Page 29 - Manual of Equine Field Surgery
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Emergency Management of the Fracture Patient 25
volemic and thus can be profoundly affected by be applied. Splinting can be done well with simple
these agents. If there is skin penetration of the equipment in field situations when attention is
injured limb, even if distant from the apparent given to proper technique. 7•8
fracture, broad-spectrum antibiotics ( e.g., gen- Radiographs can be taken either following
tamicin 6.6 mg/kg IV and potassium penicillin stabilization or later at the referral facility. The
22,000 JU/kg IV, Qr gentarnicin and procaine basic method of stabilization is a splint applied
penicillin 22,000 IU/kg IM, or cefazolin 11 mg/kg over a bandage to decrease interfragmentary
IV) should be administered, In a markedly dehy- movement and to significantly alleviate anxiety.
drated horse, administration of aminoglycosides The specific mode of immobilization differs along
(e.g., gentamicin) and nonsteroidal antiinflamma- the limb according to the locally predominant
tory drugs (NSAIDs) (i.e., phenylbutazone) should biomechanical forces. Both forelimbs and hind
be postponed until adequate hydration is achieved limbs can be divided into the following four func-
via intravenous fluid administration. The horse tional sections.!? Section 1 is the most distal fore-
should be current on tetanus vaccination, limb or hind limb segment between the coronary
band and the distal quarter of the metacarpus or
Limb Stabilization metatarsus. Section 2 in the forelimb extends
from distal metacarpus to distal radius, while in •
Immediately after initial assessment of the patient the hind limb it includes middle and proximal
and the affected limb, external coaptation should metatarsal fractures. Section 3 in the forelimb
comprises diaphyseal and proximal radial frac-
tures, while in the hind limb it includes tarsal
and tibial fractures. Section 4 in the forelimb
consists of fractures of the ulna, humerus, and
scapula, while in the hind limb it includes proxi-
mal tibial physis and femur fractures, Appropriate
stabilization techniques for the previously des-
cribed sections of both forelimbs and hind limbs
are described next.
Section 1
The most distal forelimb or hind limb segment
is between the coronary band and the distal quar-
ter of the metacarpus or metatarsus ( Figure 4-2).
Figure 4-1 Bandaging and splinting equipment. Dorsopalmar or dorsoplantar bending is the prin-
Section 4
Figure 4-2 Dividing the limbs
into four functional sections. Each
section is stabilized in a different · Section 3
technique according to the local gov-
erning biomechanical forces.
Section 1
