Return to racing after surgical management of third carpal bone slab fractures in thoroughbred and standardbred racehorses.
Authors: Doering Alyssa K, Reesink Heidi L, Luedke Lauren K, Moore Christina, Nixon Alan J, Fortier Lisa A, Ducharme Norm G, Ross Michael W, Levine David G, Richardson Dean W, Stefanovski Darko, Ortved Kyla F
Journal: Veterinary surgery : VS
Summary
# Return to Racing After Third Carpal Bone Slab Fracture Surgery Slab fractures of the third carpal bone are a significant concern in racehorses, yet little is known about realistic racing outcomes following surgical repair. Researchers retrospectively analysed 125 horses (86 thoroughbreds and 39 standardbreds) treated surgically for dorsal or sagittal C3 fractures, examining fracture characteristics, surgical technique variables, and postoperative racing performance through online racing databases. Only 43% of the entire cohort returned to racing; when stratified by breed and fracture orientation, thoroughbreds showed notably lower success rates (35% with dorsal fractures, 63% with sagittal fractures) compared to standardbreds (77% with dorsal fractures, though numbers were small). Fracture displacement, third carpal bone lysis, and cartilage damage at the time of surgery all significantly reduced the likelihood of return to racing, whilst the use of 3.5-mm screws and fewer overall screws were associated with improved outcomes. These findings suggest that practitioners should counsel owners conservatively on racing prognosis—particularly for thoroughbreds with dorsal fractures—and emphasise the importance of minimising concurrent cartilage damage during arthroscopic assessment, as concurrent joint pathology appears to be a major limiting factor in postoperative athletic function.
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Practical Takeaways
- •Inform owners that even with surgical repair, only ~42% of thoroughbreds and 67% of standardbreds will race again; set realistic expectations based on concurrent joint pathology present at surgery
- •Document cartilage damage and lysis carefully during surgery as these are strong prognostic indicators; horses with significant degenerative changes have substantially poorer racing prospects
- •Consider screw size and number during fixation planning—smaller screws (3.5-mm) and fewer total screws may optimize biomechanical outcomes for return to racing
Key Findings
- •Only 43% of surgically treated horses with C3 slab fractures returned to racing postoperatively
- •Thoroughbreds had lower racing return rates (35-63%) compared to standardbreds (77% for dorsal fractures)
- •Fracture displacement, C3 lysis, and cartilage damage significantly reduced likelihood of postoperative racing
- •Use of 3.5-mm screws and fewer total screws were associated with improved racing outcomes