large animal fracture repair

Question 1

In what scenarios would a horse be euthanised immediately

Answer 1

comminuted fractures of proximal & middle phalanx (esp. where we can’t apply internal fixation)

compound fractures of long bone
- contamination high
- not amenable to internal fixation

complete fractures of (proximal) long bone
- e.g. humerus, radius, femur, tibia

pelvic fracture
- recumbent horse can’t stand up

exceptions (except to last one)
- ponies under 300kg & foals
- financial considerations & owner expectations

Question 2

what zone is this & what is the goal, method of stabilisation & purpose

Answer 2

forelimb zone 1:
- distal metacarpus to hoof

goal:
align cortices of bones in vertical plane

stabilisation:
- apply dorsal splint & bandaging
- PVC drainpipe & heel wedge

purpose:
- get dorsal parts into straight line

Question 3

what zone is this & what is the goal, method of stabilisation & purpose

Answer 3

forelimb zone 2:
- distal radius to mid-metacarpal region

goal:
- align cortices of bones in vertical plane

stabilisation:
- apply lateral & caudal splint
- apply heavier bandage (stabilise joints)

purpose:
- keep carpus in full extension & stabilise metacarpophalangeal joint

Question 4

what zone is this & what is the goal, method of stabilisation & purpose

Answer 4

forelimb zone 3:
- proximal & middle radius

goal:
- prevent abduction of limb

stabilisation:
- full Robert Jones bandage
- lateral splint to withers

purpose:
- stop leg swinging sideways & destabilising fracture

Question 5

what zone is this & what is the goal

Answer 5

forelimb zone 4:
- proximal from zone 3
- scapula, humerus, ulna

goal:
- no stabilisation needed
- heavy distal limb bandage would have pendulum effect

Question 6

what zone is this & what is the goal, method of stabilisation

Answer 6

hindlimb zone 1:
- distal metatarsus
- proximal phalangeal bones

goal:
- maintain shape of hindlimb

stabilisation:
- plantar splint for vertical alignment

Question 7

what zone is this & what is the method of stabilisation

Answer 7

hindlimb zone 2:
- middle & proximal metatarsal regions
- doesn’t extend as proximally due to hock

stabilisation:
- heavy bandage & plantar splint for stabilisation
- possible lateral splint as well

Question 8

what zone is this & what is the goal, method of stabilisation

Answer 8

hindlimb zone 3:
- tibial fractures
- complicated to manage
- can easily become open, poor prognosis

goal:
- prevent abduction

stabilisation:
- long lateral splint
- reciprocal apparatus means flexion of stifle = flexion of hock –> collapse of tibial fracture

Question 9

what zone is this & what is the goal, method of stabilisation

Answer 9

hindlimb zone 4:
- lots of muscle so natural stabilisation

goal:
- prevent abduction

stabilisation:
- can’t apply bandage, best left without which could destabilise limb

Question 10

What are the devices seen L & R?

Answer 10

L: PVC drainpipe

R: Kimzey leg saver
- aluminum & velcro straps
- dorsal splint