Third metacarpal dorsal stress fractures

Metacarpal stress fractures are a complication and consequence of the “bucked shin complex,” and are a frequent occurrence in three-year-old Thoroughbred race horses. Stress fractures are usually detected in three year-olds and may represent the effect of stress accumulation and sudden increase in porosity associated with a return to training. History and clinical examination indicate tenderness or soreness of the left or both third metacarpal bones following high-speed work. An understanding of the etiology, pathomechanics, and pathogenesis of bone fatigue failure in the Thoroughbred racehorse would be helpful in determining treatment modalities and training regimens. Stress fractures are usually seen six months to one year following the initial bucked shin problem. Nonsurgical treatments involve controlled exercise, directed at trying to remodel bone and heal the fracture. The timing of return to exercise and racing is a difficult decision for those involved in both the surgical and nonsurgical treatment of these incomplete cortical fractures.