Equis ISSN 2398-2977

Musculoskeletal: fracture - first aid

Contributor(s): Steve Adair, Chris Whitton



  • 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.


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 and in general warrant 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 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.


  • 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

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Splinting fractures of the hindlimb

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Specific fractures

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Further Reading


Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bramlage L R (1983) Current concepts of emergency first aid treatment and transportation of equine fracture patients. Comp Cont Ed Pract Vet 5, 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, UK. 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, UK. pp 77-78.
  • Walmsley J P (2004) First Aid and Transportation of Equine Fracture Patients. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 213.
  • Bramlage L R (1999) Emergency First Aid in Treatment and Transportation of Equine Fracture PatientsIn: Equine Surgery. Eds: Aver J A & Stick J A. W B Saunders Co, USA. pp 635-638.
  • Nixon A J (1996) Ed. Equine Fracture Repair. W B Saunders, USA.
  • Dyson S (1996) Ed. A Guide to the Management of Emergencies at Equine Competitions. Equine Veterinary Journal Ltd. UK.