Short- and long-term survival, complications, return to racing, and racing performance of 150 racehorses with medial condylar fractures of the third metacarpal/metatarsal bone treated by internal fixation (2000-2020).

Objective: To report the rate of survival, rate of return to racing, and quality of racing performance following surgical fixation of medial condylar fractures.

Study design: Retrospective study.

Animals: A total of 150 Thoroughbred and Standardbred racehorses surgically treated for medial condylar fracture (100 lag screw fixation, 50 plate fixation).

Methods: Medical records, radiographs, and racing databases (2000-2020) were reviewed to collect signalment, fracture characteristics, fixation methods, survival rate, and complication rate. Change in racing performance was assessed using Wilcoxon rank sum tests.

Results: The short-term survival, long-term survival, and complication rates were 98.7% (148/150), 93.3% (140/150), 12.0% (18/150), respectively. Four horses died of fatal complications, four died from unknown causes, and two were lost to follow up. The prognosis for returning to racing was 71.3% (107/150) (80/100, 80.0% for lag screw fixation; 27/39, 69.2% for plate fixation with plate removal). Post-injury total number of races increased (lag screw fixation) (p < .001) or did not change (plate fixation) (p = .320); post-injury total earnings, average earnings/race, and average speed figure did not change for either fixation type. Additionally, 78.0% of horses increased or maintained their highest race class. Horses with spiral fractures were less likely to return to racing than those with sagittal fractures.

Conclusion: Survival rate was excellent and the rate of returning to racing was favorable, with no decline in performance following injury.

Clinical significance: Owners can expect horses to return to racing in most cases and perform as successfully as they did prior to fracture.