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Bone stress injuries and fatigue fractures of the pelvis in endurance horses

Isolated bone stress injuries and/or fatigue fractures of the ileum were the commonest followed by multiple pelvic bones involvement


The pelvis by ultrasound was reviewed. The bone stress injuries and fatigue fractures were classified as affecting the iliac wing, the iliac shaft, the tuber ischiadicum, the rest of the ischium or the pubis and subdivided in four fracture configurations: isolated iliac fracture, isolated fracture of the floor of the pelvis, isolated tuber ischiadicum fracture and multiple fractures.

Descriptive statistics were performed overall and on fracture configurations for age, sex, breed, level of activity, affected limbs, previous injuries, development of the injury, seasons in the UAE, physical and dynamic findings and outcome. For each fracture configuration and the outcome, multivariable logistic regression models were developed after univariable logistic regression and collinearity analyses. Significance was set at p≤0.05.

Retrospective case series. Sixty endurance horses were included; 48% (95% CI: 36-61%) had isolated iliac fracture, 17% (7-26%) isolated fracture of the floor of the pelvis, 15% (6-24%) isolated tuber ischiadicum fracture and 20% (10-30%) had multiple fractures. Breed (OR, 4.42; 95%CI, 1.02-19.57) was significantly associated with isolated iliac fracture and asymmetry of bone landmarks (OR, 7.42; 95% CI 1.47-37.45) with isolated tuber ischiadicum fracture. Degree of lameness (OR, 3.08; 95% CI, 1.07-8.9) and trotting on three tracks (OR, 8.62; 95% CI, 1.43-51.9) were significantly associated with the diagnosis of isolated fracture of the floor of the pelvis.

Bone stress injuries and fatigue fractures of the pelvis can affect endurance horses trained and competing on deep sand. Isolated bone stress injuries and/or fatigue fractures of the ileum were the commonest followed by multiple pelvic bones involvement. The presence of lameness and trotting on three tracks suggest the presence of bone stress injuries and/or fatigue fractures of the floor of the pelvis; asymmetry of bony landmarks is more commonly detected in horses with bone stress injuries and/or fatigue fractures of the tuber ischiadicum.


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