Tallon Rose, O'Neill Henry, Bladon Bruce
Donnington Grove Veterinary Group, Newbury, West Berkshire, UK.
Equine Vet J. 2020 Sep;52(5):692-698. doi: 10.1111/evj.13230. Epub 2020 Feb 19.
Sagittal plane slab fractures of the third carpal bone are a recognised injury in the racehorse. Currently no published data exist for the UK Thoroughbred racehorse population.
To document return to racing following sagittal slab fracture of the third carpal bone in a UK-based racehorse population, and to compare conservative and surgical management.
Single centre retrospective study.
Computerised medical and racing records were searched over a 15-year period for Thoroughbred racehorses with a simple sagittal slab fracture of the third carpal bone. Horses with comminuted fractures and short incomplete linear lucencies were excluded. Time from intervention to next race was recorded. Success rates were compared by Fisher's Exact Test and Mann-Whitney U Test.
Forty-seven horses, with 49 fractures met the inclusion criteria. Overall, 27 horses raced following injury (60%). Median time to first start was 251 days (115-600, IQR 109). Fifteen horses with 16 fractures were managed conservatively. Seven horses (47%) raced, 115-508 days following injury (median 240 days, IQR 306). Thirty horses underwent surgery; this involved placement of a single 3.5-mm lag screw under arthroscopic guidance. Twenty horses (67%) raced again 145-600 days following surgery (median 264 days, IQR 102). A higher proportion of horses managed surgically improved their Racing Post Rating (RPR) following injury (14/20), compared with those managed conservatively (1/7, P = .02).
The numbers of horses are small, particularly for those managed conservatively. Treatment was not randomly allocated, and as such several horses which underwent conservative management were subsequently retired for breeding.
This case series indicates that both arthroscopic repair and conservative management of sagittal slab fractures of the third carpal bone allows horses to successfully return to training and racing.
第三腕骨矢状面骨折是赛马中一种公认的损伤。目前，英国纯种赛马群体中尚无已发表的数据。
记录英国赛马群体中第三腕骨矢状面骨折后的重返赛场情况，并比较保守治疗和手术治疗。
单中心回顾性研究。
在15年期间，对计算机化的医疗和赛马记录进行检索，查找患有第三腕骨单纯矢状面骨折的纯种赛马。排除粉碎性骨折和短的不完全线性透亮区的马匹。记录从干预到下一场比赛的时间。通过Fisher精确检验和Mann-Whitney U检验比较成功率。
47匹马，49处骨折符合纳入标准。总体而言，27匹马受伤后参赛（60%）。首次参赛的中位时间为2５1天（115 - 600天，四分位间距109）。15匹马，16处骨折接受保守治疗。7匹马（47%）参赛，受伤后115 - 508天（中位时间240天，四分位间距306）。30匹马接受手术；这包括在关节镜引导下置入一枚3.5毫米拉力螺钉。20匹马（67%）术后145 - 600天再次参赛（中位时间264天，四分位间距102）。与保守治疗的马匹相比，手术治疗的马匹受伤后提高其赛马邮报评分（RPR）的比例更高（14/20），而保守治疗的为（1/7，P = 0.02）。
马匹数量较少，尤其是保守治疗的马匹。治疗未随机分配，因此一些接受保守治疗的马匹随后退役用于繁殖。
该病例系列表明，第三腕骨矢状面骨折的关节镜修复和保守治疗均可使马匹成功恢复训练和参赛。
