ER Care & Stabilization of Equine Fractures

Improves the chances of successful surgical repair (could literally be a matter of life and death of the patient)

Why is proper splinting and transportation important to patient care and treatment for fractures?

1. Temperament of horse

2. Health condition of horse

3. Size of horse

4. Fracture location

5. Severity of fracture

What factors should you consider when dealing with fractures? (5)

1. Small horse size

2. Good temperament

3. Closed nondisplaced single fracture plane

4. Fracture occurring in the distal limb

More favorable prognoses for fractures are associated with what? (4)

1. Larger horse size

2. Poor temperament

3. Open fracture planes

4. Fractures of the upper limb

Poorer prognoses for fractures are associated with what? (4)

1. Loss of significant blood supply to the limb

2. Accompanying soft tissue injury

When is humane euthanasia necessary for fractures?

Wound bandaging

__________________ should occur before efforts are made to stabilize the limb

Immediate immobilization

After wound decontamination and bandaging, what should be done next?

NSAIDs

Initial pain management after a fracture should involve no more than ________________

A. 4

B. 4

How many level fractures can be classified in the (A) thoracic and (B) pelvic limbs of the horse?

1. Phalanges

2. Proximal sesamoid bones

3. Distal metacarpus

What bones are affected by a level 1 thoracic limb fracture?

Suspensory apparatus

Kimzey leg saver splint (commercial splint) for level 1 thoracic limb fractures is particularly useful for treating horses with disruption of the ______________

Distal carpus, toe

For level 1 thoracic limb fractures, the bandage/splint combination should extend from the _______________ to the ________________

Minimal (thick padding would allow for excessive movement of the ends of the fracture within the bandage when the horse puts weight on the limb)

For level 1 thoracic limb fractures, it is important to apply the splint/cast over (minimal or thick) padding to achieve proper alignment of the bones of the digit

Dorsal

Level 1 thoracic limb fractures can also be stabilized with a Robert Jones bandage that incorporates a rigid splint in the _______________ aspect of the bandage

Distal radius to mid metacarpus

What bones are affected by a level 2 thoracic limb fracture?

Caudal, lateral

Level 2 thoracic limb fractures are best stabilized with a Robert Jones bandage that incorporates rigid ______________ and _______________ splints

3x

Level 2 thoracic limb fractures should have a bandage that is ~________ the diameter of the limb at the fracture site

Middle and proximal radius

What bones are affected by a level 3 thoracic limb fracture?

Prevent abduction of the injured limb

What is the primary goal of splinting level 3 thoracic limb fractures?

Caudal, an extended lateral

Level 3 thoracic limb fractures are best stabilized with a Robert Jones bandage with a _____________ splint and __________________ splint

Penetration of bone fragments through the skin of the medial side of the limb

What is the major concern of thoracic limb level 3 fractures?

1. Humerus

2. Ulna

3. Distal scapula

What bones are affected by a level 4 thoracic limb fracture?

T

T or F: Level 4 thoracic limb fractures are generally NOT splinted at the fracture site

Caudal splint that extends from the elbow to the ground

For level 4 thoracic limb fractures, a padded bandage with a _______________________________ is used to fix the carpus for improved balance for transportation

Improved balance during transportation

What is the purpose of a level four thoracic limb splint?

Phalanges and distal metatarsus

What bones are affected by a level 1 pelvic limb fracture?

Plantar

For level 1 pelvic limb fractures a Robert Jones bandage with a ______________ splint is used to stabilize the hind limb

Reciprocal apparatus

Natural flexion of the pelvic limb is induced by the what?

The front leg has a dorsal splint and the back leg has a plantar splint

How are level 1 thoracic and pelvic hindlimb fractures different in terms of stabilization with splints?

Middle and proximal metatarsus

What bones are affected by a level 2 pelvic limb fracture?

Plantar and lateral

For level 2 pelvic limb fractures a Robert Jones bandage with ___________________ splints is used to stabilize the hindlimb

Tuber calcis

For level 2 pelvic limb fractures, the _________________ acts as a functional extension of the metatarsus and provides additional support when incorporated into the bandage.

F (should be less, it is more difficult to include the tarsus in the bandage, and too much padding under the splints will make it more difficult to stabilize the fracture)

T or F: You should use more padding in the bandage for level 2 pelvic limb fractures as compared to level 2 thoracic limb fractures

Tibia and tarsus

What bones are affected by a level 3 pelvic limb fracture?

Extended lateral splint

Fractures at level 3 in the hind limb are supported by a Robert Jones bandage with an ________________________

Flexion of the stifle without flexion of the hock (leads to additional trauma to both the bones and soft tissue)

If an unstable tibia fracture is present, what will occur?

Femur or pelvis

What bones are affected by a level 4 pelvic limb fracture?

T

T or F: Level 4 fractures of the pelvic limb do not require splinting

Backward

When trailering a horse with a forelimb fracture, the horse should face (backward or forward) in the trailer

Forward

When trailering a horse with a pelvic limb fracture, the horse should face (backward or forward) in the trailer