Emergency fractures in the horse Flashcards
List 7 things fractures are classified by
location
structures involved
contamination
extent of damage
size of fragment
fracture configuration
displacement, fracture fragments and margins
what is a simple fracture
single fracture line
what is a comminuted fracture
multiple fracture lines
List the causes of fractures in horses
Trauma- stress fractures
developmental- OCD
secondary to other disease e.g. neoplasia or infection
List the places you would expect a fracture in kick injuries
splint bone
stifle bone (tibia, patella)
olecranon
head
what bones can get fractured if horse falls during anaesthetic recovery
femoral or cannon fractures
where do race hprses most commonly get stress fractures
carpal bones
third metacarpal bone
middle phalangeal bone
What do we see with acute, severe, or displaced fractures
will have obvious conformational abnormalities, severe lameness, pain and crepitus at the fracture site
what do articular fractures usually have
joint effusion
List 4 red flags for fractures in horses
are history of trauma (e.g. kick or fall)
acute onset severe lameness
acute onset joint effusion- heat, pain, swelling
palpable crepitus
How can non-displaced stress fractures present
acute onset lameness following exercise which resolves over a few days
can progress to catastrophic fractures is not recognised and treated appropriatley
Decsribe how to tell the difference between crepitus due to air or bone fragments
air under skin- usually diffuse and non-painful
bone fragments- is painful and localised
What is the first line diagnostics for fractures
radiography - minimum of 2 views
ultrasound- main use is in pelvic fractures in racehorses
What is most common cause of acute onset severe lameness in the horse?
Pus in the foot
what can be a complication of articular involvement in fractures
degenerative joint disease
List 6 potential complications of fractures
articular involvement
contamination
soft tissue involvement
unstable
damage to periosteal vascular supply
mechanical overload of contrlateral limb–> laminitis
if you have a small articular fracture what should you do
if not integral part of joint - remove it
Which fractures should you euthanase?
Open comminuted long bone fractures
Complete fractures of the scapula, humerus, radius, femur and tibia in horses over 500kg
when should you consider euthanasia
Fracture is irreparable
Horse cannot be stabilised / transported for appropriate treatment
Quality of life in long term will be poor
Owner can’t afford
Horse won’t tolerate box rest
Horse will not return to previous work
What do fracture classifications help us to do
The classifications help us both plan what to repair or treatment options are, but also what the prognosis is
what structures have specific fracture classifications
pedal bone
navicular bone
olecranon
sesamoid bone
growth plates
what is the gold standard for fracture diagnosis
CT scan
