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708 Chapter 5

adult or the neonate. In the foal injury is usually severe 7. Bramlage LR. The tibia. In Equine Surgery, 2nd ed. Auer JA, Stick
JA, eds. WB Saunders, Philadelphia, 1999;862–867.
and can cause recumbency and an inability to stand 8. Bramlage LR, Hanes GE. Internal fixation of a tibial fracture in an
VetBooks.ir tained in flexion and the stifle is subsequently extended. 9. Crawford WH, Fretz PB. Long bone fractures in large animals.
(Figure 10.60). Disruption occurs when the tarsus is main-
adult horse. J Am Vet Med Assoc 1982;180:1090–1094.
Foals are often reported to have been through difficult
A retrospective study. Vet Surg 1985;14:295–302.
births, many of which had a “hip lock” dystocia. 30 10. Derungs S, Fuerst A, Haas C, et al. Fissure fractures of the radius
Clinically, gastrocnemius disruption is demonstrated by and tibia in 23 horses: a retrospective study. Equine Vet Educ
2001;13:313–318.
hyperflexion of the tarsus when standing. The muscular 11. Dyson SJ. Stifle trauma in the event horse. Equine Vet Educ 1994;6:
injury usually occurs at the musculotendinous junction. 234–240.
The femoral vein, artery, and associated branches 12. Embertson RM, Bramlage LR, Herring DS, et al. Physeal fractures in
traverse the caudal aspect of the crus in close association to the horse. I. Classification and incidence. Vet Surg 1986;15:223–229.
the gastrocnemius muscle. Disruption of these vascular 13. Foerner JJ. Surgical treatment of selected musculoskeletal disor-
ders of the rear limb. In Equine Surgery, 1st ed. Auer JA, ed.
structures can occur along with the muscular damage and Saunders, Philadelphia, 1992;1055–1075.
can significantly affect the prognosis. Ultrasound can be a 14. Getty GR. Sisson and Grossman’s Anatomy of Domestic Animals,
very useful tool to confirm the muscular damage and asso- 5th ed. WB Saunders, Philadelphia, 1975.
ciated hematoma formation. Foals with moderate to severe 15. Harrison LJ, May SA, Richardson JD, et al. Conservative treat-
ment of an incomplete longbone fracture of a hindlimb of four
gastrocnemius disruption are thought to have a guarded horses. Vet Rec 1991;129:133–136.
30
prognosis for future athletic function. External coapta- 16. Haynes PF, Watters JW, McClure JR, et al. Incomplete tibial frac-
tion can be required in some cases in the form of sleeve tures in three horses. J Am Vet Med Assoc 1980;177:1143–1145.
casts or splints. Gastrocnemius disruption in foals usually 17. Johnson NL, Galuppo LD. Use of a stainless steel cable and head-
less tapered compression screw for repair of a tibial crest fracture in
has a favorable prognosis for athletic function. This injury a 10‐year‐old horse. Vet Comp Orthop Traum 2004;17:247–252.
in foals is also discussed in Chapter 10. 18. Juswiak JS, Milton JL. Closed reduction and blind cross‐pinning
Injury of the gastrocnemius muscle, often to the origin for repair of a proximal tibial fracture in a foal. J Am Vet Med
Assoc 1985;187:743–745.
of the muscle, is an unusual case of lameness in adult horses. 19. Mackey VS, Trout DR, Meagher DM, et al. Stress fractures of the
Forceful extension of the hindlimb may cause injury to the humerus, radius, and tibia in horses. Clinical features and radio-
gastrocnemius muscle. Affected horses may have a gait graphic and/or scintigraphic appearance. Vet Radiol Ultrasound
abnormality characterized by lateral rotation of the point 1987;28:26–31.
of the calcaneus and medial rotation of the toe. Nuclear 20. O’Sullivan CB, Lumsden JM. Stress fractures of the tibia and
humerus in Thoroughbred racehorses: 99 cases (1992–2000).
scintigraphy is critical in the diagnosis and may demon- J Am Vet Med Assoc 2003;222:491–498.
strate a focal area of intense radioisotope uptake in the cau- 21. Peloso JG, Watkins JP, Keele SR, et al. Bilateral stress fractures of
dodistal aspect of the femur in horses with injury to the the tibia in a racing American Quarter horse. J Am Vet Med Assoc
origin of the gastrocnemius muscle. Roughening of the cau- 1993;203:801–803.
dodistal cortex of the femur may be apparent radiographi- 22. Pilsworth RC, Webbon PM. The use of radionuclide bone scan-
ning in the diagnosis of tibial ‘stress’ fractures in the horse: a
cally in chronic injuries. However, radiographic imaging of review of five cases. Equine Vet J Suppl 1988; 20(6):60–65.
this area can be difficult due to the thickness of the overly- 23. Ramzan PH. Equine enostosis‐like lesions: 12 cases. Equine Vet
ing soft tissues. A lateral radiographic of the femur (not the Educ 2002;14:143–148.
stifle) is necessary to reveal proliferative changes in this 24. Ramzan PHL, Newton JR, Shepherd MC, et al. The application of
a scintigraphic grading system to equine tibial stress fractures: 42
location. This condition can occur in mature animals but cases. Equine Vet J 2003;35:382–388.
carries a poor prognosis for return to soundness. Horses 25. Ruggles AJ, Moore RM, Bertone AL, et al. Tibial stress fractures
with partial disruption of the gastrocnemius have a chance in racing Standardbreds: 13 cases (1989–1993). J Am Vet Med
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to return to athletic function. An extended period of rest 26. Schneider RK, Milne DW, Gabel AA, et al. Multidirectional in vivo
followed by a gradual return to exercise can be successful strain analysis of the equine radius and tibia during dynamic load-
in returning the horse to soundness. The amount of time ing with and without a cast. Am J Vet Res 1982;43:1541–1550.
required should be sufficient to allow the muscle to repair 27. Smith BL, Auer JA, Watkins JP. Surgical repair of tibial tuberosity
adequately. Some form of stabilization of the affected limb avulsion fractures in four horses. Vet Surg 1990;19:117–121.
may be required. The decision to use external coaptation is 28. Stover SM, Ardans AA, Read DH, et al. Patterns of stress factors
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