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Review
. 2023 Mar;55(2):171-181.
doi: 10.1111/evj.13599. Epub 2022 Jun 15.

A review of equine tibial fractures

Kristin Bowers  1 , Joshua T Weinhandl  2 , David E Anderson  1
Affiliations
Review

A review of equine tibial fractures

Kristin Bowers et al. Equine Vet J. 2023 Mar.

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.

Keywords: biomechanics; fracture; horse; racehorse; stress fracture; tibia.

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Figures

FIGURE 1
FIGURE 1
Overview of reported prevalence of tibial fracture in racehorses worldwide
FIGURE 2
FIGURE 2
Overview of injury mechanisms and clinical presentation of fatigue‐aetiology and impact‐aetiology tibial fractures in horses
FIGURE 3
FIGURE 3
Compositional and biomechanical properties of the equine tibia that affect fracture initiation and propagation
FIGURE 4
FIGURE 4
Overview of risk factors for tibial fracture; italics signify proposed risk factors that have not been unequivocally proven
See this image and copyright information in PMC

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