Post‐operative performance in Standardbreds after distal splint bone ostectomy with concurrent suspensory ligament branch desmitis

Summary Background Distal splint bone fractures are often complicated by suspensory ligament branch (SLB) desmitis. These combined injuries are known to impair postoperative performance, but contemporary data on prognosis is limited. Objective To evaluate the postoperative performance of Standardbred horses following distal splint bone fracture ostectomy with concurrent SLB desmitis. Study design Retrospective cohort study. Methods Clinical, demographic and racing data were retrospectively analysed from Standardbreds racing in Malta. Horses with a splint bone fracture and concurrent SLB desmitis underwent standing ostectomy and were followed for 24 months. Kaplan–Meier survival analysis assessed the time to return to racing. Pre and postoperative performance was compared within the surgery group and against age‐, sex‐ and breed‐matched controls using mixed effects models. The effects of SLB lesion grade and adjunctive platelet‐rich plasma (PRP) therapy were also analysed. Results Eleven horses [median age 10 years (9‐11)] with fractures of the distal 1/3 of the splint bone and concurrent SLB desmitis were included. The mean time to return to racing was 8.5 months (95% CI: 7.5–9.5). Sixty‐four % (7/11) of horses raced at least three times postoperatively. The surgery group raced significantly more than controls over 24 months (mean difference: 2.2 ± 0.4; p < 0.0001). No difference was found between pre and postoperative performance within the surgery group ( p > 0.05). Horses with grade 1 SLB lesions raced more than those with grade 2 or 3 lesions ( p < 0.0001) and controls ( p = 0.0008). Age and PRP treatment had no effect. Main limitations Small sample size ( n = 11) and lack of conservatively treated group for comparison. Conclusion Older Standardbred horses with distal splint bone fractures and mild SLB desmitis can successfully return to racing. Prognosis is favourable for less severe SLB lesions, emphasising the importance of accurate lesion grading in surgical decision‐making.