10/13/2011 11:45AM

Condylar fractures no longer spell the end of careers


LEXINGTON, Ky. − When Fasig-Tipton announced it will offer Ballerina Stakes winner Hilda’s Passion as a racing or broodmare prospect at its Nov. 6 select mixed sale, news that she might run again caught people’s attention.

Hilda’s Passion won the Ballerina this summer by 9 1/4 lengths, adding a Grade 1 win to an impressive résumé that already included five other stakes wins, including a track record in Gulfstream’s Grade 2 Inside Information Stakes, and more than $790,000 in purse earnings. But she came out of the Ballerina with a non-displaced condylar fracture that many people assumed would end her racing days. Thanks to veterinary advances, that diagnosis rarely spells the end of a runner’s career anymore, orthopedic surgeon Dr. Larry Bramlage said.

“More condylar fractures will race than not, and with her particular injury, we expect them to race in this day and age,” said Bramlage, 60, who performs about 40 condylar fracture surgeries a year at Rood and Riddle Equine Hospital in Lexington, including the repair on Hilda’s Passion on Aug. 31. “We’re not particularly concerned with that injury. We can get those horses back to the same level where they were before when they have the version of the condylar fracture that she has. Condylar fractures have become so much more successful over time for several reasons.

“First of all, we’re better surgeons,” he said. “We’ve gotten more and more experience with the procedure, and so it’s something that’s routine veterinary care these days. Second of all, digital radiography picks up the fractures earlier, so if you look at the whole population, we get an earlier version of the fracture than we used to. So the diagnostic capabilities have helped us. Third, we understand the injury a lot better than we did 15 or 20 years ago. We know they start with bruises on the bottom of the cannon bone, and we know that when they start to get that, the horses are at risk of fractures. So we even circumvent some not with surgery, but we take them out of training before they happen. The ones that do happen, we pick them up before they progress to the point where they become irreparable.”

Technology, such as a better orthopedic screw to close fractures, also has advanced fracture repair.

“The advent of the 5.5-millimeter screw, which is 25 years ago now, that moved us up a lot,” Bramlage said. “It’s a much stronger screw, and you can tighten that screw down a lot tighter than you could the 4.5-millimeter screw, the previous screw. That gives a lot more compression on the joint surface and gives us the ability to close the joint surface better than you used to be able to.”

Some condylar fractures still are irreparable as far as racing is concerned. When Archarcharch sustained a condylar fracture in the 2011 Kentucky Derby, it was displaced and damaged the joint surface more severely, Bramlage noted. Archarcharch underwent surgery and was retired to stud.

“We know when we’ve got that severe an injury that the joint surface cannot survive that amount of damage and still be 100 percent sound,” Bramlage said. “We still aren’t able, and probably never will be able, to repair a fracture that does serious damage to the joint surface and leaves deficits in the joint surface. Those horses we repair, and they become sound broodmares and stallions, but they wouldn’t be sound for racing.”

Even with veterinary advances, it takes time and patience to bring a horse back from injury.

In the case of Hilda’s Passion, it’s been smooth sailing so far, said Frances Relihan of Vinery in Lexington. Relihan, 36, has overseen Hilda’s Passion’s therapy since she arrived at Vinery shortly after her surgery. For Vinery staff, the task has been simultaneously to provide Hilda’s Passion’s therapy, maintain her health as she transitions from racing fitness to a slower-paced rehabilitation, and prepare her for the sale.

“We got her just a couple of days after her surgery on Aug. 31,” Relihan said. “She was obviously very much racing fit. She went for surgery immediately after the Ballerina, and then she came to us. That can be a little challenging sometimes, because horses go from being totally race-fit to being on stall rest, but she has been wonderful to deal with. She just exudes class, and she’s taken the whole thing in her stride.

“We gave her 30 days of stall rest, and we kept that surgery site bandaged for the first 30 days,” she said. “We just started hand-walking her on Oct. 2, so she’s still currently on stall rest with hand-walking. Our number-one priority with her is to keep her settled, keep her enjoying the rehabilitation, letting her down gradually from being race-fit, and try to keep her mind right. She’s been a wonderful patient to deal with.

“For her condition, we have to be careful with the stall rest,” she said. “You want to keep her looking as good as you can, but you don’t want to feed too much concentrated feed where you run the risk of colic, which can be an issue with horses that are coming from being racing fit to being up in a stall.”

Relihan said the filly hasn’t required any tranquilizers during her rehab and is now walking 10 minutes twice a day, plus a little grazing on a lead shank outside her stall.

“We have her in a stall in a very quiet area, and she has a full door so she can look out the back of the stall and the front to see what’s going on in the barn,” Relihan said.

The goal is to give Hilda’s Passion some activity to watch, but not so much that she could become too excited or fractious.
Bramlage will come to Vinery to assess Hilda’s Passion and her progress at the end of the month, Relihan said.

Bramlage said horses with condylar fractures similar to Hilda’s Passion’s can come back to training in three months. Hilda’s Passion is cataloged in Taylor Made’s consignment at the Fasig-Tipton November sale Nov. 6 in Lexington, so it will be up to a new owner whether she really does come back to the races. But at least they’ll have an option that owners 20 years ago could only have dreamed of.

Back then, Bramlage said, the prognosis would have been, “Try it and see.”

“We weren’t confident enough then to say she will come back,” he said. “But enough water has been under the bridge that when you see the post-op films on a condylar fracture where the fracture closes at the surgery table and disappears, you know they’ll be fine.”