Smith M R W, Corletto F C, Wright I M
Newmarket Equine Hospital Referrals, Newmarket, Suffolk, UK.
Equine Vet J. 2017 Nov;49(6):784-788. doi: 10.1111/evj.12707. Epub 2017 Jul 6.
Thirty years have elapsed since the last published review of outcome following fracture of the proximal phalanx in Thoroughbred racehorses in the UK and contemporary results are needed to be able to advise of expected outcome.
Collect and analyse outcome data following repair of fractures of the proximal phalanx in Thoroughbred racehorses in the UK.
Retrospective case series.
Case records of all Thoroughbred racehorses admitted to Newmarket Equine Hospital for evaluation of a parasagittal fracture of the proximal phalanx during a 5 years period were reviewed. Follow-up data regarding racing careers was collected for horses that underwent repair. Following exclusion of outliers, cases with incomplete data sets and comminuted fractures, mixed effect logistic regression was used to identify variables affecting returning to racing and odds ratios and confidence intervals calculated.
Of 113 repaired cases, fracture configurations included short incomplete parasagittal (n = 12), long incomplete parasagittal (n = 86), complete parasagittal (n = 12) and comminuted (n = 3). A total of 54 (48%) cases raced after surgery. Horses that fractured at 2 years of age had increased odds of racing following surgery than those older than 2 years of age (OR 1.34; 95% CI 1.13-1.59, P = 0.002). Horses sustaining short incomplete parasagittal fractures had increased odds of racing following surgery compared with those with complete parasagittal fractures (OR 2.62; 95% CI 1.36-5.07, P = 0.006). No horses with comminuted fractures returned to racing.
Data are relevant only to Thoroughbred racehorses in the UK.
Approximately half of the cases in this series raced following surgical repair. More 2-year-old horses raced following surgery, but this likely reflects horses, specifically older horses, passing out of training from unrelated factors. Fracture configuration affects odds of racing, which is relevant to owners when deciding on treatment.
自上次发表关于英国纯种赛马近端指骨骨折预后的综述以来，已经过去了30年，需要当代的结果来提供预期预后的建议。
收集并分析英国纯种赛马近端指骨骨折修复后的预后数据。
回顾性病例系列研究。
回顾了在5年期间入住纽马克特马医院评估近端指骨矢状旁骨折的所有纯种赛马的病例记录。收集了接受修复的马匹的赛马生涯随访数据。在排除异常值、数据集不完整的病例和粉碎性骨折后，使用混合效应逻辑回归来识别影响重返赛场的变量，并计算优势比和置信区间。
在113例修复病例中，骨折类型包括短的不完全矢状旁骨折（n = 12）、长的不完全矢状旁骨折（n = 86）、完全矢状旁骨折（n = 12）和粉碎性骨折（n = 3）。共有54例（48%）病例术后参加了比赛。2岁时骨折的马匹术后参赛的几率高于2岁以上的马匹（优势比1.34；95%置信区间1.13 - 1.59，P = （此处原文可能有误，推测应为P = 0.002））。与完全矢状旁骨折的马匹相比，短的不完全矢状旁骨折的马匹术后参赛几率增加（优势比2.62；95%置信区间1.36 - 5.07，P = 0.006）。没有粉碎性骨折的马匹重返赛场。
数据仅与英国的纯种赛马相关。
本系列中约一半的病例术后参加了比赛。更多2岁的马匹术后参赛，但这可能反映了马匹，特别是老年马匹，因无关因素而停止训练。骨折类型影响参赛几率，这在主人决定治疗方案时具有相关性。
