Treatment Options for Large Animal Fractures

nothing to bring horse back

welfare grounds → euthanise

when welfare grounds means euthanise

-comminuted fractures of proximal and middle phalynx especially where cannot apply internal fixation

compound fractures of long bone

-complete fractures of long bones

-pelvic fracture

why euthanise in compound fractures of long bone

-contamination high

-not amenable to internal fixation

exception of euthanasia when complete fractures of long bones

-ponies under 300kg or foals

-financial considerations and owner expectations

when is fracture treatment not a day one skill

-incomplete fractures (immobilisation of site)

-isolation and stabilisation key

What is the forelimb zone 1 stabilization?

from distal metacarpus to hoof.

How should the cortices of the bone be aligned during forelimb zone 1 stabilization?

Align cortices of bone in a vertical plane.

How is stabilisation achieved for forelimb zone 1 stabilization?

Dorsal splint and bandaging, PVC drainpipe, and heel wedge.

What is the purpose for the dorsal parts during forelimb zone 1 stabilization?

Get dorsal parts into a straight line.

What is the location for forelimb zone 2 stabilization?

Distal radius to mid metacarpal region

How should the cortices of bones be aligned during forelimb zone 2 stabilization?

Align cortices of bones in vertical plane

What type of splint should be applied for forelimb zone 2 stabilization?

Apply lateral and caudal splint

apply a heavier bandage (stabilise joints)

In forelimb zone 2 stabilization, how should the carpus be positioned?

Keep carpus in full extension

Which joint should be stabilized during forelimb zone 2 stabilization?

Stabilize metacarpophalangeal joint

What are the components of the forelimb zone 3 stabilization?

Proximal and middle radius

What is the purpose of stabilizing the forelimb zone 3?

Prevent abduction of limb

What type of bandage is used for forelimb zone 3 stabilization?

Full Robert Jones bandage

What additional support is used alongside the bandage for forelimb zone 3?

Lateral splint to withers

What is one goal of stabilizing the forelimb zone 3?

Stop leg swinging sideways and destabilizing fracture

forelimb zone 4 stabilisation

-proximal from zone 3 including scapula, humerus, ulna

-no stabilisation needed

-heavy distal limb bandage would have pendulum effect

hindlimb zone 1

-distal metacarpus, proximal phalangeal bones

hl zone 1 goal

-maintain shape of hindlimb

hl zone 1 stabilisation

-plantar splint for vertical alignment

hindlimb zone 2 area

-zone 2 does not extend as proximally due to hock,

so middle and proximal metatarsal regions

hindlimb zone 2 stabilisation

-heavy bandage and plantar splint

-possible lateral splint

hindlimb zone 3 area

-tibial fractures

-complicated to manage

-easily become open so poor prognosis

goal of stabilisation of zone 3

prevent abduction

stabilisation of zone 3 hindlimb

-long lateral splint

-reciprocal apparatus means flexion of stifle=flexion of hock, leads to collapse of tibial fracture

hindlimb zone 4 area

lots of muscle so natural stabilisation

hindlimb zone 4 goal

prevent abduction

hindlimb zone 4 stabilisation

-cannot apply bandage

-best left without as destabilise distal limb

what is kimzey leg saver

-aluminium and velcro straps

-dorsal splint

hindlimb stabilisation compared to forelimb in zone 3

moulded metal splint in zone hindlimb