Exam 1 - Equine Common Fractures Flashcards
what are the 3 big options for a horse with a fracture?
conservative treatment
surgery
euthanasia
what are the objectives of any surgical repair of a fracture?
want appropriate biological viability - intact blood supply
mechanical strength - strong enough fixation post-op for weight bearing
stability!!!!!
why is fracture stability so important in equine fracture repair?
stability = comfortable horse
uncomfortable horse = likely to founder
need to have a stable fracture that is non-infected & get horse comfortable to avoid any support limb issues
what are the 3 main types of fractures discussed in this lecture?
nondisplaced - incomplete or complete
displaced
articular
when do we commonly see non-displaced fractures in adult horses?
blunt force trauma from kicking
look for external evidence - wound
where are the most common locations in adult horses for non-displaced fractures?
ulna, metatarsal IV, & radius
why should you always radiograph a horse with a kick injury upon initial exam and then follow up days later with recheck rads?
you need to treat the wound for any infection & evaluate for any fracture
look a few days later for radiographic evidence of a fracture - if you miss it, you run the risk of the fracture becoming displaced & unsalvagable
horses with kick injuries that are housed adjacent to each other typically have a fracture in what location?
mt 4
horses with kick injuries that are housed with each other typically have fractures in what locations?
radius/ulna/mt 4
T/F: horses with fractures will present with an acute 4/5 lameness
true
what is the typical pattern seen in horses with non-displaced fractures?
wound treatment & NSAIDS initially decrease their lameness with fx undiagnosed - which is why you repeat rads a few days later
how are non-displaced fractures managed in horses?
wound therapy & confinement
prevent recumbency - risk of becoming displaced
monitor them for displacement & healing
what is the major complication of non-displaced fractures?
fractures become displaced - catastrophic results
T/F: with displaced & articular fractures, there is a necessity for surgical repair
true
what is the biggest cause for seeing a horse with a ‘dropped elbow’?
olecranon fracture - disrupts the triceps attachment, so the horse can no longer hold the elbow/carpus in extension or engage their stay apparatus
can’t bear weight
what is a flail limb fracture?
animal has no control on the limb whatsoever
what are common causes of olecranon fractures in horses?
adults - kick
foals - fall
which one of this horses has a displaced olecranon fracture?
horse on the left - significant effusion/swelling
both have dropped elbow
what do you think this foal has fractured? why?
humerus - big swelling in the brachial region, can see well in the cranial aspect
what are some differentials for olecranon fractures?
humeral fracture
radial neuropathy
scapular neck fracture
what is the emergency coaptation indicated for an olecranon fracture?
full limb bandage & caudal splint - need to fix the knee in extension so the horse can bear weight
this is a foal with a humeral fracture - is this okay coaptation?
nope - don’t splint humeral fractures, risk of radial neuropathy
T/F: fractures at the olecranon in foals are not salter harris fractures
true - traction epiphysis fractures
what specific olecranon fracture can you choose conservative treatment for? what does that entail?
non-displaced & non-articular fractures
stall +/- splint bandage
what is the most common treatment used for olecranon fractures?
ORIF plate fixation - useful for displaced/articular fractures, but most are non-articular & non-displaced
what are some complications of conservative management of olecranon fractures?
displacement, pseudoarthrosis, & prolonged lameness
T/F: surgery for olecranon fractures has a high success rate & low complication rate
true - internal fixation, tension band plate to neutralize the forces of distraction being placed on the triceps
long term soundness prognosis
what long bones are commonly seen for fracture repair in horses?
phalanges, mc/mt 3, radius/tibia, & humerus/femur
what components make up case selection for equine fractures?
patient - age, size, & temperament
fracture - bone affected, location of fracture, & configuration of fracture (need purchase above & below the fracture & can’t be highly comminuted)
T/F: olecranon, phalanges, & mc/mt 3 fractures are very repairable on adult horses
true
what biological injuries should be considered in equine fractures?
soft tissue envelope, contamination, & neurovascular supply
when do we commonly see humeral/femoral fractures in horses?
weanling quarter horse had an accident during halter breaking or when out on the pasture
T/F: temporary stabilization for humeral/femoral fractures can increase soft tissue damage
true
how are humeral fractures fixed surgically?
interlocking nail & plate combo that watkins made
what emergency management is indicated for radial/tibial fractures in horses?
modified rj bandage & splint
radial - caudal & lateral splints
tibial - lateral splint
try to protect the medial soft tissue envelope from a displaced fracture
when may conservative therapy be indicated for a radial/tibial fracture in a horse?
if it is a fissure line fracture
what surgical repair is commonly performed for radial/tibial fractures?
ORIF - double plating
what emergency management is indicated for mc/mt 3 fractures in horses?
splint cast
forelimb - up to the elbow
hindlimb - to the tuber calcanei
caudal & lateral splints!!!
what surgical repair is commonly done for diaphyseal fractures of mc/mt 3 in horses?
double plate correction
T/F: fractures of the distal 1/3 of the splint bones do well with removal & have a good prognosis
true
what emergency management is indicated for phalangeal fractures in horses?
distal limb splint cast with minimal padding from the hoof to proximal mc/mt
use a dorsal splint for axial alignment of the dorsal cortices
what surgical procedures can be used for phalangeal fracture repairs?
simple - lag screw
comminuted - intact strut with lag screw & cast or if no bone strut - transfixation cast & bridging plate
T/F: for middle phalanx fractures, palmar/plantar stability is very important, & unstable fractures affect this
true
which fracture is unstable?
the one on the right - needs double plate fixation
stable fracture only needs single plate fixation/transarticular lag screws
