Page 31 - Manual of Equine Field Surgery

Emergency Management of the Fracture Patient 27

Figure 4-6 Section 2 hind limb fracture, third Figure 4-7 Section 3 forelimb, diaphyseal and prox-

metatarsal bone, stabilized using plantar and lateral imal radial fractures, stabilized using similar bandage

splints over a moderate Robert Jones bandage. and palmar splint as for section 2 fractures. Here the

lateral splint is extended to lie against the lateral aspect

of the shoulder and prevent limb abduction.

Section 3

Diaphyseal and proximal radial fractures should

be stabilized with a Robert Jones bandage aL1g-

mented with caudal and lateral splints applied as

for section 2 with the exception that the lateral

splint extends proximally to lie against the lateral

aspect of the shoulder (see Figure 4-2). The prox-

imal extension of the splint is essential because

of minimal soft tissue protection over the medial

aspect of the radius. The splint prevents abduc-

tion of the distal limb and penetration of the skin

by the fractured bone ends at the medial aspect of

the fracture line (Figure 4- 7). Tarsal and tibial

fractures are especially difficult to immobilize

because of the reciprocal apparatus ( see Figure 4-

2). A Robert Jones bandage is applied as for

section 2, but in this case the bandage should

extend to the level of the patella with the splint

preventing slippage. The splint should extend

proximally to lie against the lateral thigh and hip

and prevent skin penetration by fracture bone

ends from limb abduction. Ideally, a lightweight

metal splint or steel concrete reinforcement rod

shaped to the hock and stifle angulations and bent

back upon itself is used as the lateral portion of a Figure 4-8 Section 3 hind limb, tibia, and tarsal frac-

Schroeder-Thomas splint, Cast material can be tures, stabilized using lateral splint over a moderate

wrapped around the bent rod for additional Robert Jones bandage. The splint is made of a specifi-

strength (Figure 4-8). Alternatively, the splint can cally bent aluminum rod enforced with synthetic cast

be made of a wide (20 cm) wooden board (Figure material and extending proximally to lie against the

4-9). In all options, the splint is incorporated into thigh and hip to prevent limb abduction.