treatment options for large animal fractures

Question 1

What types of fractures in horses need to be euthanised immediately?

Answer 1

Comminuted fractures of the proximal and middle phalanx. Especially where we cannot apply an internal fixation
Compound fractures of long bone. Contamination high. Not amenable to internal fixation
Complete fractures of long bones (proximal long bone i.e humerus, radius, femur, tibia. (exception for ponies under 300kg or foals)
Pelvic fracture: recumbent horse and cannot stand up.

Question 2

Describe the goal, stabilisation and purpose of forelimb zone 1 (distal metacarpus to hoof)

Answer 2

Goal:
- Align cortices of bones in a vertical plane.

Stabilisation:
Apply a dorsal splint and bandaging
PVC drainpipe and heel wedge

Purpose:
Get the dorsal parts into a straight line.

Question 3

Describe the goal, stabilisation and purpose of forelimb zone 2 (distal radius to mid-metacarpal region)

Answer 3

Goal:
- Align cortices of bones in a vertical plane.

Stabilisation:
Apply a lateral & caudal splint
Apply a heavier bandage (stabilise joints)

Purpose:
Keep carpus in full extension and stabilise metacarpophalangeal joint.

Question 4

Describe the goal, stabilisation and purpose of forelimb zone 3 (proximal and middle radius)

Answer 4

Goal:
- Prevent abduction of the limb.

Stabilisation:
Full Robert Jones bandage
Lateral splint to withers

Purpose:
Stop leg swinging sideways and destabilizing the fracture.

Question 5

Describe the goal, stabilisation and purpose of forelimb zone 4 (proximal from zone 3, scapula, humerus, ulna)

Answer 5

No stabilization needed. Heavy distal limb bandage would have a pendulum effect

Question 6

Describe the goal, stabilisation and purpose of forelimb zone 1 (distal metatarsus, proximal phalangeal bones)

Answer 6

Goal:
- Maintain shape of hind limb

Stabilisation:
- Plantar splint for vertical alignment

Question 7

Describe the goal, stabilisation and purpose of forelimb zone 2 (middle and proximal metatarsal regions)

Answer 7

Stabilisation:
Heavy bandage and plantar splint for stabilization, possible lateral splint as well

Question 8

Describe the goal, stabilisation and purpose of forelimb zone 3 (tibial fractures)

Answer 8

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, leading to collapse of tibial fracture.

Question 9

Describe the goal, stabilisation and purpose of forelimb zone 4

Answer 9

Lots of muscle so natural stabilisation

Goal:
Prevent abduction

Stabilisation:
Cannot apply a bandage, best left without which could destabilize distal limb.

Question 10

What commercial devices are available for equine splints?

Answer 10

Kimzey leg saver
- Aluminum & Velcro straps
- Dorsal splint