Nonsurgical fracture management

The horse must be prevented from laying down for an extended time depending on the severity of the fracture. Radiographically the fracture may be evident for months after the injury. In severe cases, it may be advisable to keep the horse standing for up to 3 months. An additional 30 to 60 days of confinement in a stall are recommended once the horse has been allowed to move around freely.

An alternative technique is to keep the patient in a sling, which is not snugly applied to the belly. The sling shown here, is manufactured in Switzerland and is very well tolerated.

Additional therapy should include wound care. In cases where the soft-tissue wound is substantial and communicates directly with the underlying fracture, local and systemic antimicrobial therapy are indicated during the initial treatment period. In addition, the wound is bandaged and the limb is maintained in a compression bandaged to prevent swelling.
Non-steroidal anti-inflammatory therapy is used judiciously to encourage weight-bearing on the injured leg to reduce the potential for support limb laminitis.
Horses which tend to stand with the carpus flexed for an excessive amount of time may benefit from a splint applied to the caudal aspect of the compression bandage.

Follow up films are taken periodically to assess progression of the fracture.

In most cases healing is adequate in 90-120 days to allow transition to paddock exercise.

Occasionally an incomplete fracture may turn into a complete fracture. Dependent upon the configuration of the fracture surgical fixation applying ORIF is performed or the animal is euthanatized.

Left: An oblique incomplete fracture is visible in the mid-radius region.

Left: The horse was found the following day in the stall with a complete short-oblique fracture of the proximal radius and was subsequently euthanatized.