Clinical evaluation of a titanium, headless variable-pitched tapered cannulated compression screw for repair of frontal plane slab fractures of the third carpal bone in thoroughbred racehorses.
Authors: Hirsch Jonathan E, Galuppo Larry D, Graham Lindsay E, Simpson Edwin L, Ferraro Gregory L
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Third carpal bone slab fractures represent a significant career-threatening injury in racing Thoroughbreds, and surgical stabilisation with headless compression screws offers a potential route back to competition. Between 1999 and 2004, Hirsch and colleagues retrospectively evaluated 17 Thoroughbreds (mean age 3.3 years) that underwent repair of frontal plane C3 slab fractures using the Acutrak titanium screw system, tracking surgical outcomes, return-to-racing timelines, and subsequent race performance. Twelve of the fifteen horses with pre-injury racing records successfully returned to racing after an average interval of 349 days, with horses that resumed competition actually completing significantly more race starts post-operatively (median 6.5 versus 3.5 pre-injury; P=.04) and maintaining comparable earnings per start, suggesting the repair did not compromise long-term athletic function. The titanium headless design with variable pitch proved effective at achieving adequate fracture reduction and interfragmentary stability whilst minimising complications associated with screw head prominence irritating carpal soft tissues. For practitioners managing C3 slab fractures in racing stock, these findings support the Acutrak system as a viable technique when conservative management is not an option, though the relatively small cohort and specific population (Thoroughbred racehorses) means applicability to other equine disciplines warrants further investigation.
Read the full abstract on PubMed
Practical Takeaways
- •Acutrak screw fixation offers a reliable surgical option for C3 slab fractures with good return-to-racing rates (80%) in thoroughbreds
- •Plan for approximately 11-12 months rehabilitation time before return to racing, though individual recovery varies widely (range 196-653 days)
- •Horses that do return to racing maintain competitive earning capacity, making this a worthwhile investment for valuable racing animals
Key Findings
- •12 of 15 horses (80%) that raced before injury returned to racing after Acutrak screw repair
- •Mean time to first race start was 349.3 days post-operatively
- •Horses returning to racing had significantly more starts post-repair (median 6.5 vs 3.5 pre-repair, P=0.04)
- •Earnings per start did not decrease after repair (median $2452 vs $3061 pre-repair, P=0.30)