Short- and long-term survival, complications, return to racing, and racing performance of 150 racehorses with medial condylar fractures of the third metacarpal/metatarsal bone treated by internal fixation (2000-2020).
Authors: Ruspi Bianca D, Bramlage Larry R, Ruggles Alan J, Slone Stacey A
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Surgical Fixation of Medial Condylar Fractures in Racehorses Medial condylar fractures of the third metacarpal and metatarsal bones represent a significant challenge in racehorse orthopaedics, yet limited data exists on long-term prognosis following surgical repair. This retrospective analysis of 150 Thoroughbred and Standardbred racehorses treated between 2000 and 2020 compared outcomes between lag screw fixation (n=100) and plate fixation (n=50), evaluating survival rates, return to racing, and subsequent performance metrics including race frequency, earnings, and speed figures. Short-term and long-term survival rates were excellent at 98.7% and 93.3% respectively, with a modest complication rate of 12%; crucially, 71.3% of horses returned to racing, with lag screw fixation demonstrating superior return rates (80.0%) compared to plate fixation with removal (69.2%). Post-injury racing performance remained stable or improved—horses treated with lag screws increased their total number of races (p<0.001), whilst 78% of all horses maintained or improved their highest race class, with no decline in earnings per race or speed figures. Fracture morphology influenced outcome, with spiral fractures showing lower return-to-racing rates than sagittal fractures, suggesting this classification should inform prognostic counselling. These findings provide robust evidence that medial condylar fractures carry a genuinely favourable prognosis when surgically managed, allowing owners and trainers realistic expectations of functional recovery and competitive performance restoration.
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Practical Takeaways
- •Medial condylar fractures treated surgically have excellent survival outcomes (93-99%) and most horses (71%) return to racing successfully
- •Lag screw fixation shows slightly better return-to-racing rates (80%) than plate fixation (69%), which may inform treatment selection
- •Horses that do return to racing perform at pre-injury levels without decline in earnings or speed, making this a viable treatment for racing prospects
Key Findings
- •Short-term survival rate was 98.7% (148/150) and long-term survival was 93.3% (140/150) following surgical fixation
- •71.3% of horses (107/150) returned to racing, with 80.0% success for lag screw fixation versus 69.2% for plate fixation
- •Post-injury racing performance did not decline; horses maintained or improved race class in 78.0% of cases
- •Spiral fractures had significantly lower return-to-racing rates compared to sagittal fractures