Emergency Care And Stabilization Of Fractures In The Field Flashcards
What gives a horse a chance?
Stabilizing level 1 splint applied prior to transport to medical facility (don’t just wrap!)
Fracture location
Articular fractures may result in a permanent unsoundness
More favorable prognosis
Small horse
Good temperament
Closed non displaced single fracture plane
Fracture on distal limb
Poor prognosis
Large horse size
Poor temperament
Open fracture planes
Fractures of the upper limb
When should humane euthanasia be used?
Loss of significant blood supply with ST injury
2 important considerations when dealing with a fractured limb
Protect the area from additional contamination
Immediate immobilization
Protecting the fracture from additional contamination (1)
Gentle cleansing or simple lavage with tap water
Bleeding controlled by direct P
Wound bandaging then stabilize the limb
NSAIDs
Immediate Immobilization (2)
Stabilize fracture with splint to prevent further damage (more damage if they bear weight on it)
Correct amount of sedation if needed
Improper splinting
Closed fractures become compound if excessive movement
Movement of fractures = complete deterioration of fracture site and make repair impossible
Level 1 thoracic limb fractures
Phalanges, proximal sesamoid bone and distal metacarpus
Cast or padded bandage and dorsal splint to align the dorsal cortices of the bones of the digit in a straight line
Kimzey Leg Saver splint
From distal carpus to the toe
Tx horses with disruption of the suspensory apparatus
Used for level 1 fractures
What’s another bandage that can be used for level 1 fractures?
Robert Jones bandage with a rigid split in the dorsal aspect of the bandage
Level 2 thoracic limb fractures
Mid forelimb: distal radius to mid metacarpus
Robert Jones bandage with caudal and lateral splints
How should the robert jones bandages be placed with level 2 fractures?
1 inch layer of cotton padding compressed with gauze and elasticon bandage (3x diameter of limb)
Secured with duct tape
Level 3 thoracic limb fractures
Middle and proximal radius (open, difficult and grave)
Robert Jones from the axilla to the toe with a lateral splint that extends up the lateral aspect of the chest and lying against rib cage and caudal splint
What is the goal of splinting level 3 fractures?
Prevent abduction of the injured limb
but euthanasia often recommended
Level 4 thoracic limb fractures
Humerus, ulna and distal scapula (not splinted @ fractured site)
Cannot fix the elbow
How are Level 4 thoracic limb fractures treated
Padded bandage with a caudal splint that extends from the elbow to the ground to fix the carpus
Level 1 hindlimb fractures
Phalanges and distal metatarsus
Robert Jones with plantar splint (easy due to reciprocal apparatus)
Level 2 hindlimb fractures
Middle and proximal metatarsus
Robert Jones with plantar and lateral splint
What provides additional support in Level 2 hindlimb fractures
Tuber calcis acts as a functional extension of the metatarsus
Level 3 hindlimb fractures
Tibia and tarsus (difficult, grave in adults)
Robert Jones bandage with extended lateral splint that prevents abduction and rotation of the limb
Unstable tibial fractures
Flexion of the stifle occurs without flexion of the hock
Create abnormal abduction of the distal portion of the limb
Level 4 hindlimb fractures
Femur or pelvis (not splinted)
