Ramzan P H L, Newton J R, Shepherd M C, Head M J
Beaufort Cottage Stables, High Street, Newmarket, Suffolk CB8 8JS, UK.
Equine Vet J. 2003 Jun;35(4):382-8. doi: 10.2746/042516403776014253.
Tibial stress fractures are an important cause of lameness in the Thoroughbred racehorse. While it is recognised that these injuries can vary in clinical presentation and radiographic or scintigraphic appearance, little has been done to quantify lesion severity. By contrast the scintigraphic grading of tibial stress fractures in human athletes is widely reported and assists in the selection of appropriate management regimes.
To determine the relationship between scintigraphic grade, clinical severity and radiographic appearance of tibial stress fractures.
The current study involved the retrospective analysis of records from 42 Thoroughbreds with abnormal tibial scintigraphic activity.
There was a significant association between lesion site and scintigraphic grade and good correlation of scintigraphic scoring between investigators. No significant association was found between scintigraphic grade and either radiographic grade or degree of lameness.
The study confirmed that radiographic appearance is an unreliable measure of clinical severity or stage of progression of lesions. The scintigraphic grading system used in the study was not of use in defining stress fracture severity in the equine tibia.
Despite this finding, there is clearly a need for prospective investigations to explore the potential for targeted management regimes for tibial injuries based on lesion site or clinical criteria.
胫骨应力性骨折是纯种赛马跛行的重要原因。尽管人们认识到这些损伤在临床表现、影像学或闪烁扫描表现上可能存在差异，但在量化损伤严重程度方面所做的工作很少。相比之下，关于人类运动员胫骨应力性骨折的闪烁扫描分级有广泛报道，且有助于选择合适的治疗方案。
确定胫骨应力性骨折的闪烁扫描分级、临床严重程度和影像学表现之间的关系。
本研究对42匹胫骨闪烁扫描活动异常的纯种马的记录进行回顾性分析。
损伤部位与闪烁扫描分级之间存在显著关联，且研究者之间的闪烁扫描评分具有良好的相关性。未发现闪烁扫描分级与影像学分级或跛行程度之间存在显著关联。
该研究证实，影像学表现是损伤临床严重程度或进展阶段的不可靠指标。本研究中使用的闪烁扫描分级系统在界定马胫骨应力性骨折的严重程度方面并无用处。
尽管有这一发现，但显然需要进行前瞻性研究，以探索基于损伤部位或临床标准对胫骨损伤采取针对性治疗方案的可能性。
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