Fractures in the Horse. Группа авторов
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the abaxial margin of the medial base of fractured bones was up to 3.5 mm more prominent than in non‐fractured bones [78]. Both fractured and non‐fractured bones from horses that had sustained a proximal sesamoid bone fracture had more compact trabecular bone than bones from horses that had died for other reasons [79].
If identification of markers for pre‐fracture change can be detected, using either existing or future imaging modalities, then reliable screening methods for fracture risk can be developed. A key advance will be our ability to correctly identify and select horses for whom such ‘intensive’ screening would be most useful. Identification of a reliable pre‐imaging screening test that effectively rules out a large proportion of horses from being at risk of fracture should therefore be the priority. In other words, a simple, quick and cheap pre‐screening test that has a very high sensitivity (resulting in very few false negatives and a high negative predictive value) is required so that only those horses that are at greatest risk are evaluated. This would effectively increase the prevalence of fracture in the population subjected to the secondary test with resultant improvement in its positive predictive value. A substantial reduction in false positive results increases the reliability of a positive result and thus enhances confidence in making recommendations for future training. Such screening programmes would permit the introduction of interventions, such as alterations to training regimens based on known risk factors that, in turn, should reduce the likelihood of fracture in susceptible horses.
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