A review of equine tibial fractures

Abstract

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.

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“…Bowers et al . (2023) 20 revisa el conocimiento actual de las fracturas de tibia en equinos e identifica factores de riesgo para tanto las etiologías por impacto traumático y relacionadas a la fatiga. Solo a través del entendimiento de los factores de riesgo asociados, las fracturas pueden ser efectivamente diagnosticadas, ojala en el estado pródromo, y a largo plazo, medidas de prevención pueden ser implementadas para reducir las probabilidades de lesiones en la pista de carrera.…”

“…In combination with these highlighted themes and as the social licence of equestrian sport finds itself more in the media spotlight than ever before, our remit must expand to incorporate injury prevention in addition to the classical ‘fire brigade response’, if we are to ensure the welfare of our equine athletes. Bowers et al 20 review the current knowledge on equine tibial fractures and identify risk factors for both their traumatic impact‐, and fatigue‐related, aetiologies. Only through increasing the understanding of associated risk factors can fractures be effectively diagnosed, hopefully at the prodromal stage, and longer‐term, can preventative measures be implemented to reduce injury rates on the racetrack.…”