Type of fracture, diagnosis, and treatment dictate a horses chances of recoveryVeterinarians can use digital radiograph units to diagnose fractures right away on the farm. | Photo: Anne M. Eberhardt/The HorseFinding 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 dont 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, former head of surgery at the George D. Widener Hospital for Large Animals at the University of Pennsylvanias New Bolton Center, in Kennett Square, says the biggest horse owner misconception is that you cant treat a fracture.You need to get every case evaluated separately, says Richardson. Just because somebody has experience with a fracture that couldnt be repaired doesnt mean that the one youre looking at cant be repaired. Some of them have a terrible prognosis, and some have an excellent prognosis. Also, not every fracture in the horse needs surgery.Lets look at types of limb fractures and how to handle them.Horse Limb Fracture DiagnosisThe 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 swellingeither alone or in combination with lameness. These are typically the first clinical signs youll 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 horses pain or lameness, says Laurie Goodrich, DVM, PhD, Dipl. ACVS, professor of surgery and lameness at Colorado State Universitys 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 its 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.Locking plates and screws allow surgeons to compress and stabilize fractures, improving horses prognoses significantly. | Photo: Courtesy Dr. Laurie GoodrichHealing and Prognosis for Horse Limb FracturesBone healing in adult horses typically takes at least four months, whereas foals heal faster. Veterinarians might recommend rehabilitation exercises (e.g., mobilization, swimming, water treadmills) to restore mobility to joints and rebuild muscle function.Some equine limb fractures have better outcomes than others. Prognosis can depend on many factors, says Richardson, including the horses expected use, age, size, whether the fracture restricts mobility, if the fracture is displaced, etc. One of the biggest factors affecting prognosis, however, is the fractures location.Fractures that typically have good prognoses include:Those of the ulnas olecranon process, which is the point of the elbow. Richardson estimates that 90% of horses survive this common fracture, with many returning to full athletic function.Chip fractures, which surgeons can remove arthroscopically. You can have a very high expectation that the horse goes back to full athletic soundness for many, many types of those, Richardson says.Fractures repaired surgically using lag screw fixation to compress fragments together. In most cases the hardware remains in the horse for his lifetime. These horses can return to full function.Simple fractures with simple repairs.RELATED CONTENT | 12 Fracture Repair Take-Homes from a Top Equine SurgeonFractures with poorer prognoses include:Displaced radius (the forearm bone extending down from the elbow) fractures, which Richardson says are expensive and very difficult to repair.Moderate or severe articular fractures requiring surgery to fuse the affected joint to reconstruct it. The horse can live a good life but might never return to full athletic function, says Richardson.Open fractures. When you place implants to stabilize a fracture thats contaminated, then the likelihood of having an infection is almost guaranteed, says Goodrich.Complex fractures with complicated repairs.One of Richardsons most important reminders to owners is to get radiographs for any horse kicked above the knee thats not sound. With a correct diagnosis and stall rest, horses with incomplete fractures of the radius can recover and go back to full work with no problems.But if you take that same horse and think, Oh, thats nothing, and turn it out, thats a horse that can come in with its radius completely separated and displaced or catastrophically fractured, and then youve got a $15,000 to $20,000 (procedure) with a poor expectation of a good outcome, he says.Take-Home MessageFracture repair in horses has come a long way. Having a veterinarian splint the injury properly in the field before transporting him to an emergency clinic is critical to success, our sources say. With advancements in treatment, many horses with fractures either return to partial or complete athletic function or can be used as breeding stock. This can provide horse owners with hope they can save their horses and give them functional, happy, and comfortable lives.[/et_pb_text]