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  • David Jefferson

Hopeless Fractures

There is something about riding down the street on a prancing horse that makes you feel like something, even when you ain’t a thing………. Will Rogers

One reason for euthanizing horses “before their time” is leg fractures. A question I have been asked many times is: “Do you still have to put down horses with broken legs?” The simple answer is, “it depends”.

Would you consider skiing down a mountain knowing that if you broke your leg that would be the end of you? Me either. Hundreds of skiers suffer fractured legs every year, and within months most are walking without a limp. So why is it that you can’t fix a horse with a broken leg? What’s the story here? Are horse doctors so far behind medically that they have to kill the problems they can’t fix?

In order to answer this question, let’s return to the ski slope. Ann, trying to avoid a small child, veers off course, hits a patch of ice and is thrown into a tree. She struggles to get up, but can’t bear any weight on one leg. Within minutes the ski patrol has arrived and has air splinted her leg. Soon Ann is sledded down to an ambulance, and is on her way to the hospital. On the way care is taken to insure that there is no leg movement. At the hospital X-rays are taken and show a complete midshaft fracture of the femur. That’s the big leg bone that runs from our hip to the knee. Complete means that the bone is broken in half. It is a bone literally in two pieces, a far more serious situation than just a crack in the bone.

Muscles around Ann’s complete fracture went into spasm immediately after the break. Now the two ends of the bone may no longer be in alignment. That’s the surgeon’s first job. It requires muscle-relaxing drugs to ease those powerful leg muscles and special appliances used to pull the bones back into place. It will take hours, sometimes days with Ann on her back, her leg elevated by cables and pulleys. Once the two ends are in alignment, a fixation system will be applied, which, in this case, includes hardware-like rods, screws, and plates, and then, often, a full length cast. At this point the fracture is not really “fixed”. The bones have just been brought back into position and kept from moving so that the body can begin the true repair. Ann’s fracture will heal if the blood supply is not too severely damaged and if the reduction and fixation are successful. She will have to keep her leg elevated as she lies on the couch for weeks. Then the progression is from couch to crutches, perhaps a walker, and finally, Ann will likely ski again.

Let’s compare Ann’s fractured femur with what happens to a horse with the same bone, the femur, with a similar break. Most of the ones I have seen have been from slips on winter ice or slick mud. The horse can fall with one leg too far under the body. As the huge weight of the hind end is driven onto that leg, the bone can snap. It happened to my own horse, Pat, whom you will learn about in a later chapter. I have been called out in the early morning on several occasions to check on a horse who might have been lying on that fractured leg for several hours. Sometimes the owner and some friends have been trying to get the horse up for an hour or more. Typically the horse is laying on the fractured leg. It usually takes at least 3 people to safely roll a 1000 pound horse over onto his other side. Once the horse is rolled over and the broken leg is on top, the leg will bend unnaturally in the middle.

If we suspect a fracture, but aren’t sure, X-rays will be necessary. Most equine vets carry an X-ray machine, but there is the problem of getting power to a horse way out in a field. Some portable X-rays are battery powered, but even so the X-Ray has to penetrate the huge muscles of the hind leg. The muscle mass can cause the X-rays to scatter enough to prevent getting a good diagnostic image. X-Ray machines powerful enough to get detailed images of that big leg don’t fit in a truck. Another issue is that the animal still has to be transported to the nearest major equine hospital. This is not an easy job in any non-walking horse. If there is a complete separation of the bone as in Ann’s case, the two ends have to get lined back up just as with her broken leg. For that to happen it would mean general anesthesia or at least profound tranquilization to ensure that the horse remains still for hours while the muscles are stretched out to get the ends back in position. I’m sure you are seeing the problem. All this technically can be done with horses less than a year old, but when I see a full grown horse with a complete fracture of the femur, I recommend immediate humane euthanasia. The fact is, this leg cannot be stabilized so the fracture can be repaired. There is a somewhat better chance in dealing with the tibia, the bone between the stifle and hock, but it is still very challenging.

I suppose if a 1000 pound horse fractured one of these big bones while in the operating room of an equine hospital there might be a chance. Even so, it would be a very difficult repair with a guarded prognosis. Fortunately, big bone fractures of horses are rare. Successful repairs of this type of break have been mostly limited to youngsters.

On the bright side, there has been a tremendous amount of progress made in the last 20 years on bone fractures in horses. Cannon bones, and occasionally tibia repairs are successful with advanced orthopedic equipment in the hands of skilled veterinary surgeons. Horses with fractured pasterns that used to be considered hopeless now have at least a chance of being mobile again. Fractured coffin bones will usually heal in six months, and new techniques may have a race horse returning to work in half that time. Of course, part of the owner’s decision is always the expense on an uninsured animal.

Skilled small animal orthopedic surgeons often repair every conceivable type of fracture in dogs or cats hit by cars. Dealing with horse leg fractures is completely different. The size and temperament of horses makes repair of big bone fractures impractical and usually impossible. So, as I said, it depends, but too often we have no choice but to put these unfortunate animals down.

We should never underestimate the powerful draw of a bond with a being that loves us unconditionally, asking very little in return. Losing this comfort and source of joy can be incomprehensible……….Linda Lipshutz


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