Avulsion Fracture- Sound?

[kly0004]

Have you guys ever known a vet to clear a horse to go back to work that has a fracture? Horse is completely sound and was x rayed for an unrelated reason but was found to have a (probable) avulsion fracture of the long pastern bone. He believes that the fracture is pretty old and said that since it isn’t affecting his soundness that he doesn’t recommend doing anything for it.

I plan on getting a second opinion, but I was just curious if you had ever heard/seen a situation like this and what your opinions are on it. The horse is an older lower level eventing packer.

Thanks!

[Texarkana]

Horses regularly go back to work after an old fracture has healed.

It can be very difficult to tell the age of a fracture from radiographs alone, since many fractures heal with low density fibrous unions that do not appear on x-rays.

When in doubt, it’s common to say “30-60 days before strenuous work” just to be safe.

[kly0004]

So a fracture can heal and still show up as completely separated on an X-ray??? He believed that it was old because all of the edges are rounded.

[Texarkana]

[QUOTE=kly0004;7824694]
So a fracture can heal and still show up as completely separated on an X-ray??? He believed that it was old because all of the edges are rounded.[/QUOTE]

Yup. In horses, many fractures never fully ossify, especially in the lower limbs. That does not generally affect soundness-- in fact, often it has a better prognosis, as ossified fractures can have a lot of issues with arthritis. But since you can’t see the union on x-rays, the fracture line can be strikingly prominent. MRI can better help confirm the degree of healing… or you can just give the horse a little extra time to be on the safe side.

[kly0004]

[QUOTE=Texarkana;7824714]
Yup. In horses, many fractures never fully ossify, especially in the lower limbs. That does not generally affect soundness-- in fact, often it has a better prognosis, as ossified fractures can have a lot of issues with arthritis. But since you can’t see the union on x-rays, the fracture line can be strikingly prominent. MRI can better help confirm the degree of healing… or you can just give the horse a little extra time to be on the safe side.[/QUOTE]

Thank you! I will have to do some research on that, you learn something new everyday!

[kly0004]

[QUOTE=Texarkana;7824714]
Yup. In horses, many fractures never fully ossify, especially in the lower limbs. That does not generally affect soundness-- in fact, often it has a better prognosis, as ossified fractures can have a lot of issues with arthritis. But since you can’t see the union on x-rays, the fracture line can be strikingly prominent. MRI can better help confirm the degree of healing… or you can just give the horse a little extra time to be on the safe side.[/QUOTE]

Are there any sources that you could share that talk about this? I have been looking and haven’t been able to find anything! My late night Googling skills are failing me!

And does anyone else have any input???

[BoyleHeightsKid]

My boy has an old avulsion fracture in his left front, if I remember correctly because it’s been quite a while, I think at the back of his knee… Vet said he probably raced on it. It has never been an issue for him while I’ve had him and that’s been over 10 years now.

[Texarkana]

[QUOTE=kly0004;7825917]
Are there any sources that you could share that talk about this? I have been looking and haven’t been able to find anything! My late night Googling skills are failing me!

And does anyone else have any input???[/QUOTE]

Any veterinary text will talk about fibrous unions. For example, this one:

http://books.google.com/books?id=EU9PAQAAQBAJ&pg=PA387&lpg=PA387&dq="avulsion+fracture"+fibrous+horse&source=bl&ots=J87OG91rVx&sig=ErZJ5r-dQ1TrbAnmf4D98LZv2SE&hl=en&sa=X&ei=2iJOVMi7K5LpggSU_IAw&ved=0CB4Q6AEwAA#v=onepage&q="avulsion%20fracture"%20fibrous%20horse&f=false

The fibrous union results in a persistent fracture line on radiographs.

That passage is specifically talking about a carpal avulsion fracture and not one of the first phalanx, but it does not change the fact that a fracture line can persist forever.

If it were me and I was wanting the horse to do serious performance, I’d want to double check the associated tendon or ligament before completely signing off on a clear bill of health! But seeing a fracture line well after the fact is not abnormal.