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The Surgical Management of Equine Fractures
T. Greet
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This paper will describe the surgical treatment of some equine fractures, but exclude the removal of intra-articular fragments under endoscopic control. Whilst the TB racehorse is the most common patient to which these techniques have been applied by the author, the techniques are equally valuable in the treatment of fractures in other types of equine athlete.
The use of internal fixation has been recommended for the treatment of equine fractures increasingly over the last 40 years or more. In particular the development of specific implants to create compression at the fracture site has allowed many horses involved in athletic competition to return to their former use, even after significant intra-articular fractures. Lag screws inserted in a variety of locations using 3.5, 4.5, or even 5.5 mm cortical implants provide a very effective means of reducing fracture gaps and in creating stable intrafragmentary compression. These have traditionally been used for long bone fractures in combination with dynamic compression plates. The adaptation of medical surgical techniques and implants, such as the sue of dynamic hip or condylar screw/ plate systems has also achieved popularity with some equine surgeons. Tthe recent arrival of the locking screw/plate system will also probably find its place in the equine surgeon`s armamentarium.
The presentation will review some of the fractures encountered in equine practice and describe a rational approach to their management using the various techniques now available to the equine surgeon. The intention is not to give a comprehensive technical review but to highlight some of the pitfalls of fracture management in foals and adult horses.
“Take Home Messages”
- Most fractures will heal if given the chance
- Conservative management is effective for some injuries
- Many common fractures can be repaired successfully
- Most long bone fractures in adult horses remain a challenge to the surgeon Make sure that the client is aware of the likely outcome from the start
and the costs involved
and remember that.... [...]
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