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Fractures of the greater tubercle of the humerus in horses: 15 cases (1986–2004)

Jason C. Mez DVM1, Robin M. Dabareiner DVM, PhD, DACVS2, Robert C. Cole DVM, DACVR3, and Jeffery P. Watkins DVM, MS, DACVS4
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  • 1 Departments of Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.
  • | 2 Departments of Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.
  • | 3 Department of Radiology, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.
  • | 4 Departments of Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.

Abstract

Objective—To determine clinical and radiographic abnormalities in and outcome of horses with fractures of the greater tubercle of the humerus and to develop a radiographic technique for obtaining a cranioproximal-craniodistal oblique projection of the proximal portion of the humerus in standing horses.

Design—Retrospective case series.

Animals—15 horses.

Procedures—Data collected from medical records included signalment, history, horse use, severity and duration of lameness, radiographic and ultrasonographic findings, treatment, and outcome.

Results—All horses had a history of acute, unilateral lameness. Twelve of 15 had visual or palpable abnormalities in the shoulder region. In 6 of 8 horses, the fracture could be seen on a cranioproximal-craniodistal projection of the proximal portion of the humerus. In 2 horses, this was the only projection on which the fracture could be seen, and in an additional 2, this was the projection on which the fracture could be seen most reliably. Ten horses underwent surgery (fragment removal, 7; open reduction and internal fixation, 2; and exploration without fragment removal, 1), and 5 were treated with variable periods of stall rest and turnout. Eleven horses returned to athletic use, including 9 of the 10 treated surgically and 2 of the 5 treated without surgery.

Conclusions and Clinical Relevance—Results suggested that horses with fractures of the greater tubercle of the humerus can return to athletic soundness following treatment and emphasized the need for obtaining a cranioproximal-craniodistal radiographic projection of the proximal portion of the humerus in horses suspected to have an injury in this region.

Abstract

Objective—To determine clinical and radiographic abnormalities in and outcome of horses with fractures of the greater tubercle of the humerus and to develop a radiographic technique for obtaining a cranioproximal-craniodistal oblique projection of the proximal portion of the humerus in standing horses.

Design—Retrospective case series.

Animals—15 horses.

Procedures—Data collected from medical records included signalment, history, horse use, severity and duration of lameness, radiographic and ultrasonographic findings, treatment, and outcome.

Results—All horses had a history of acute, unilateral lameness. Twelve of 15 had visual or palpable abnormalities in the shoulder region. In 6 of 8 horses, the fracture could be seen on a cranioproximal-craniodistal projection of the proximal portion of the humerus. In 2 horses, this was the only projection on which the fracture could be seen, and in an additional 2, this was the projection on which the fracture could be seen most reliably. Ten horses underwent surgery (fragment removal, 7; open reduction and internal fixation, 2; and exploration without fragment removal, 1), and 5 were treated with variable periods of stall rest and turnout. Eleven horses returned to athletic use, including 9 of the 10 treated surgically and 2 of the 5 treated without surgery.

Conclusions and Clinical Relevance—Results suggested that horses with fractures of the greater tubercle of the humerus can return to athletic soundness following treatment and emphasized the need for obtaining a cranioproximal-craniodistal radiographic projection of the proximal portion of the humerus in horses suspected to have an injury in this region.

Contributor Notes

Address correspondence to Dr. Mez.