Equis ISSN 2398-2977

Musculoskeletal: fracture - first aid

Contributor(s): Steve Adair, Chris Whitton

Introduction

Aims
  • Reduce anxiety in horse:
  • Obtain preliminary diagnosis.
  • Prevent further injury to soft tissues, eg neural and vascular structures, associated with fracture site.
  • Prevent laceration of skin associated with closed fracture   →   open fracture.
  • Prevent secondary traumatic injury to other three weightbearing limbs.

Immediate first aid

  • Apply physical restraint, eg twitch   Restraint methods  and attempt a brief assessment of the injury before considering systemic medication.

Inappropriate analgesia or sedation could result in further injury due to horse's loss of awareness of the injury; sedation may also prevent safe transport.

Medication

Acepromazine should not be used   →    hypotension.

Assessment of injury

  • Conduct a thorough general physical assessment   Musculoskeletal: physical examination - adult  .
  • Observe the horse's stance, gait   Musculoskeletal: gait evaluation  (where appropriate), ability to weight bear on each limb.
  • Check history: any previous injuries?
  • Although some injuries can be diagnosed immediately, check for other concurrent injuries.
  • If necessary, wash limb to ensure complete evaluation.
  • Some injuries are not amenable to treatment andin generalwarrant immediate euthanasia   Euthanasia 
    • Comminuted fractures + severe soft tissue damage.
    • Femoral fractures: complete.
    • Humeral fractures: complete in horses >300 kg.
    • Tibial fractures: complete.

If there is uncertainty about the severity of the injury do not euthanize until a full assessment has been made.

Splinting

  • Splinting is important to prevent further damage to neural/vascular elements, bone ends, soft tissues, and to prevent a closed fracture becoming an open fracture.
  • Must be easy to apply with minimal assistance from lay bystanders.
  • Splinting also stabilizes the limb which relieves stress/anxiety, permitting the horse to ambulate.
  • General anesthesia not recommended in the field on stressed horse.
  • Must neutralize damaging forces, eg contracture of muscles no longer on a skeletal frame, at the fracture site.
  • Choice of splint will depend on biomechanical forces at work at the site of injury.
  • Combinations of light bandaging, splints, Robert Jones bandage   Musculoskeletal: Robert Jones bandage  and casts   Musculoskeletal: external fixation - casts  may be used.

Transport

  • Forelimb fractures have facing backwards - should be as confined as possible to allow support on all sides.
  • For hindlimb fractures have facing forwards.
  • An injured horse can travel in either its accustomed vehicle or by ambulance   Transport  .
  • Ideally a low-loading vehicle should be used.

Print off the Owner Factsheets on Bandaging - the dos and don'tsEmergencies - when to call the vet and Fractures to give to your clients.

Splinting fractures of the forelimb

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Splinting fractures of the hindlimb

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Specific fractures

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers
  • Bramlage L R (1983)Current concepts of emergency first aid treatment and transportation of equine fracture patients. Comp Cont Ed Pract Vet5, 564-574.

Other sources of information

  • Bramlage L (2004)Development of Fracture Management in the Horse.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 27-28.
  • Smith R K W (2004)Handling and Moving the Suspected Equine Fracture Patient.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 77-78.
  • Walmsley J P (2004)First Aid and Transportation of Equine Fracture Patients.In: Proc 43rd BEVA Congress. Equine Vet J Ltd, Newmarket. pp 213.
  • Bramlage L R (1999)Emergency First Aid in Treatment and Transportation of Equine Fracture Patients .In: Equine Surgery. Eds: Aver J A & Stick J A. W B Saunders Co, Philadelphia. pp 635-638.
  • Nixon A J (1996) EdEquine Fracture Repair .W B Saunders. Philadelphia.
  • Dyson S (1996) EdA Guide to the Management of Emergencies at Equine Competitions.Equine Veterinary Journal Ltd. Newmarket, UK.


ADDED