Objective To determine the prevalence of surgical site infection (SSI) after internal fixation and to identify risk factors for SSI and nonsurvival. Study design Retrospective study. Animals One hundred fifty‐five horses with long bone fractures or arthrodesis treated by internal fixation at 1 hospital between 2008–2016. Methods Signalment, diagnosis, surgical repair, surgeon, surgical time, antimicrobial use, SSI onset, bacterial identification, and adjunct treatments were recorded. Perioperative variables were analyzed to identify risk factors associated with outcomes. Results Surgical‐site infection was reported in 22 of 155 (14.2%) horses, which is lower than what has been previously reported (P = .003). Horses with fetlock arthrodesis or ulnar fracture were more likely to develop SSI. Local prophylactic antimicrobial therapy was associated with an increased risk of SSI. Horses with SSI were 12 times (P < .0001) less likely to survive to discharge than horses without SSI. Horses with a fetlock or carpal arthrodesis or those with radial/humeral/femoral fractures were less likely to survive. No association was identified between open fractures, open reduction and internal fixation, or surgical times and SSI. Conclusion The prevalence of SSI in this population was lower than what has been previously reported. Horses with fetlock or carpal arthrodesis or radial/humeral/femoral fractures were at increased risk for SSI and/or nonsurvival to discharge. A protective role of local antimicrobial therapy for SSI could not be established. Clinical relevance The impact of SSI on outcomes of cases of equine internal fixation remains substantial. Identification of cases at higher risk of SSI should influence surgical technique, postoperative management, and early intervention when SSI is suspected. Additional investigation is warranted regarding local antimicrobial therapy.

Background Subchondral bone pathology is common in Thoroughbred racehorses and believed to precede more serious injury. Early identification of pathology is critical to allow for intervention. Objectives To determine interobserver variability of fetlock subchondral bone lesions using cone beam and fan beam computed tomography (CBCT, FBCT) and to validate a robotics‐controlled CBCT to identify fetlock subchondral bone pathology in the Thoroughbred racehorse. Study design Prospective cohort study. Methods FBCT and CBCT images were acquired of 25 metacarpo‐/metatarsophalangeal joints of Thoroughbred racehorses. Images were analysed for subchondral bone lesions commonly identified in Thoroughbred fetlocks by an imaging specialist and surgery specialist. Interobserver and intermodality equivalence were determined with a Pearson correlation analysis and Bland‐Altman equivalence test. Results Interobserver FBCT correlation was significant (P < .05) for 19 of 25 variables (Pearson R mean 0.77). Concordance was significant for all 25 variables (Bland Altman average difference 0.28 ± 0.21 mm). Interobserver CBCT correlation was significant for 21 of 25 variables (Pearson R mean 0.73). Concordance was significant for all variables (Bland Altman average difference 0.07 ± 1.90 mm). Intermodality (FBCT vs CBCT) correlation and concordance was significant for all variables as interpreted by the radiologist (Pearson R mean of 0.72, Bland Altman average difference 0.21 ± 0.47 mm). Intermodality correlation was significant for 19 of 25 variables as interpreted by the surgeon (Pearson R mean of 0.72). Concordance was significant for all variables (Bland Altman average difference 0.49 ± 0.52 mm). Main limitations Neither FBCT nor CBCT images were compared with other imaging modalities/histopathology; limited number of cases included; inconsistent agreement of small lesions in specific categories. Conclusions Standing CBCT is a valid diagnostic modality to identify subchondral bone lesions in Thoroughbred fetlocks. This technology may provide valuable information regarding the development and progression of fetlock pathology and yield insight into predisposing factors leading to more severe pathology.

The use of 3 short LCP should be considered as a strategy to facilitate pancarpal or partial carpal arthrodesis by providing superior stability without placement of implants in the diaphysis of the radius and third metacarpus.

Objective To report an epiglottopexy technique for the treatment of epiglottic retroversion (ER) in 2 horses. Study design Case report. Animals A 2‐year‐old thoroughbred gelding and a 6‐year‐old standardbred gelding, both with ER. Methods Epiglottic retroversion was diagnosed via exercising endoscopic examination in both horses. Epiglottopexy technique was performed in both cases. Results Both horses returned to previous racing class within 1 year after surgery. Repeat exercising endoscopy of 1 horse 6 months postoperatively revealed resolution of the ER. Conclusion Epiglottopexy should be considered for treatment of ER in the equine athlete. Clinical significance Previously reported surgical techniques for ER in the equine athlete have not resulted in horses returning to previous performance level. The technique reported here resulted in both horses achieving athletic status.

Summary Background Epiglottic entrapment can occur in yearling Thoroughbreds (TB); however, race performance following surgical correction is unknown. Objectives To determine the race performance of horses treated surgically for epiglottic entrapment as yearlings as compared to an untreated cohort. A second objective was to identify risk factors for treated horses not racing post‐operatively. Study design Retrospective cohort and case–control studies. Methods Medical (1989–2014) and race records of 66 treated TB racehorses were reviewed. Observed abnormalities on pre‐ and post‐operative endoscopic images and surgical method were recorded. Race records (EquineLine) were recorded. Racing performance of treated yearling TBs and two of their maternal half‐siblings, which were used as the untreated cohort, was evaluated in a cohort study. A case–control study was used to investigate risk factors for not racing post‐operatively among treated horses. Quarterly starts and earnings were compared to an untreated cohort. Survival analysis was used to assess career longevity. Rates of racing and earnings were compared between groups using Poisson and negative binomial regression respectively. Associations between clinical variables and not racing post‐surgery were evaluated using logistic regression. Results Sixty‐six treated horses were identified, 65 of which had at least one half‐sibling. Proportions of horses that raced were similar for treated and maternal cohorts (70.0 vs. 70.8%, P = 0.9). Treated horses performed similarly to untreated horses. In treated horses, epiglottic entrapment with abnormal right arytenoid movement was associated with never racing (OR 15.40, 95% CI 1.64–144.23, P = 0.02). More females were affected by epiglottic entrapment than males (47/66 vs. 19/66 respectively, P<0.001). Main limitations The retrospective design over a prolonged period of time with cases obtained from a single hospital population. Low case numbers likely influenced the outcome of the multivariable analysis. Conclusions Thoroughbred racehorses treated in their yearling year for epiglottic entrapment had no differences in performance variables compared to their untreated cohort. Epiglottic entrapment with abnormal right arytenoid movement might decrease odds of racing post‐operatively.

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