Emergency First Aid Treatment

For Equine Fractures

Sam Morehead

Paul Hollier

Dr. Honore Ame’ Walesby

As large and powerful as horses are and given the work they regularly perform, broken bones occasionally happen. Advances in veterinary medicine have made fractures not as devastating as they once were. However, it is essential that a horse with a fracture be managed appropriately and proper first aid be given. Improper management can render a fracture with a good prognosis fatal. Any fracture sustained by a horse is an emergency, requiring immediate veterinary care. This is because a horse with a fracture requires stabilization, pain management and proper fracture immobilization to optimize the outcome.

A very important part of fracture first aid is splinting. A splint will reduce further damage to the injured limb and allow for safe transport. The method of splinting varies according to the area on the limb that has been injured. The limb is divided into four areas that dictate the type of splint and bandage that should be used. The first area includes fractures that occur in the region of the foot up to the level of the bottom of the cannon bone. The goal of splinting of this area is to align the front surface of the leg and the hoof, and reduce motion at the fracture site. The splint is placed on the front of the leg over a light bandage that runs from the toe up to the knee. Nonelastic tape, such as duct tape, should be used to attach the splint to the bandage. Any straight object, such as a board, PVC pipe cut in thirds, or even an old farrier’s rasp may serve as a splint. There is also a commercial splint called the Kimsey Leg Saver that works well for fractures in this region.

The second area of the limb extends from the bottom third of the cannon bone up to the forearm region just below the knee. This region requires a heavier multilayered bandage called a Robert Jones Bandage. A rule of thumb is the diameter of the bandage should be about three times the diameter of the leg at the fracture site. The splint in this area should span from the foot to the elbow. One splint should be placed over the top of the bandage and secured with duct tape on the outside of the leg. Another splint should be fixed on the back of the leg, ninety degrees to the first splint.

The third area extends from the bottom of the forearm up to the elbow. The leg is bandaged and splinted the same way as in the second area, except that the splint is placed on the outside of the leg and should end at the level of withers. The portion of the splint that extends above the bandage should be padded.

The fourth area of the foreleg includes fractures from the elbow upward. In this case the leg should be bandaged and splinted so the knee is extended and the patient can bear weight on the leg. Additional bandaging is not needed for fractures in this region.

Like the forelimb, the hind limb may be divided into four areas. However, the arrangement of muscles and tendons in the hind leg called the reciprocal apparatus make splinting the hind limb more challenging. This is due to the fact that as the stifle actively flexes, the reciprocal apparatus passively flexes the hock and the fetlock. Therefore the hind limb should be splinted in extension, slightly behind the opposite leg. In addition, a splint extending from the toe to just below the hock should then be placed on the back side of the limb instead of the front and secured with nonelastic tape. With fractures in the fourth area of the hind limb, including fractures of the femur, stabilization is difficult and often unnecessary. The muscle mass in this area lends some stabilization. There is not a temporary splinting technique available that would improve the stability of the facture site more than leaving it alone.

Once the limb is properly splinted, the next step is to transport the patient to a referral institution for further treatment. The distance that the horse has to walk should be as minimal as possible. The trailer can be brought to an adult horse and foals can be carried. Gooseneck trailers are preferable to tag-along-trailers because they are more stable. Adult horses with forelimb injuries should be loaded in the trailer facing the rear and horses with hind limb injuries should be facing the front to minimize the deceleration forces on the affected limb when the vehicle stops. The horse should then be strictly confined to the smallest space possible in the trailer using rump and chest bars, leaving the head and neck free for balance. Hay should be offered during transport to help calm the patient. Loading in this manner helps keep the horse relaxed and supported during the trip. Young foals that sustain fractures may be transported laying down on soft hay in a gooseneck trailer or large van. If this is done a person should ride with the foal to watch him during transport.

In conclusion, fractures should be dealt with as emergencies, requiring immediate veterinary care. Proper bandaging and splinting, as well as proper transport to a referral clinic helps reduce the risk of further injury and greatly improves the prognosis.