Pelvic fractures in horses are an uncommon injury, most often occurring in horses that undergo repetitive loading in training and competition. This stress can cause microdamage to bones that can interfere with remodeling, weakening the bone and leading to fractures.
Though most athletically induced pelvic fractures occur in racehorses, endurance horses have also been shown to experience these breaks.
A study by Dr. Massimo Puccetti, associate veterinarian for the Dubai Equine Hospital, investigated pelvic fatigue fractures in endurance horses in the United Arab Emirates from January 2012 to March 2020. He hypothesized that training in deep sand may influence the fractures.
He and a team of researchers used 60 endurance horses that were between 5 and 18 years old in the study; 57 percent of the horses were Anglo-Arab and 43 percent were pure Arabian. Forty percent of the horses were competing at novice or intermediate levels and 52 percent of the horses had musculoskeletal injuries in a location other than the horse's pelvis.
Horses used in the study were lame or had intermittent lameness; they also had poor engagement; a reluctance to walk or trot; weight loss; and an irregular trot or canter. Some were eliminated from competition because of metabolic disorders or gait abnormalities.
The team inspected and palpated the horses, then asked them to walk in both straight lines and circles. Horses that were able were asked to trot on a straight line. Each horse was then assigned a lameness score based on the American Association Equine Practitioners (AAEP) scale of 0 to 5. A diagnostic ultrasound was also used on the horses to identify bone stress and fatigue fracture.
Bone stress injury or fatigue fractures were found in 58 percent of the cases after they had completed a training session while 42 percent of injuries or fractures were found during or after a competition.
Two-thirds of the horses developed pelvic injuries after their first year of training or competition in the UAE. The authors noted that deep sand affects the way horses move and how their muscles develop.
In total, 103 pelvic bone injuries or fatigue fractures were found by ultrasound. Injuries were found in the iliac wing, tuber ischiadicum, and pubis. For every increase in lameness grade, the risk of bone-stress injury and/or fatigue fractures of the pelvic floor increased by 208 percent.
The most common location of isolated fatigue fracture was the iliac wing. Half of these injuries occurred bilaterally, similar to findings in Thoroughbred racehorses. The second most common location affected by fracture was the pubis; this injury is not common in Thoroughbred racehorses.
In study horses, 62 percent of cases returned to successful competition after rest and rehabilitation; 20 percent of study horses retired for unrelated reasons, three horses retired because of their fractures, and two horses were euthanized because of the extent of their injuries. Six horses were still in rehabilitation at the time of the study.
The study concluded that endurance horses that train and compete in deep sand are at risk of pelvic fractures or bone-stress injuries. In the UAE, horses are trained at the canter for 45 minutes up to 4 hours a day for several days a week, usually in sand that is at least 4 inches deep. Though sand decreases impact forces and loading rate on the limbs, it does amplify muscle strain.
The study team recommended that trainers allow time for horses to adjust to different footing; this will prevent microdamage to tissues and subsequent injury.
Read more at EquiManagement.
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