Type of fracture, diagnosis, and treatment dictate a horse’s chances of recovery
Finding a horse unable to bear weight on a limb can be a nightmare. And when your veterinarian says the word fracture, you might immediately anticipate the worst-case scenario: euthanasia. But don’t jump to conclusions.
With all the advancements in modern veterinary medicine, fractures are no longer death sentences for horses. Veterinarians can repair and rehab many limb fractures, and the horse might even be able to return to work.
Dean Richardson, DVM, Dipl. ACVS, head of surgery at the George D. Widener Hospital for Large Animals at the University of Pennsylvania’s New Bolton Center, in Kennett Square, says the biggest horse owner misconception is that you can’t treat a fracture.
“You need to get every case evaluated separately,” says Richardson. “Just because somebody has experience with a fracture that couldn’t be repaired doesn’t mean that the one you’re looking at can’t be repaired. Some of them have a terrible prognosis, and some have an excellent prognosis. Also, not every fracture in the horse needs surgery.”
Let’s look at types of limb fractures and how to handle them.
The first thing to understand about fractures is that they encompass a wide range of bone injuries, from small chips to large fragments called slab fractures. Common types include:
- Simple Only one crack in the bone.
- Comminuted Splintered or having many pieces of separated bone.
- Incomplete A fracture on only one side of the bone.
- Complete A full break that results in separated bone fragments.
- Displaced When bone fragments have moved out of their original position.
- Stress Small, incomplete fractures.
- Star Multiple cracks radiating from a central area.
- Articular A fracture involving a joint.
- Closed Without a wound.
- Open With a wound.
A fracture can produce localized heat, pain, and swelling—either alone or in combination with lameness. These are typically the first clinical signs you’ll notice, especially if you did not see the injury occur.
The presence of a wound can throw some owners off as to the underlying cause of a horse’s pain or lameness, says Laurie Goodrich, DVM, PhD, Dipl. ACVS, professor of surgery and lameness at Colorado State University’s Equine Hospital and Orthopaedic Research Center, in Fort Collins.
“Sometimes they assume that the wound is the primary scenario that is causing the soreness, but it’s important for them to be aware that the bone underneath it can be affected,” she says.
While lameness is the most relevant clinical finding, not every lame horse has a fracture. “You can imagine how many horses have come in over the years to any hospital with an owner convinced the horse has broken his leg, when in fact what it has is a hoof abscess,” says Richardson. “The thing we always teach veterinary students is that if you have a severely lame horse, there are two differentials (conditions to consider that cause similar clinical signs): a fracture or an infection.”
An accurate diagnosis is important so the veterinarian can stabilize the limb properly to prevent further damage. Diagnostics have come a long way due to most vets having digital radiograph (X ray) units, allowing them to detect fractures in the field, says Goodrich.
Because it can be more difficult to get a good radiograph as you move up the limb, due to the additional muscle tissue, Goodrich says some veterinarians might opt to perform an ultrasound.
This article continues in the September 2019 issue of The Horse: Your Guide to Equine Health Care. Subscribe now and get an immediate download of this issue, including this in-depth feature on how fracture type, diagnosis, and treatment dictate a horse’s chances of recovery.