindlimb apical fractures carry genuinely good prognosis, medial forelimb cases demand candid conversations about substantially reduced probability of return to competitive racing.
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Practical Takeaways
- •Arthroscopic removal of apical sesamoid fragments offers good to excellent prognosis for return to racing in mature Thoroughbreds without severe suspensory damage; hindlimb fractures have significantly better outcomes than forelimb injuries
- •Medial forelimb fractures warrant cautious prognostication and owner communication, as only 47% of these horses return to racing
- •A horse's prior racing record should not be used to predict success after this procedure in Thoroughbreds—individual fracture location and ligament integrity are more predictive
Key Findings
- •77% of treated Thoroughbred racehorses returned to racing after arthroscopic removal of apical sesamoid fracture fragments
- •Hindlimb fractures had 83% return-to-racing rate versus 67% for forelimb fractures
- •Medial forelimb fractures had poorest prognosis at 47% racing return rate
- •Prior racing history did not predict post-operative racing success in mature Thoroughbreds, unlike in Standardbreds