Fractures in horses are
devastating injuries. The large size of the horse, their
inability to stand on only 3 legs for any length of time and
the demand for maintaining athletic performance makes Equine
orthopaedics a challenging business. The horses’ innate
instinct to flee when there is pain or fear makes many a
perfect fracture repair disintegrate during anaesthetic
recovery. However new knowledge and techniques are
constantly being developed to increase our chance of
success. Fractures of the knee or hock & below carry the
best prognosis. Severe upper limb fractures in mature horses
are still beyond our capabilities. Dr. Kleider has received
training in this area through basic and advanced courses
provided by the AO foundation, a group dedicated to the
Anatomical Study of Internal Fixation (ASIF). The following
are examples of fractures that we have successfully
repaired. Brief descriptions of the techniques used are
provided. Coffin Bone Fractures:
These are now approached
through the hoof wall utilizing a “Herbert screw”.
This is a titanium non allergenic screw that is placed with
a guide wire and does not require removal. Many of these
have been left to heal with a bar shoe but compression with
a screw decreases chance of arthritis. Believe it or not these can
be removed arthroscopically (in pieces of course!) and carry
a fair to good prognosis! Pastern fractures:
These come in all degrees of
severity. Non displaced fractures are treated by ASIF
technique through stab incisions. More severe injuries may
be salvaged for breeding and may require arthrodesis of the
pastern joint. Splint or cast
immobilization immediately after injury is mandatory in many
fractures to prevent their falling apart on route to the
hospital. Cannon bone:
Some condylar fractures can
spiral up to the knee and can be devastating. Besides bone
screws these and transverse fractures require plating.
Splint fractures:
These come in all sorts of
assortments and may require surgical removal. Ulnar fractures are frequent
in foals and can be approached by plating or screw and wire
techniques. Fractures involving the knee
or fetlock joints are commonly repaired using a combination
of arthroscopy to monitor articular reduction and alignment
and standard ASIF technique. Bone Marrow Grafts are
frequently used to fill in spaces and in hard to heal areas
such as sesamoid fractures. Prevention of infections is
paramount to successful bone or joint surgery. Techniques
such as local intraosseous or intravenous infusion of
antibiotic during surgery are commonly used in fracture
management (see section on control of
infections). Our
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Kleider
Veterinary Services
8036 - 232 Street RR#6 Langley, British Columbia V1M 3R8
Office (604) 888-7565 Fax: (604) 888-4033 nkleider@aol.com
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