title: Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002).
abstract: BACKGROUND
  Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses.
  
  
  OBJECTIVE
  To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years.
  
  
  METHODS
  Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed.
  
  
  RESULTS
  Sixty-four percent of fractures occurred in the hindlimbs and 36% in the forelimbs. Horses with forelimb fractures had a reduced probability of return to racing (67%) compared to those with hindlimb fractures (83%), but the majority (77%) of treated horses recovered to return to race post operatively. Horses with medial forelimb fractures raced at only a 47% rate; those with suspensory desmitis at 63%. Unlike Standardbreds, there was no difference in probability of racing post operatively between horses that had, and had not, raced preoperatively.
  
  
  CONCLUSIONS
  Data show that arthroscopic removal of apical proximal sesamoid fracture fragments is successful at restoring ability to race in skeletally mature TB horses without evidence of severe suspensory ligament damage. Prognosis for return to racing is excellent (83%) in horses with hindlimb fractures and good (67%) in those with forelimb fractures. Medial fractures of the forelimb have the worst prognosis.
  
  
  CONCLUSIONS
  The determination of prognosis for differing sites in TB racehorses should increase knowledge of apical proximal sesamoid bone fractures and improve communication from veterinarian to owner, and trainer, on the potential for arthroscopic restoration of the ability to race.
authors.affiliation: Rood and Riddle Equine Hospital, Lexington, Kentucky 40580, USA.
authors.forename: L V
authors.initials: LV
authors.lastname: Schnabel
authors.forename: L R
authors.initials: LR
authors.lastname: Bramlage
authors.forename: H O
authors.initials: HO
authors.lastname: Mohammed
authors.forename: R M
authors.initials: RM
authors.lastname: Embertson
authors.forename: A J
authors.initials: AJ
authors.lastname: Ruggles
authors.forename: S A
authors.initials: SA
authors.lastname: Hopper
mesh_terms: D000367:Age Factors; D000818:Animals; D001182:Arthroscopy / Q000379:methods / Q000662:veterinary*; D005260:Female; D005552:Forelimb / Q000293:injuries / Q000601:surgery; D050723:Fractures, Bone / Q000601:surgery / Q000662:veterinary*; D006614:Hindlimb / Q000293:injuries / Q000601:surgery; D006736:Horses / Q000293:injuries / Q000601:surgery*; D008297:Male; D010805:Physical Conditioning, Animal / Q000502:physiology*; D011379:Prognosis; D012189:Retrospective Studies; D012716:Sesamoid Bones / Q000293:injuries* / Q000601:surgery*; D013177:Sports; D016896:Treatment Outcome