Due to the heavy weight of our patients and their nature as flight animals, the treatment of fractures in equine medicine presents a particular challenge. However, thanks to continuous development in veterinary medicine, a bone fracture is no longer necessarily a death sentence for the affected horse, unlike a few decades ago.

Thanks to many years of experience and continuous further training, we at Pferdeklinik Bargteheide have specialised in the surgical treatment of bone fractures.

Important parameters that are decisive for the prognosis of a horse with a fracture are the affected bone, the size or weight of the horse, the fracture configuration and whether it is an open or closed fracture. Overall, the prognosis for lighter horses with lower limb fractures is significantly better than for heavier horses with upper limb fractures. Comminuted fractures are more difficult to treat than simple longitudinal fractures. Open fractures, i.e. those in which the skin is severed, generally have a poorer prognosis, as the bacteria that penetrate through the skin injury often lead to infection, especially if plates and screws are used for osteosynthesis.

Grip bone fractures are the most common fractures in horses. The prognosis after surgery is generally favourable because the cannon bone bears the main load of the limb. As a rule, the blind-ending lower fragment of the handle bone is amputated. In the case of closed fractures in the upper third of the handle bone, treatment using plate osteosynthesis may be advisable. Open fractures of the lower part of the handle bone can usually be successfully treated surgically; open fractures in the head of the handle bone are usually not treated surgically, but must heal on their own. In rare cases, a total resection of a handle bone may be unavoidable.

Fractures of the coffin bone represent a surgical challenge due to the localisation of the coffin bone within the horn capsule of the hoof. Fractures in the Coffin bone area are treated with stall rest, special shoeing and a hoof cast. Longitudinal fractures of the coffin bone have a less favourable prognosis due to joint involvement and the resulting risk of arthrosis and can be treated either with screws or a cast.

Fractures of the coronet bone are rare and usually comminuted fractures with poor healing prospects. In some cases, the horse can be saved by an arthrodesis, i.e. joint fusion, of the crown joint.

Pastern fractures often occur as stress fractures in the centre of the pastern and can be screwed and additionally plastered with favourable healing prospects.

Hairline cracks in the pastern bone (pastern fissure) can usually be treated with box rest and, if necessary, plaster fixation for restless horses. These pastern fissures usually have a good chance of healing.

Fractures in the area of the upper long tubular bones such as Lower and upper arm, and Lower and upper thigh represent a major surgical challenge. The prognosis depends very much on the weight of the horse, the type of fracture (covered / open fracture) (plain fracture / spiral fracture / comminuted fracture) and any joint involvement.

Fractures of the ulna / elbow are an exception. (Ulna fracture) represent. These often occur in young horses and have a cautious to favourable prognosis depending on the course of the fracture.

The decision to operate on a fracture should be carefully weighed up between the surgeon and owner, taking into account animal welfare, economic aspects and surgical feasibility.

The surgical treatment of Fractures is particularly difficult due to the following factors:

The heavy weight of a horse leads to a high mechanical load on the fracture both in the standing phase after the operation and in the healing phase. The strain on the injured limb cannot be reduced by lying down or using walking aids, as is the case with humans. Additional fixation by plastering is not possible, especially in the upper limb area, so that immediately after the operation a Load stability must be given. In order to reduce mechanical stress after fracture operations, we have a Swing lift is available. This supports part of the body weight by means of a flexible hanging construction and the horse can still move and lie down freely in the box.

A distinction is made between smooth fractures from Spiral fractures and Comminuted fractures, In the latter case, the chances of recovery are generally hopeless due to the lack of load stability. With open fractures is in contrast to covered fractures the skin is opened by sharp bone ends or by external force. These fractures usually also have a hopeless prognosis due to the penetration of bacteria via the wound.