Condylar fractures are a large part of practice at Hogan Equine at Fair Winds Farm in Cream Ridge, N.J. Owner Patty Hogan,
VMD, Dipl. ACVS, repairs about 50 condylar fractures a year. "It's the most common fracture we see in Thoroughbred racehorses,"
A recent case in the Thoroughbred racing world was Majesticperfection, who sustained a condylar fracture in September. Alan
J. Nixon, BVSc, MS, Dipl. ACVS, director of the Comparative Orthopaedics Laboratory at Cornell University's College of Veterinary
Medicine, did the surgical repair the same day. "He's resting comfortably after surgery," Nixon notes. "And though the surgery
has put the fracture back together again with every likelihood of complete healing, the horse is going to be retired from
racing, exiting with an impressive race record and strong stud potential."
Preventing breakdowns: Uses of MRI and bone scans are helping to prevent condylar fractures, veterinarians say.
A couple of weeks before, Harbinger, winner of the 2010 King George VI and Queen Elizabeth Stakes at Ascot, England, was retired
after sustaining a similar condylar fracture. Bone scans also revealed that Kentucky Derby winner Super Saver showed marked
activity in all four cannon bones, with a major condylar bruise on the left front fetlock, according to a statement from Larry
Bramlage, DVM, MS, Dipl. ACVS, Rood & Riddle Equine Hospital, Lexington, Ky.
"It's hard to say if condylar fractures are becoming more frequent," says Carter E. Judy, DVM, Dipl. ACVS, Alamo Pintado Equine
Medical Center, Los Olivos, Calif. "At least in California, the type of fractures we're seeing has changed a bit since the
advent of artificial surfaces. We still see condylar fractures but to a much lesser degree, and we're seeing a different configuration
of the fracture type, with the fractures being shorter and thinner than they were previously. In my opinion, they tend not
to be as severe as they were before." Unfortunately, no hard numbers are available to track this potential trend.
"I think these fractures will always be part of our racing scene," Nixon says. "The more you train and race these horses,
the more they seem to get microfractures that predispose them to more complete and even catastrophic fractures. I wish we
could detect microfractures better before they propagate," says Nixon. "The problem with this fracture is that there are areas
that have accumulated stress within the fetlock joint and the metacarpal condyles, primarily along the palmar surfaces."
This particular area is predisposed to a subsequent propagating fracture. As a horse is trained more and runs more races,
a change occurs in the way the bone structure is oriented. It is not a common fracture in 2-year-olds but is quite common
in 3-year-old horses and older. "Bone scan and MRI may help us pick up the early changes that later lead to more complete
fracture," Nixon says.
Data from these diagnostic studies are still being accumulated, but the eventual hope is that these noninvasive studies done
without general anesthesia will provide enough warning of impending fracture that training can be tapered to allow recovery.
"At this stage, we can't say with complete confidence that a fracture is inevitable, but as MRI becomes more available and
more precise, it may well be our best tool for limiting complete condylar fracture," Nixon says.