b'2019 AAEP CONVENTION WRAP-UPToo many people believe this car-toon, Richardson said. We have to change that.During his lecture, Richardson, who serves as chief of surgery at the Univer-sity of Pennsylvanias New Bolton Center School of Veterinary Medicine, took the opportunity to change preconceived no-tions that equine fractures equal eutha-nasia. While he originally named his presentation, From Larson to Laotzu, he settled on The Tao of Equine Fracture Management and continually returned to the theme of balance. Here are 12 of his takeaways.1. Successful Fracture Repairs Are All About Balance As Richardson transi-tioned from Larsons cartoon to Laotzus Daoism, he shared an image of the taijitu (the symbol of yin yang fundamental to Daoism). In his analogy, the image repre-sented biology as it relates to horses and COURTESY AAEPthe mechanics of surgery and orthopedic repair. His approach, in all aspects of sur-gery and recovery, comes back to balanc-ing the two and creating harmony thatDr. Dean Richardson delivered the 2019 Milne lecture on managing limb fractures in horses.leads to successful surgical outcomes.2. Recovery Is Achievable if Balancedhe said, showing photo and radiographpost-surgery, and the best preventive is With Expectations Horses are not some- examples of complex breaks and surgicalgetting the horse to move, he said. how inept at healing, said Richardson.solutions in Minis, followed by videos ofWhen dealing with limb fractures, We They are not some biological misfit inone of the patients sashaying around hisfail almost every time we dont get the the big scheme of natural selection. Thepaddock with a friend. You put (Minis)horse comfortable and walking after sur-reality is that quite a few horses with or- back together and, presto, theyre fixed gery, he said. We have to fix it in a way thopedic problems could adequately healits as easy as that, he said. If I had athat the animal can bear weight. If we their injuries if we didnt have demands1,200-pound Warmblood turn out likedont get them comfortable, theyll often for their performance or wildly disparatethat, Id be really happy, he said. be euthanized for laminitis, and thats the opinions about their suffering. 5. Horses Are Not Humans Equinejust the reality.3. Three Is Lead to Fracture Surgeryorthopedic surgeons rely on human7. Poor Soft Tissue Coverage Compli-Failure Richardson outlined them: medical devices, such as plates and othercates Healing Most fractures in horses Infection: Surgical wounds are morehardware, to repair horses, even thoughoccur in the limbs, which have very little susceptible to infection and biofilmshorses are much larger than humanssoft tissue and muscle coverage; in fact, (challenging-to-treat bacterial commu- and cant understand rehab instructionstheres no muscle below the knee and nities) than traumatic wounds; for rest. Richardson summed up the finehock. Muscle is the most valuable tissueI naccuracy: Tools such as CT, arthros- print on the hardware: to have over a fracture, Richardson said. copy, and radiography can improveYou arent supposed to fix fracturesIt provides the major blood supply to heal-accuracy and reduce surgery-relatedwith these devices in an overweighting bones and offers protective covering. tissue trauma; and patientwho is going to be walking or8. Splinting Is Critical Proper emer-Instability: It takes more screws andrunningwho is senile or mentally ill.gency splinting of a leg injury can be a other hardware to surgically stabilizeThis is the absolute, quintessential defini- life-saving procedure, Richardson said, injuries in horses than in humans andtion of my patient: a morbidly obese,adding that having appropriate splinting other species. hyperkinetic nut job. materials immediately available can make Those are the keys, he said. Those6. A Horse Must Walk After Surgery Ad- all the difference.are what we screw up when we screw upditionally, Richardson noted equine ortho- Six-inch diameter PVC pipes halved surgery. pedic surgeons must use more metal thanlengthwise are versatile and create a stable 4. A Horses Size Matters Size is a bigtheir human surgeon counterparts be- splint, he said, when applied correctly. The deal, he said about horses and fracturecause, unlike humans, horses must standkey is to ensure the splint itself is sturdy repair. It makes it hard. after surgery. Thats because supporting- and placed close to the limb. He showed Miniature Horses are easier to fix,limb laminitis is all too common in horsesexamples of failed splints and pointed 32March 2020The Horse|TheHorse.comAAEPWrapUp.indd 32 2/5/20 2:54 PM'