Page 32 - Manual of Equine Field Surgery

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28 PRESURGICAL PREPARATION AND ASSESSMENT

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Figure 4-9 Section 3 hind limb, tibia, and tarsal frac- Figure 4-10 Section 4 forelimb fractures disabling

tures, stabilized using a lateral splint over a moderate the triceps apparatus such as olecranon fractures. A

Robert Jones bandage. The splint is made of a broad caudal splint over a light bandage is applied in order to

wooden board extended proximally to lie against the lock the carpus in extension and by that aid in control

thigh to prevent limb abduction. and use of the limb.

the coaptation as tightly as possible with liberal cases, initial stabilization of the limb and the

use of inelastic tape. patient and consultation with the nearest surgical

facility will provide the best service to the horse

Section 4 and the client. The horse should be transported in

Fractures of the ulna, humerus, and scapula are a confined area with minimal space for body

unstable as a result of loss of the triceps function, movement and adequate room for head motion

which precludes use of the limb ( see Figure 4- a11d foot placement to aid in balance. A horse with

2). A light bandage from the ground to the elbow an injured forelimb should face backward and a

combined with a caudal splint spanning the horse with a hind limb injury should face forward

carpus to lock the carpus in extension will enable so as to prevent additional stress on the injured

weight bearing on a limb affected with an ulnar limb during emergency stops. Providing distrac-

fracture (Figure 4-10). Splinting cannot aid prox - tion for the ride in the form of a small amount of

imal tibial physeal and femur fractures ( see Figure hay is recommended. 2

4-2). Heavy coaptation may actually cause further

damage by increasing the fulcrum to distract the

fragment and potentially open a closed proximal COMPLICATIONS

tibial fracture.

Improper splinting such as using one thick

padding layer without intermittent tightening

PREPARATION FOR REFERRAL with elastic gauze or a very heavy splint improp-

erly secured to the limb can actually increase the

In most cases, it is advisable to discuss referral and amount of damage to the fractured limb.v"

surgical options with the client only after the

patient is relatively calm and the limb is properly

stabilized. The nearest surgical facility should be EXPECTED OUTCOME

contacted and consulted prior to transporting the

horse. Euthanasia is definitely indicated in certain The prognosis depends on the horse's weight and

situations such as an open comminuted tibial temperament, the specific bone involved and the

fracture in an adult size horse.5 However, in most location of the fracture within the bone, the frac-

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