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CONSULTANT’S CORNER
ideal splint should counteract the gle to help prevent shifting during
Gary M. Baxter, VMD, MS damaging biomechanic forces in the transport, and they should be tightly
Diplomate, ACVS affected area without being so cum- secured to the bandage using nonelas-
Department of Clinical Sciences bersome as to hinder the animal’s tic white tape. If PVC material is not
College of Veterinary Medicine and movement. The splint should also be available, any lightweight, rigid mate-
Biomedical Sciences economic and capable of being ap- rial (e.g., wood, aluminum, flat steel)
Colorado State University plied in any field situation without is effective.
the need for general anesthesia. Portions of the forelimb above and
below the site of a midshaft metacar-
B
efore tending to the fractured Fracture Stabilization pal fracture can facilitate splint appli-
limb, a good physical examina- Open transverse midshaft metacar- cation. In this case, the small size of
tion should be performed and pal fractures are located in the mid- the foal should also aid in obtaining
the wound cleaned and lavaged if forelimb division and are thus best good stabilization of fracture frag-
possible. However, local treatment of stabilized with Robert–Jones ban- ments. Because of the sparse soft tis-
wounds may be difficult in young, dages combined with full-limb sue coverage in the metacarpal region,
fractious foals. Sedating the foal with polyvinyl chloride (PVC) splints ap- however, closed fractures in this loca-
xylazine may enable examination of plied caudally and laterally. The ban- tion can easily become open if not ad-
the limb and help control skeletal dage should be applied in several lay- equately splinted (or, in this case, the
pain. ers; each layer of padding (cotton) wound may enlarge and cause further
To minimize bacterial colonization should be no more than 1-inch thick contamination of the fracture site).
of the fracture site, broad-spectrum and compressed with elastic or brown This is especially true for foals because
antimicrobials (e.g., penicillin com- gauze to increase its stiffness. The to- their thin skin provides little resis-
bined with gentamicin, amikacin, or tal diameter of the finished bandage tance to bone penetration. However,
ceftiofur) should be administered be- should be approximately three times foals tend to protect their fractured
fore transporting the foal; this may the diameter of the limb at the frac- limbs better than do adults, which
also help prevent osteomyelitis devel- ture site. Splints should extend from aids in the transport of young horses.
opment if internal fixation is per- the elbow to the ground at a 90° an- The mare and foal should be trans-
formed. In addition, it may be bene-
ficial to apply an antibiotic dressing
over the wound and administer non- Consultant’s Corner is a regular feature in the Equine section of Compendium.
steroidal antiinflammatory drugs (e.g., The purpose of the column is to provide expert answers to questions that are fre-
phenylbutazone, flunixin meglumine, quently asked by practitioners. Readers are encouraged to ask questions that they
or ketoprofen). would like to have answered, and experts are welcomed to submit questions they
For the purposes of fracture splint- would like to address. For suggestions involving topics in equine medicine, please
ing, the forelimbs and hindlimbs can contact James N. Moore, DVM, PhD, Department of Large Animal Medicine,
be divided into four functional units College of Veterinary Medicine, University of Georgia, Athens, GA 30602; 706-
depending on the biomechanic forces 542-3325; fax 706-542-8833; email jmoore@cvm.vet.uga.edu.
acting in each area (Figure 1). The
Equine 20TH ANNIVERSARY Compendium January 1999
Bibliography
Goals of First Aid Fracture Management Bramlage LR: Current concepts of emergency first aid treatment and
transportation of equine fracture patients. Compend Contin Educ Pract
■ Prevent damage to neural and vascular elements of Vet 5(10):S564–S574, 1983.
the limb. Bramlage LR: First aid and transportation of fracture patients, in Nixon
■ Prevent skin penetration by the fracture fragments. AJ (ed): Equine Fracture Repair. Philadelphia, WB Saunders Co, 1996,
■ Minimize further contamination of an existing pp 36–42.
wound. Brodell JD, Axon DL, Evarts CM: The Robert Jones bandage. J Bone
■ Relieve the animal’s anxiety by stabilizing the Joint Surg 68:776–779, 1986.
fractured limb. Herthel DJ: A systematic approach to long bone fracture management. J
■ Minimize further damage to the fractured bone Equine Vet Sci 13:258–260, 1993.
Turner AS: Long bone fractures in horses. Part I. Initial management.
ends and surrounding soft tissue.
Compend Contin Educ Pract Vet 3(9):S347–S354, 1981.