Large Animals Fracture Repair

Equine Fracture Repairs

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.

Figure 81:  Small lateral malleolar fracture fragment (arrow), suitable for arthroscopic removal.

Figure 82:  Large medial malleolar fracture in a 15-year old Throughbred (A), repaired with two 5.5 mm cortical screws placed in lag screw fashion (B). The horse returned to athletic performance.

Figure 83:  Lateromedial radiographic projection of the tarsus of a horse with slab fracture of the third tarsal bone. B. Six months after conservative treatment, the originally nondisplaced fracture has collapsed and partial ankylosis has occurred. The horse remained lame and was retired from racing.

Figure 84:  A. Displaced fracture of the third tarsal bone. B Lag screw repair of the slab fracture with two 3.5 mm cortical screw, resulting in satisfactory fracture-line compression.

Figure 85:  Displaced metatarsal fracture with tarsometatarsal subluxation (A) and following repair by cobra plate application to fuse the distal hock joint and the thirk metatarsal fracture (B).

Figure 86:  Cranial to caudal (A) and lateral to medial (B) radiographs depicting a simple spiral diaphyseal fracture of the tibia in a foal.

 Figure 87:  Lateral to medial radiograph of tibia tuberosity avulsion fracture in an adult horse. The fracture enters the femorotibial joint proximally.

 Figure 88:  Cranial to caudal radiograph depicting nondisplaced diaphyseal fracture (arrowheads) of the tibia in an adult horse.

 Figure 89:  A and B, Lag screw and tension-band plate fixation of the tibial tuberosity avulsion fracture depicted in figure 27-4

 Figure 90:  Long oblique fracture of the distal tibia in an adult miniature horse, opened medially (type II open injury). Lateral to medial (A), and cranial mto caudal (B) radiographic projections demonstrate the proximity of the fracture to the tarsocural joint. Lateral to medial projection (C) and cranial to caudal projection (D) demonstrate double plate fixation with the use of a 4.5 mm broad dynamic compression plate (DCP) contoured to the distal cranial aspect of the tibia extending proximally to the craniolateral aspect of the tibia and affixed with 5.5mm cortical bone screws. A 4.5 mm narrow DCP was applied laterally to avoid the soft tissue injury secondary to the open nature of the fracture. Numerous plate screws were placed across the fracture in lag-screw fashion, and the cranial plate was luted. Healing proceeded without complication.

Figure 91:  Double-plate fixation of the spiral tibial fracture of the foal shown in figure 27-2. Cranial to caudal (A) and lateral to medial (B) radiographs show the 4.5,, broad dynamic compression plate (DCP) that was contoured to extend from the distal cranial to the proximal craniolateral aspect of the tibia, spanning the distance between the proximal and distal physes. A 4.5 mm narrow DCP was applied medially. Note the 5.5 mm screws throughout the majority of the medial plate and at the proximal and distal ends of the cranial plate. A number of plate screws were used in lag-screw fashion, and the cranial plate was luted to increase stability. Healing was uncomplicated.

Figure 92:  Fracture of the dens of the axis with ventral displacement and subluxation of the atlantoaxial junction in a foal. The spinal cord can move lateral to the fractured dens, lessening the severity of the neurologic deficit.

 Figure 93:  Radiograph of atlantoaxial luxation with the dens of the axix (arrows) displaced ventral to the ventral atlantal arch.

 Figure 94:  Multiple fractures of the fifth cervical vertebra resulting from a "de-roofing" hyperextension injury. The entire dorsal lamina and pedicles are cleaved from the vertebral body, and tension fractures of the vertebral end plate are evident. The horse was recumbent and was subsequently euthanized.

Figure 95:  Oblique lateral radiograph showing an acute fracture of the pedicle of the fourth cervical vertebra (arrow).

 Figure 96:  Fourteen months following plate application, the fracture of C$ has healed. Residual degenerative joint disease and fusion of C4-C5 has developed, and a small fragment of the ventral crest of C2 (arrow) has fractured because of interference of the plate with C2-C3 flexion.