Risk Factors for Biaxial Proximal Sesamoid Fractures
Because sesamoid fractures are common in Thoroughbred racehorses, researchers are working to better understand them and their predisposing factors. | Photo: iStock
Two tiny bones located at the back of the fetlock—the proximal sesamoid bones—can cause a world of trouble for horses (particularly racehorses) if they’re damaged. The consequences of sesamoid bones fractures can range from time off from training and racing for minor ones to death if a serious injury occurs.

Because sesamoid fractures are common in Thoroughbred racehorses, researchers are working to better understand them and their predisposing factors. Scott E. Palmer, VMD, Dipl. ABVP, the Equine Medical Director for the New York State Gaming Commission, and colleagues recently completed a preliminary study on the risk factors associated with biaxial sesamoid fractures. He presented the results at the 2016 American Association of Equine Practitioners’ Convention, held Dec. 3-7 in Orlando, Florida.

Biaxial proximal sesamoid bone (BPSB) fractures—when the horse breaks both sesamoid bones in the same leg—are severe and often associated with damage or rupture of the suspensory ligament and flexor tendons, which run behind the fetlock joint. In some cases, these fractures also break through the skin, leaving them open to environmental contamination. Surgical repair can be complicated or impossible. As a result, Palmer said, veterinarians’ only option with many of these fractures is euthanasia.

In their study, Palmer and colleagues evaluated the histories of 20 horses with BPSB fractures as well as 40 control horses, which were randomly selected from the fields of the races in which the case horses suffered their catastrophic injuries (the “incident race”). They examined 82 different potential risk factors for each horse to find associations with BPSB fractures

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