Page 173 - Speedhorse February 2020

sound. This is an option for cases where the boney lump is very large, for whatever reason,” says Baxter.
“The majority of splints don’t need surgery, and the prognosis is usually very good. With surgical removal, sometimes you get recurrence of bony growth because you’ve disturbed, irritated and stimulated the bone-forming
cells in the periosteum again. This causes it
to lay down more layers of bone. Usually you don’t get as much bony regrowth, however, as the original lump. So even if you get a little
bit of regrowth, the surgery is usually still an improvement,” explains Baxter.
Generally, however, splints are not a complicated problem. “It tends to be more
of an issue for owners with show horses.
Some owners want to remove a splint, just
to minimize the cosmetic blemish. With the majority of splints I’ve removed, it was because they were causing lameness, or it was for cosmetic reasons. Either way, you can improve them, but for a show horse you also have to worry about the hair changing color if you do surgery,” he says.
“Any splint can result in a bony lump,
or at least a temporary thickening of the periosteum and the ligament. Even if it’s not
a bony enlargement, it might be a soft-tissue fibrous enlargement in that area. This kind of enlargement may tend to resolve with time,
but if it is re-injured it could revert back to inflammation and a bony enlargement as well.” The best thing to do if you want to figure out whether it’s bony enlargement or just soft tissue swelling is to radiograph or ultrasound the area. Then you can decide what you might do for treatment,” explains Baxter.
“Repetitive injury and inflammation is when you end up with a bony enlargement. There are many horses that have bony enlargements on the proximal, medial splint bone (under the knee, on the inside of the leg), but if these chronic splints don’t bother the horse, they really don’t need treatment. The horse may have been a little lame at first or had some inflammation and then it quiets down and doesn’t cause any problems. So, when you see a bump on the inside of the leg, this does not necessarily mean it’s the cause of a lameness if the horse is lame on that leg.
“First aid treatment on most of these, when the horse first goes lame and has heat and swelling in that area, is to decrease the inflammation. Many people recommend cold hosing or ice on the area and/or non-steroidal anti-inflammatory therapy and wrapping
the leg. This is a great use for topical anti- inflammatories like Surpass or diclofenac liposome cream. Historically, we used DMSO and glycerin in a sweat, and I think this
type of counter-pressure with a good snug wrap is helpful. The more you can decrease the persistent inflammatory response, the less likely the injury will result in bony enlargement,” he says. The most important thing is to reduce the inflammation.
“For chronic splints—bony lumps that still have some inflammation—some people have tried shock wave treatment to try
to knock down the inflammation in the ligament itself, which could be beneficial. This type of treatment is controversial, however. Some people feel that the shock waves actually stimulate the periosteum, which could result in more bone growth,” he explains.
Some people try counter-irritation in the acute stage. “This consists of local injection of a small dose of steroid (triamcinolone) along the ligament to really knock out
the inflammation. This treatment is also controversial because the steroid may contribute to bony growth. But the whole idea is to locally treat the inflammation. You don’t want to use repeated injections
of steroid because this is usually counterproductive,” he says.
“With these types of treatments, a person usually has to consider them on a case by
case basis, and just select the ones that might possibly benefit,” says Baxter. Splint swelling and lameness will generally heal just fine with time, rest, and compression, but some people want to treat them more aggressively so the horse can get over the lameness and back into training more quickly.
“Horse people may use things like therapeutic ultrasound, cold laser therapy, etc., to try to reduce inflammation, but I haven’t used these treatments very much,” says Baxter. Cold therapy, topical anti-inflammatory medication, and rest are generally very adequate and effective.
PREVENTION
Some people try different types of shoeing to help take stress off that part
of the leg, but there’s not a lot you can do with the foot really help keep splints from occurring. “About all you can do is try to keep the feet as well balanced as possible. If horses have bench knees (with extra stress on the inner splint bone), you can’t really correct that with shoeing,” says Baxter.
If you do too much “correction” you are working against the way the horse’s legs are structured and may create more stress.
“The best way to prevent splints is to take it slow with young horses in training, and not be in too big a hurry,” he says. The most common cause of splints is pushing a young horse too fast, too soon, especially on hard surfaces.
EQUINE HEALTH
FRACTURED SPLINT BONE
A fractured splint bone is sometimes mistaken for splint lameness, but in most cases a fracture has more swelling and the horse is lamer for a longer period of time. This problem is also most common on the inside of the leg, as a result of being hit by the opposite hoof when the horse is working at
high speed. Occasionally, a splint bone may be fractured by running into something solid or by a kick from another horse, but these are usually on the outside splint bones. Breaks can occur anywhere on the bone, but are most common in the top third of the bone. Sometimes lengthwise tension may create a transverse fracture. A combination of weight, pressure and twisting can break the bone obliquely, especially in racehorses.
A fractured splint bone is usually very painful when pressed with your fingers. Some of these fractures eventually heal with a lengthy rest, leaving a large bony lump. By contrast, splint inflammation usually goes away more quickly, with no complications.
A fractured splint bone may continue to produce new bone growth over several weeks or months and may need surgical correction or removal.
A fracture caused by an external blow may develop infection if the skin is broken. Other complications may include a dead piece of bone that becomes separated from the healthy bone, which hinders proper healing. This will nearly always cause drainage from the site.
Radiographs may be necessary
to diagnose the fracture. “A non- displaced fissure fracture can sometimes be difficult to see with radiographs, however. A veterinarian can sometimes miss this, when it mimics a splint,” says Baxter.
“If there’s a crack in the bone, there is usually more lameness, more pain on palpation, and more severity of clinical signs than the average splint. This
is not always the case, but a fracture should always be suspected if the horse is quite lame,” he says.
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