Clinical and imaging features of suspected prodromal fracture of the proximal phalanx in three Thoroughbred racehorses

Ramzan, P. H. L.; Powell, S. E.

doi:10.2746/042516409x478695

Cited by 49 publications

(78 citation statements)

References 42 publications

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“…Therefore, the end result of the modelling in response to exercise and remodelling in response to focal microcracks is areas with variable SCB bone density (Martin et al. ; Riggs & Boyde, ; Stover & Murray, ; Ramzan & Powell, ). Although the present study cannot differentiate modelling and remodelling events, the changes of density seen in the CF group are consistent with bone turnover linked to increased fracture risk (de Laet et al.…”

Section: Discussionmentioning

confidence: 99%

“…). As such we propose that the CF group bones were undergoing remodelling at the time of bone failure in the opposite limb, accounting for significant variance in SCB density in this group, which would lead to a decrease in biomechanical integrity and, ultimately, increased propensity to fracture (Riggs & Boyde, ; Firth & Rogers, 2005b; Ramzan & Powell, ; Whitton et al., ; van Oers et al. ; Vickerton et al.…”

Section: Discussionmentioning

confidence: 99%

“…). This view suggests that the acute event is predicated on longer term repetitive loading that promotes bone remodelling that can weaken the bone as it attempts to respond to the low level but frequent stimulus (Riggs & Boyde, ; Firth & Rogers, 2005b; Ramzan & Powell, ; Whitton et al. ; van Oers et al.…”

Section: Introductionmentioning

confidence: 99%

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Does subchondral bone of the equine proximal phalanx adapt to race training?

Noble

Singer²,

Jeffery

2016

Journal of Anatomy

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Sagittal fractures of the first phalanx are a common, potentially catastrophic injury in racehorses. These fractures are often linked to an acute, one time, biomechanical event; however, recent evidence implies that chronic exposure to stress can lead to the accumulation of bony changes that affect the structural integrity of the bone and increase the likelihood of fracture. The aim of the study was to compare variations of two common metrics of bone adaptation - subchondral bone density and thickness across the proximal articular surface of the first phalanx in Thoroughbred horses that (1) raced but never experienced a first phalanx fracture (Raced Control); (2) raced and had experienced fracture of the contralateral first phalanx (Contralateral to Fracture); (3) had never raced or experienced a first phalanx fracture (Unraced Control). A total of 22 first phalangeal bones were sampled post-mortem and imaged using micro-computed tomography calibrated for mineral density measures. Measurements of volumetric subchondral bone mineral density and thickness were taken from images at five sites from medial to lateral, in three coronal planes (25, 50 and 75% dorsal-palmar). At each of the 15 sites, measurements were repeated and averaged across 10 adjacent micro-computed tomography slices of bone, spanning 0.75 mm. The magnitude and variance of these measurements were compared between sites and between cohorts with non-parametric statistical tests. Across the proximal osteochondral surface of the first phalanx, the pattern of subchondral bone volumetric bone mineral density and thickness varied with each coronal section studied. The subchondral bone thickness was greater for the central and dorsal coronal sections, compared with the palmar section. For the race-fit groups (Raced Control and Contralateral to Fracture), the highest volumetric bone mineral density was in the central sagittal groove. The volumetric bone mineral density was significantly greater in the sagittal groove in the central coronal section in the raced than the unraced group. The Contralateral to Fracture group demonstrated significantly greater variance of volumetric bone mineral density compared with the Raced Control and Unraced Control (P < 0.0001), with no difference in variance noted between the Raced Control and Unraced Control groups. There was a small (R rank = 0.3) but significant correlation between subchondral bone volumetric bone mineral density and thickness in the Contralateral to Fracture group (P = 0.005). The findings demonstrate that differences exist in subchondral bone volumetric bone mineral density and thickness across the proximal osteochondral surface of the equine first phalanx in horses with different training histories. The findings also demonstrate that the subchondral bone of the sagittal groove of the equine first phalanx adapts to race-training in the race-fit groups (Raced Control and Contralateral to Fracture) with an increase in volumetric bone mineral density relative to unraced controls. Within the race-trained ...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Does subchondral bone of the equine proximal phalanx adapt to race training?

Noble

Singer²,

Jeffery

2016

Journal of Anatomy

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“…15,19,20,24,26,32,[34][35][36][37][38][39] Evidence of preexisting periosteal callus was noted in association with complete fractures of the scapula, humerus, and tibia for some Quarter Horses of the present study. [46][47][48][49][50][51] Computed tomography has yet to become widely used for the detection of clinical injury apparent in racehorses at the track. 15,24,31,33,[36][37][38]40 Consequently, strategies used for detecting mild injuries that predispose to catastrophic injuries in Thoroughbred racehorses can be applied to Quarter Horse racehorses.…”

Section: Discussionmentioning

confidence: 99%

Fatal musculoskeletal injuries of Quarter Horse racehorses: 314 cases (1990–2007)

Sarrafian¹,

Case²,

Kinde³

et al. 2012

javma

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“…A 0.27 Tesla Hallmarq EQ2 dedicated equine MRI system was used and images were acquired in a standard procedure. The sequences used were described by Ramzan and Powell (2010) for the fetlock. Due to increasing discomfort during the examination the study was finished with a shortened protocol.…”

Section: Diagnostic Imagingmentioning

confidence: 99%

Unusual incomplete frontal plane third metacarpal fracture in a dressage horse

Paschke¹,

Walliser²

2016

PHK

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Summary: Different types and locations of fractures of the third metacarpal bone have been discussed for decades, especially in regard to treatment and prognosis. There is lack of documentation of frontal plane third metacarpal fractures diagnosed by MRI within the extensive previous literature. The present case report describes an incomplete frontal plane third metacarpal fracture in a dressage horse. The A 6 year-old Hanoverian mare was suddenly lame during side passes within a dressage contest. Physical examination revealed a grade 3/5 lameness of the left forelimb. When standing the horse showed a tendency to leg rest. A discrete oedematous swelling from the medioproximal metacarpus to the middle third of the flexor tendons was palpable. Rotation of the phalanx resulted in a mild pain response. Initially a basic set of x-ray images was carried out, which did not show an evident fractureline. To further evaluate the cause of local swelling and lameness a standing MRI examination was carried out with a 0.27 Tesla Hallmarq EQ2 dedicated equine MRI system. In consequence, an incomplete frontal plane fracture of the third metacarpal bone was confirmed. The images depict typical features of acute fractures in MR studies. Angle adapted x-ray images were taken and the fracture line initially obscured by the splint bones became visible. No diagnostic block was performed due to the risk to worsen the incomplete fracture. Conservative management was chosen. During the first four weeks immobilisation was applied and exercise was restricted to box rest for another four weeks. During that time the mare was re-evaluated regarding to lameness in the walk, by MRI and by x-ray images. In the present case conservative management led to complete recovery. The last recheck in the stable took place after 46 weeks by the referring veterinarian. Until that time no signs of secondary osteoarthritis had occurred in follow-up radiographs taken by the referring veterinarian.

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Clinical and imaging features of suspected prodromal fracture of the proximal phalanx in three Thoroughbred racehorses

Cited by 49 publications

References 42 publications

Does subchondral bone of the equine proximal phalanx adapt to race training?

Does subchondral bone of the equine proximal phalanx adapt to race training?

Fatal musculoskeletal injuries of Quarter Horse racehorses: 314 cases (1990–2007)

Unusual incomplete frontal plane third metacarpal fracture in a dressage horse

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