Large Animals Fracture Repair                         

Equine Fracture Repairs

Figure 1  Radiograph of a 10-week-old foal with a long oblique fracture of the third metatarsal bone with a large butterfly fragment. B. Nine weeks following repair with a single broad 4.5 mm dynamic compression plate and appropriate lag screw in the butterfly fragment, the fracture has healed without callus formation.

Figure 2:  Severely comminuted fracture of the proximal third metacarpal bone of a 16 weeks old. Through-bred foal at the time of injury (A). 2 weeks following cast immobilization (B), and 7 weeks following casting (C), showing bony union by callus formation.

Figure 3:  A, Comminuted femur fracture in a miniature foal. B. Treatment of the fracture by the use of stacked  pin fixation in conjunction with multiple cerglage wires.

Figure 4:  The large animal intramedullary interlocking nail system showing targeting jig, nails of various lengths, and drill guides.

Figure 5:  Cross section of a foal humerous, demonstrating the procedure for drill-hole preparation with the use of a targeting jig and a drill guide.

Figure 6:  Radiograph showing substantial bone resorption at the site of the transfixation pin utilized for transfixation-cast stabilization of a distal limb injury. In this case, a single transfixation pin was utilized, which may have contributed to the degree of resorption.

Figure 7:  Ring sequestrum at the transfixation pin site secondary to faculty technique for pin insertion.

Figure 8:  A, A transfixation cast was used in this instance to protect an internally stabilized fracture. The type IV physeal fracture has been present for 3 weeks prior to fixation, resulting in significant bone resorption along the fracture line. The fracture was stabilized with 4.5 mm cortical bone screw to maintain articular congruency and increase stability at the fracture site. The transfixation cast protected the fixation from displacement during postoperative weight-bearing. B, Following-up radiographic evaluation 3 months postoperatively demonstrates excellent healing of the fracture with maintenance of articular congruency.

Figure 9:  Postoperative radiographic examination of the right hind-limb in a distal limb cast following arthrodesis of the proximal interphalangeal joint. Obsterical wires, seen on the medial and lateral sides, were placed to avoid laceration of the skin or deeper structures during cast removal.

Figure 10:  Plantar process abaxial "wing" fracture of the proximal phalanx. B/ Lag screw repair of plantar process fracture.

Figure 11:  Medial collateral ligament avulsion of the proximal articular surface of the proximal phalanx. B, collateral ligament avulsion fracture repaired by lag screw insertion.

Figure 12:  A, A small medial collateral ligament avulsion of the proximal phalanx prior to surgery (A), and following repair with a single 3.5 mm lag screw and a 2mm pin (B).

Figure 13:  Complete nondisplaced sagital fracture of the proximal phalanx. B., After repair of nondisplaced fracture using cortical screws placed through stab.

Figure 14:  Dorsoplantar (A) and oblique radiographs of a moderately comminuted proximal phalanx fracture with an intact medial cortical stru, suitable for a lag screw reconstraction using the intact strut as a framework.

Figure 15:  Dorsoplantar (A) and oblique (B) radiographs of fracture shown in figure 12-5, following multiple lag screw repair using an open surgical repair with fetlock luxation to allow reconstruction of the smaller fragments to the intact medial strut.

Figure 16:  Lateromedial radiography of a severely comminuted fracture of the proximal phalanx. Without an intact strut, it is not a candidate for internal fixation.

Figure 17:  An external fixation device stabilizing a comminuted proximal phalanx fracture in a horse.

Figure 18:  Lateromedial (A) and dorsopalmar (B) radiograph of the comminuted proximal phalanx fracture shown in figure 12-8, following removal of the external fixator. The fracture is stable.

Figure 19:  A and B, Radiographic appearance of comminuted fracture at the time of removal of the external fixator. External coaptation in a fiberglass cast was continued for a further 4 weeks.

Figure 20:  Radiograph demonstrating palmar luxation of the proximal interphalangeal joint subsequent to an avulsion injury of the palmar periartecular soft-tissue support structures.