Activity type, sex, season, and number of prior starts are associated with proximal sesamoid bone fractures in Thoroughbred racehorses in South Korea.

Activity type, sex, season, and training intensity predict proximal sesamoid fractures in racehorses.

This retrospective case-control study identified multiple risk factors for proximal sesamoid bone fractures in South Korean Thoroughbred racehorses. The investigation included 138 horses with diagnosed fractures and 580 healthy controls (635 observations) between 2020-2025. Racing or trial activities carried substantially higher fracture risk (OR 17.41) compared to racetrack training. Sex influenced susceptibility, with intact males and females demonstrating approximately 2-fold increased risk versus geldings. Exercise-related variables emerged as significant risk factors: horses with ≥6 gallop training days in 120-180 days and ≥37 racetrack training days in 180 days showed elevated fracture risk. Notably, higher cumulative starts and gallop training days were protective, suggesting conditioning effects. Seasonal variation demonstrated increased risk during spring and summer months (OR 1.74). The authors concluded that activity profiling and cumulative workload management strategies may reduce proximal sesamoid bone fracture incidence in racing Thoroughbreds.

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