Abstracts | EQUINE
Nonsurgical and surgical management of metacarpo/
metatarsophalangeal joint dorsal chip fracture in the
Thoroughbred racehorse
P. H. L. Ramzan, C. E. Wylie
Background
Arthroscopy is considered the treatment of choice for
dorsal osteochondral chip fractures of the metacarpo/
metatarsophalangeal (MCP/MTP) joints in the racehorse;
however, there is no published research on non‐surgical
management of this injury.
Objectives
To compare clinical features, intra‐articular medication
use and return to racing in Thoroughbred racehorses
with non‐surgically (non‐SX) or surgically (SX) managed
MCP/MTP dorsal chip fracture.
Study design
Retrospective observational study conducted between
2006 and 2014.
Methods
Radiographs of Thoroughbred racehorses were
reviewed to identify MCP/MTP dorsal osteochondral
chip fractures. Clinical and intra‐articular medication
data were obtained from veterinary records, and return
to racing data from a public online resource.
Results
the majority were considered by the treating clinician to
be clinically active (n = 85, 86.7%). Significantly more
SX horses had a reported ongoing problem associated
with the affected joint than non‐SX horses (P = 0.002),
however there was no significant difference between
non‐SX and SX horses in the number of intra‐articular
medications of affected joint per month of follow‐up (P
= 0.22). The proportion of horses racing post‐diagnosis
was not significantly different between non‐SX (55/70;
78.6%, 95% CI 69.0, 88.2%) and SX horses (24/28; 85.7%,
95% CI 72.8, 98.73%) (P = 0.57). Median time to first start
following diagnosis for non‐SX (106 days, range 1–326)
was significantly shorter than for SX horses (203 days,
range 9–559) (P = 0.002).
Main limitations
Management technique was not randomised or blinded,
with few surgically managed horses.
Conclusions
The results contribute to the current evidence base used
to guide management of osteochondral chip fractures
of the MCP/MTP joints in the racehorse, and indicate
that non‐surgical management may be a valid treatment
option for some injuries.
A total of 98 MCP/MTP horses with dorsal chip fractures
were identified (70 non‐SX, 28 SX). Median age was 2
years (range 2–7 years). Osteochondral chip fractures
predominantly involved the forelimbs (n = 92, 93.9%) and
• Volume 21 Issue 4 | December 2019 •
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