Page 55 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

30 CHAPTER 1

VetBooks.ir 1.56 1.57

Fig. 1.56 Lateral radiograph of a
neonatal foal that sustained a mid-
diaphyseal transverse fracture of the
radius shortly after birth.

Fig. 1.57 Postoperative radiograph
showing placement of a single
4.5 mm broad DCP plate cranially,
not crossing any physis. There is
good anatomical reduction and the
foal made a full recovery.

repairs, particularly those of long bones. In order to and swelling are present, and a discharging sinus
mitigate some of these risks, various recovery strate- and/or wound breakdown is common. Infective
gies have been attempted: water pool recovery sys- osteitis and osteomyelitis may be seen on postopera-
tems; sling recoveries; and, more commonly, assisted tive radiographic evaluation if infection is present.
rope recovery systems. In addition, equine surgeons The limb may be only poorly- or non-weight bear-
have developed faster and more accurate surgeries ing. This delays the healing of the fracture, reduces
with the aid of direct radiography, surgical CT scan- weight bearing (which can lead to flexural limb
ners and computer assisted fracture repair. For some deformities and/or contralateral laminitis and sus-
distal limb bones (metacarpal/metatarsal III and the pensory ligament breakdown) and significantly
proximal phalanx) with simple fracture configura- increases the cost. The chances of contamination
tions, the use of standing sedation with regional are increased in open fractures and/or where the soft
analgesia permits internal fixation procedures to be tissues are badly damaged, and perfusion is altered at
performed, avoiding the risks of general anaesthesia the outset. Mixed bacterial populations are usually
and uncontrolled recoveries. present and include Enterobacteriacae, Streptococcus
spp., Staphylococcus spp., Pseudomonas spp. and anaer-
Complications of fracture treatment obes. Treatment involves giving broad-spectrum or
The most common and serious complication follow- specific (based on bacterial culture and sensitivity
ing fracture repair involves infection at the fracture testing) systemic and locally delivered antibiotics
site and surrounding soft tissues. Heat, local pain (such as using gentamicin-impregnated PMMA or