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EQUINE VETERINARY EDUCATION / AE / SEPTEMBER 2017


a)


reciprocal apparatus makes alignment of the dorsal cortices of the third metatarsal bone and phalanges impossible. A plantar (board type) splint that produces a greater degree of distal joint flexion is preferred whenever joint flexion is indicated in temporary immobilisation of this region.


Fractures of the proximal phalanges Sagittal and parasagittal fractures of the proximal phalanges in the hindlimbs are less common than their forelimb counterparts (Hill 2003a). They are also more usually simple and/or incomplete although all configurations can occur. Horses find it easier to ambulate on two fore- and one hindlimb than vice versa; they also protect better distal hindlimb fractures during movement and transport. The principles of temporary immobilisation are similar to the forelimb although proprietary boots fit poorly and are less well tolerated on the hindlimbs. Positioning a painful hindlimb with the metatarsophalangeal


b)


and interphalangeal joints extended (in a weightbearing position) often cannot be achieved with the leg perpendicular to the ground i.e. parallel to the uninjured limb. However, by positioning the leg in a protracted position and, with a steadying hand on the calcaneus, a sedated horse will usually keep the limb there while support is fitted (Fig 16). A Robert Jones bandage or bandage cast generally are the techniques of choice. Fractures of the plantar processes of the proximal phalanx may be immobilised with a plantar board splint.


Fractures of the distal condyles of the third metatarsal bone Like parasagittal fractures of the proximal phalanx, these are less common training and racing injuries in the hindlimb than the forelimb but the disparity is not as great. The severity of fractures of the hindlimb lateral condyle also is less than in the forelimb but the propensity towards medial, proximally propagating fractures is greater.


Fig 15: Displaced fracture of the right scapula; (a) marked swelling produced by haemorrhage; (b) segmental shortening between the proximal margin of the scapula and the lateral tuberosity of the humerus.


ambulance from the racetrack. Further examination in clinical facilities may be more rewarding. Confirmation can usually be achieved at this time by ultrasonographic examination. In the author’s hands complete, displaced fractures of


the scapula in adult horses carry a hopeless prognosis for humane preservation of life. Even short-term comfort while connections are consulted can be difficult to achieve. Sedation and combination analgesia are employed, while decision making processes are expedited.


Hindlimb fractures


Fractures of the middle and distal phalanges and navicular bone The mechanics of fractures of these bones are identical to those involving their forelimb counterparts. However, the


© 2016 EVJ Ltd


Fig 16: Hindlimb positioned for application of support for distal limb fractures in a weight bearing position.


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