Large Animals Fracture Repair

Equine Fracture Repairs

Figure 61:  Vertical accessory carpal bone fracture at time of fracture (A) and after 12 month (B).

Figure 62:  Craniocaudal radiographic view of a three-fragment, open radial fracture in an adult horse. A. Preoperative radiography B. Immediate postoperative radiograph showing good anatomic reconstruction with the help of two dynamic compression plates spanning the entire bone. The fragment on the lateral aspect was attached to the periosteum and was therefore left in place. C, Eight-month follow-up radiograph of the healed radius, taken after removal of the cranial plate. Note that the fragment has healed back.

Figure 63:  Craniocaudal postoperative radiographic views of the distal radius of the same foal as that in Figure 22-1. A Immediate postoperative view showing a four-hole T-plate, applied to the medial aspect of the bone, bridging the physis. Two short cancellous screws were inserted in the epiphysis, and three cortical screws in the metaphysic. The distal cortical screw was-up radiograph showing the healed fracture with the implants still in place. The medial part of the physis is fused, whereas the lateral is still open. Minimal varus deviation (overcorrection) is present. The implants were left in place too long.

Figure 64:  Radiograph of a diaphyseal fracture in a foal treated with two bone plates. A A 10-hole narrow dynamic compression plate (DCP) was applied to the lateral aspect, and a seven-hole broad DCP to the cranial aspect of the bone. Note that at least one plate should have been longer to reach farther distally into the metaphysic of the bone. B, Refracture of the radius at the distal end of the lateral plate 18 days postoperatively. A longer plate would have prevented the fracture.

Figure 65:  Postoperative lateromedial radiographs of a radial fracture treated with two broad dynamic compression plates spanning the entire bone. A, Immediate postoperative radiograph. Note that the cranial plate is poorly contoured at the proximal aspect (arrows). B, The fracture fixation broke down 5 days postoperatively, after the mare had been using the limb well.

Figure 66:  Radiograph of a 2mmonth-old foal with a distraction fracture of the olecranon apophysis. Disintegration of the apophyseal portion of the olecranon following pin and tension band wire fixation.

Figure 67:  Plate fixation of the ulna in a 12-months old horse, with all distal screws engaging only the ulnar shaft, to avoid complications of the screws bridging the radius and the ulna.

Figure 68:  A, Chronic nonunion fracture in a 4 year old horse 10 weeks after initial injury. Note the comminuted fragments forming the ulnar (semilunar) notch. B Postoperative radiography following surgical debridement and plate application.

Figure 69:  A plated repair of a simple oblique fracture in the sagittal plane. The over-riding fragments were compressed by a single lag screw prior to plate application.

Figure 70:  Adult ulnar fracture repaired with a narrow dynamic compression plate, overcontoured and distracting the cranial (intra-articular) portion of the fracture line.

Figure 71:  Radiograph of a typical oblique spiral fracture of the humerous found in foals and some adults

Figure 72:  Comminuted fracture in a 150 kg foal, stabilized with a single 4.5 mm broad dynamic compression plate applied to the cranial aspect of the humerous.

Figure 73:  Double plating in an adult using two broad dynamic compression plates applied with 5.5 mm and 6.5mm screws, bone graft, and plate luting, and with the distal screw engaging the medial epicondyle for added stability.

Figure 74:  Compression of a sagittal fracture of the talus, using three screws. The horse subsequently returned to competitive racing.

Figure 75:  Sagittal fracture of the talus (arrows) in a 4-year-old Standardbred racehorse. Minimal displacement has occurred.

Figure 76:  Comminuted fracture of the talus in a Throughbred Stallion. The bone was too fragmented for surgical reconstruction and the horse was euthanized.

Figure 77:  Comminuted fracture of the calcaneous 12 months after injury. There has been minimal callus formation, and light riding is possible. Two years after injury, the horse was sound and had returned to competitive race.

Figure 78:  Comminuted fracture of the calcaneus, with fractures of the body (open arrowheads) and lateral articular portions (solid arrowheads).

Figure 79:  Lag-screw repair of a large malleolar fracture.

Figure 80:  Fracture of the lateral malleolus (arrowhead), demonstrated by a dorsoplantar projection of the hock. These fragments are too small for reattachment and can be removed via open incision.