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Shan R, Johnston AS, Rosanowski SM, O'Shea J, Riggs CM. Stress fracture of the palmar, distal cortex of the third metacarpal bone: A diagnostic challenge with a good prognosis. Equine Vet J 2021; 54:74-81. [PMID: 33454998 DOI: 10.1111/evj.13426] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 01/03/2021] [Accepted: 01/10/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Transverse stress fracture of the palmar cortex of the distal aspect of the third metacarpal bone (TSF PCD McIII) is poorly documented. OBJECTIVES To describe the typical signalment of this injury, the common clinical and radiological signs and prognosis. STUDY DESIGN A retrospective hospital-based case series with follow-up of racing records. METHODS All cases of TSF PCD McIII diagnosed among racehorses in training at the Hong Kong Jockey Club between 2011 and 2019 were identified. Clinical records were reviewed and documented signs were recorded for each case. Findings from a predefined list of radiological features were listed. Descriptive statistics were used to describe the age and training profile of horses, the clinical and radiological findings and time to return to ridden exercise. RESULTS Twenty-three cases (n = 23) were identified. The majority (57%) had recently started or returned to training from a break and 35% (n = 8) of cases had not yet undertaken timed gallops at the time of injury. Most cases (20/23; 87%) were lame; in nine (39%), lameness was severe. Localised swelling of superficial soft tissues was reported in 15/23 (65%) cases. Pain on palpation of the distal McIII was present in 15/23 (65%) cases and in response to fetlock flexion in 12/23 (52%). Diffuse, localised increase in radiopacity, disruption to the outline of the bone periosteal surface and outward displacement of the button of the splint bone were common radiological features in early cases (70%, 67% and 67% of all cases). Sixty-one per cent of cases (14/23) were initially misdiagnosed. Most horses (n = 18/23) resumed training and racing after a median of 83 and 246 days. MAIN LIMITATIONS Clinical notes were not consistent between cases. Radiographs were taken at different times. CONCLUSIONS Horses commencing training are at risk of TSF PCD McIII, which presents with confusing clinical signs and subtle radiological findings. The long-term outlook is favourable.
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Affiliation(s)
- Ran Shan
- Veterinary Clinical Services, Equine Hospital, Hong Kong Jockey Club, Hong Kong SAR
| | - Anna S Johnston
- Centre for Applied One Health Research and Policy Advice, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR
| | - Sarah M Rosanowski
- Centre for Applied One Health Research and Policy Advice, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR.,EVC Limited, Hong Kong SAR
| | - John O'Shea
- Veterinary Clinical Services, Equine Hospital, Hong Kong Jockey Club, Hong Kong SAR
| | - Christopher M Riggs
- Veterinary Clinical Services, Equine Hospital, Hong Kong Jockey Club, Hong Kong SAR
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Gray SN, Spriet M, Garcia TC, Uzal FA, Stover SM. Preexisting lesions associated with complete diaphyseal fractures of the third metacarpal bone in 12 Thoroughbred racehorses. J Vet Diagn Invest 2017; 29:437-441. [DOI: 10.1177/1040638717704866] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We characterized features of complete diaphyseal fractures of third metacarpal bones in Thoroughbred racehorses. Given that stress fractures are known to occur in the third metacarpal bone, an additional aim was to determine if complete fractures are associated with signs of a preexisting incomplete stress fracture. Bilateral metacarpi from 12 Thoroughbred racehorses euthanized because of complete unilateral metacarpal diaphyseal fracture were examined visually and radiographically. Open, comminuted, transverse or short oblique fractures occurred in the middle of the diaphysis or supracondylar region. Periosteal surface discoloration and bone callus formation contiguous with the fracture line were present in fractured bones. All contralateral intact metacarpi had gross anatomic lesions, and 10 had radiographic abnormalities similar to those observed on fractured metacarpi. Catastrophic metacarpal fractures occurred in racehorses with bilateral evidence of preexisting bone injury.
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Affiliation(s)
- Sarah N. Gray
- Veterinary Medical Teaching Hospital (Gray), School of Veterinary Medicine, University of California, Davis, CA
- Department of Radiological and Surgical Sciences (Spriet), School of Veterinary Medicine, University of California, Davis, CA
- Department of Anatomy, Physiology, and Cell Biology (Garcia, Stover), School of Veterinary Medicine, University of California, Davis, CA
- California Animal Health and Food Safety Laboratory System (Uzal), School of Veterinary Medicine, University of California, Davis, CA
- Ballarat Veterinary Practice, Miners Rest, Ballarat, Victoria, Australia (Gray), School of Veterinary Medicine, University of California, Davis, CA
| | - Mathieu Spriet
- Veterinary Medical Teaching Hospital (Gray), School of Veterinary Medicine, University of California, Davis, CA
- Department of Radiological and Surgical Sciences (Spriet), School of Veterinary Medicine, University of California, Davis, CA
- Department of Anatomy, Physiology, and Cell Biology (Garcia, Stover), School of Veterinary Medicine, University of California, Davis, CA
- California Animal Health and Food Safety Laboratory System (Uzal), School of Veterinary Medicine, University of California, Davis, CA
- Ballarat Veterinary Practice, Miners Rest, Ballarat, Victoria, Australia (Gray), School of Veterinary Medicine, University of California, Davis, CA
| | - Tanya C. Garcia
- Veterinary Medical Teaching Hospital (Gray), School of Veterinary Medicine, University of California, Davis, CA
- Department of Radiological and Surgical Sciences (Spriet), School of Veterinary Medicine, University of California, Davis, CA
- Department of Anatomy, Physiology, and Cell Biology (Garcia, Stover), School of Veterinary Medicine, University of California, Davis, CA
- California Animal Health and Food Safety Laboratory System (Uzal), School of Veterinary Medicine, University of California, Davis, CA
- Ballarat Veterinary Practice, Miners Rest, Ballarat, Victoria, Australia (Gray), School of Veterinary Medicine, University of California, Davis, CA
| | - Francisco A. Uzal
- Veterinary Medical Teaching Hospital (Gray), School of Veterinary Medicine, University of California, Davis, CA
- Department of Radiological and Surgical Sciences (Spriet), School of Veterinary Medicine, University of California, Davis, CA
- Department of Anatomy, Physiology, and Cell Biology (Garcia, Stover), School of Veterinary Medicine, University of California, Davis, CA
- California Animal Health and Food Safety Laboratory System (Uzal), School of Veterinary Medicine, University of California, Davis, CA
- Ballarat Veterinary Practice, Miners Rest, Ballarat, Victoria, Australia (Gray), School of Veterinary Medicine, University of California, Davis, CA
| | - Susan M. Stover
- Veterinary Medical Teaching Hospital (Gray), School of Veterinary Medicine, University of California, Davis, CA
- Department of Radiological and Surgical Sciences (Spriet), School of Veterinary Medicine, University of California, Davis, CA
- Department of Anatomy, Physiology, and Cell Biology (Garcia, Stover), School of Veterinary Medicine, University of California, Davis, CA
- California Animal Health and Food Safety Laboratory System (Uzal), School of Veterinary Medicine, University of California, Davis, CA
- Ballarat Veterinary Practice, Miners Rest, Ballarat, Victoria, Australia (Gray), School of Veterinary Medicine, University of California, Davis, CA
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