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Bucked Shins (Sore Shins):
Bucked Shins (Sore Shins):
- Definition: Acute periostitis on the dorsal surface of the third metacarpal bone (cannon bone).
- Etiology: High-strain cyclical fatigue caused by excessive compression on bone that has not remodeled sufficiently to tolerate racing/training stress.
- Risk Factors: Primarily affects young Thoroughbreds (2-year-olds); often occurs sequentially with the left leg affected first due to counterclockwise racing directions.
- Clinical Indicators: Soreness over the dorsal aspect of the cannon bone, particularly after a horse’s first race or high-speed work.
- Diagnosis: Based on history and clinical exam; radiographs determine the amount of periosteal reaction and if dorsal cortical stress fractures are present.
- Management:
- Training Adjustment: Switching to short bursts of speed 2–3 times per week.
- Acute Treatment: Rest, anti-inflammatory analgesics, and cold packs.
- Surgery: Screw placement is the method of choice for treating radiographically visible stress fractures.
Splints (Exostoses of the 2nd and 4th Metacarpal Bones):
Splints (Exostoses of the 2nd and 4th Metacarpal Bones):
- Definition: Periostitis and production of new bone (exostoses) involving the interosseous ligament between the large (3rd) and small (2nd/4th) metacarpal bones.
- Contributing Factors: Concussive trauma, excess training in immature horses, faulty conformation, and improper shoeing.
- Location Trends: Spontaneous cases almost always occur medially; lateral splints are typically caused by blunt trauma or fracture.
- Clinical Presentation:
- Lameness usually occurs only while the splint is actively forming in young horses.
- Early stages show painful subperiosteal swelling on deep palpation; later stages present a visible bony enlargement (exostosis).
- Management:
- Complete rest and anti-inflammatory therapy.
- Intralesional corticosteroids to decrease inflammation and prevent excessive bone growth.
- Surgical removal if the exostosis impinges on the suspensory ligament.
Fracture of the Third Metacarpal (Cannon Bone):
Fracture of the Third Metacarpal (Cannon Bone):
- Condylar Fractures (Most Common):
- Occur in the sagittal plane at the distal articulation (condyle); lateral condyle fractures are most prevalent.
- Signs: Acute lameness after exercise with marked effusion in the fetlock joint.
- Treatment: Lateral fractures are treated with lag screw fixation (treatment of choice) or casting; medial fractures require plate fixation due to their tendency to spiral and propagate proximally.
- Diaphyseal Fractures:
- Unstable and difficult to treat; typically result from pasture trauma.
- Treatment: Open reduction and internal fixation is preferred to prevent the fracture from becoming open due to lack of soft tissue coverage.
- Prognosis: Generally only pursued in foals; prognosis for adult horses is poor.
Fractures of the Splint Bones (Small Metacarpal-Metatarsal):
Fractures of the Splint Bones (Small Metacarpal-Metatarsal):
- Etiology: Caused by direct trauma (kicks/interference) or associated with suspensory desmitis (ligament inflammation).
- Typical Location: Approximately 5 cm from the distal end of the bone.
- Diagnosis: Confirmed via radiography; ultrasonography of the suspensory ligament is critical for an accurate prognosis.
- Management:
- Distal Fractures: Surgical removal of the bone proximal to the fracture site.
- Proximal Fractures: May require surgical stabilization to prevent carpal instability.
- Prognosis: Future performance depends more on the severity of associated suspensory desmitis than the fracture itself.
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