Page 50 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.1 A pproach to the lame horse 25

VetBooks.ir must be used with care since ataxia and collapse Fractures from the mid-metacarpus to
may occur in a compromised horse; small doses are distal radius
advisable. Systemic analgesics such as NSAIDs can
toe to the elbow in the normal standing position.
be given, and antibiotics should be prescribed if an A full Robert Jones bandage is applied from the
open fracture is present. The horse’s tetanus status Splints are then taped tightly to the lateral and
should be checked. caudal aspects of the bandaged limb. The proxi-
First-aid fracture support is best achieved with the mal ends of the splints must be padded to prevent
use of bandages and splints rather than casts. This rubbing.
is due to the difficulty in proper cast application
in the standing horse and the fact that casts do not Fractures of the mid and proximal radius
accommodate post-injury swelling. Casts must also It is necessary to minimise abduction of the limb
be removed and reapplied in order to readjust them, due to the lateral musculature of the forearm.
which is time consuming and unnecessarily expen- A Robert Jones bandage is applied from the ground
sive. A splint should ideally immobilise the joints to the elbow. A splint is tightly applied laterally,
proximal and distal to the fracture. It should be quick extending from the foot to the mid-scapula level.
and easy to apply. Wood (45 mm × 20 mm) and/or The proximal end of the splint must be padded as
PVC guttering cut lengthways to give a U-shape are previously.
suitable splint materials. The length of splint depends
on the size of the horse and the injury. Snug padding Fractures of the ulna, humerus and scapula
at the proximal and distal ends of the splint before These fractures cannot be splinted and, therefore,
application lessens the incidence of pressure points. supported, but their location disables the triceps
Commercial splints (e.g. the Kimsey splint) may also muscles, which affects ambulation of the horse.
be used with certain fracture types. Sufficient ban- A splint is applied caudally to fix the carpus in
daging materials for a half- or full-length Robert extension and allow the horse to move more easily.
Jones bandage should be available depending on the A Robert Jones bandage is applied from the foot to
fracture. It is useful to divide the fore- and hindlimbs the elbow. The splint is tightly taped caudally from
into regions for appropriate splint application. the fetlock to the elbow.

Forelimbs Hindlimbs
Fractures of the distal metacarpus and the The reciprocal apparatus of the hindlimb presents
proximal and middle phalanges problems with splinting and the splint can be less
If a transverse or oblique fracture is suspected, well tolerated than the forelimb. Further bandaging
aligning the dorsal cortices of the third metacarpus is often necessary after ambulation due to loosening
and phalanges is advisable in order to minimise a ful- of the splint.
crum effect of the fracture on loading. An assistant
holds the limb off the ground by the forearm so that Fractures of the distal metatarsus and below
the distal limb is vertical. One or two bandage layers As for the forelimb, but the splint is placed on the
are applied to the distal limb and the splint is applied plantar rather than the dorsal aspect. An assistant
dorsally. A further one or two layers are applied should hold the limb above the hock so that the dis-
over this to protect the splint and further stabilise tal limb is vertical for application.
the limb. Heavy, tightly applied taping from the toe
to the carpus prevents the splint loosening. A heel Fractures of the mid and proximal metatarsus
wedge is sometimes a useful addition. A Robert Jones bandage is applied from the toe
If a fracture in the sagittal plane is suspected, two up to and including the calcaneus, with the limb
splints on the lateral and medial aspects of the distal weight bearing. Splints are tightly applied caudally
limb are applied over a half-limb Robert Jones ban- and laterally to the level of the calcaneus (Fig. 1.48).
dage, with the limb weight bearing.