Large Animal Clinical Sciences, University of Tennessee College of Veterinary Medicine, Knoxville, Tennessee, USA.
Department of Kinesiology, Recreation, and Sport Studies, University of Tennessee, Knoxville, Tennessee, USA.
Equine Vet J. 2023 Mar;55(2):171-181. doi: 10.1111/evj.13599. Epub 2022 Jun 15.
Equine tibial fractures are relatively infrequent in racing and non-racing sport horses, but limitations in successful treatment of tibial fractures in adult horses result in relatively high mortality compared with other musculoskeletal injuries. The aetiology of tibial fracture can be classified into two general categories: traumatic impact or fatigue failure. Tibial stress fractures, also known as fatigue fractures, are often rated as the second most common stress fracture in racing Thoroughbreds; young age, early stage in race training, and initiation of training after a period of rest are the reported risk factors. Both impact and fatigue fracture propagation are dependent on the magnitude of force applied and on the local composition/alignment of mineralised collagen in the tibial lamella. Extensive research has characterised the pattern of strain distribution and stress remodelling within the equine tibia, but in vivo measurement of load and angular moments are currently not feasible. Further research is warranted to correlate biomechanical theory of tibia fatigue fracture propagation with current histopathological data. Preventative measures for fatigue fractures aim to optimise diagnostic efficiency, reduce the interval between injury and diagnosis and modify racing and training conditions to reduce non-specific fracture risk. Treatment options for complete tibial fractures in adult horses are limited, but with careful case selection, successful outcomes have been reported after open reduction and internal fixation. On the other hand, tibial stress fractures and minimally displaced incomplete fractures are typically treated conservatively and have good prognosis for athletic recovery. This review aims to describe the current literature regarding tibial fracture aetiology, prevalence, risk factors, fracture biomechanics, treatment, prognosis and prevention.
马胫骨骨折在赛马和非赛马运动马中相对少见，但由于成年马胫骨骨折治疗效果不理想，其死亡率相对其他肌肉骨骼损伤较高。胫骨骨折的病因可分为两类：创伤性冲击或疲劳性失效。胫骨应力性骨折，也称为疲劳性骨折，通常被认为是赛马纯种马中第二常见的应力性骨折；年龄较小、训练早期和休息一段时间后开始训练是报道的风险因素。冲击和疲劳性骨折的扩展都取决于所施加力的大小以及胫骨板层中矿化胶原的局部组成/排列。大量研究已经描述了马胫骨内应变分布和应力重塑的模式，但目前无法对负载和角动量进行体内测量。需要进一步的研究将胫骨疲劳性骨折扩展的生物力学理论与当前的组织病理学数据相关联。疲劳性骨折的预防措施旨在提高诊断效率，减少损伤和诊断之间的间隔，并改变赛马和训练条件，以降低非特异性骨折的风险。成年马完全胫骨骨折的治疗选择有限，但经过精心选择病例，已经有报道称开放复位和内固定后可获得成功的结果。另一方面，胫骨应力性骨折和轻度移位不完全骨折通常采用保守治疗，对运动恢复有良好的预后。本综述旨在描述胫骨骨折病因、患病率、风险因素、骨折生物力学、治疗、预后和预防的现有文献。
