Page 51 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

26 CHAPTER 1

VetBooks.ir Fractures of the tibia and tarsus FRACTURE TREATMENT OPTIONS
The splint must counteract the medial force of
the lateral musculature of the tibia and the desta-
of the musculoskeletal system and can range from a
bilising effect of stifle flexion by the reciprocal Fractures can potentially occur in any of the bones
apparatus. A full Robert Jones bandage is applied small chip fracture of the distal radial carpal bone
from the toe to the proximal tibia. A splint is tightly to an open, comminuted long bone fracture. The
applied to the lateral aspect of the limb and should range of treatments currently available reflects this
extend to the tuber coxae. In many textbooks it is diversity, but they can be divided into conservative
suggested that a light steel rod (12 mm), shaped and surgical treatments. The goal is to restore func-
to form a loop proximally, can be used as a splint; tion to the affected limb so that the horse can either
however, this is rarely available, and a long, thin return to full work, become a breeding animal or
wooden splint can be used instead. retire to pasture pain free.

Fractures of the stifle, femur and pelvis Conservative
These fractures are not amenable to external coapta- Box rest
tion and should be cross-tied, if possible, to mini- All types of fracture require box rest whether treated
mise further damage. by conservative or surgical means. Fractures that are
amenable to box rest and bandaging as a sole treat-
ment for a full return to function include certain
splint fractures, incomplete non-displaced fractures
1.48 of long bones, such as the radius and tibia, and some
incomplete fractures of P1. The decision for this
form of treatment alone must be based carefully on
the individual case. The length of time required for
complete healing will depend on the type of frac-
ture and any complicating factors encountered, but
it is often 10–12 weeks. Some cases may need cross-
tying to prevent the horse lying down and getting
up, which could be catastrophic. Additionally, the
temperament of a horse is extremely important to
the final outcome.

External coaptation
Splints Splints are generally used for first-aid treat-
ment of fractures to reduce further damage and allow
safe transportation. In certain circumstances they can
be used in fracture treatment (e.g. an adjunct after
internal fixation immediately postoperatively or when
a cast has just been removed).

Casts Impregnated fibreglass casting materials have
largely replaced the use of plaster of Paris in the horse
(Figs. 1.49, 1.50). Casts can be used as a primary
Fig. 1.48 A full-limb splinted Robert Jones bandage treatment only for a limited number of fracture types
used in the hindlimb of a horse for the conservative (e.g. half- [distal/short] limb cast for an incompletely
treatment of a medial condylar fracture of the distal fractured pastern or a foot cast for a pedal bone wing
third metatarsus. Note the lateral and plantar splints. fracture). The proper application of a cast requires