In the past, a horse with a broken leg was a dead horse. Even though fracture repair surgery has long been possible and is internally very similar to the techniques used in humans and domestic animals, the successful healing of fractures in horses is heavily dependant upon the stabilization done in the field and the ability to immobilize the limb after surgery. Great strides have made in the post-surgical immobilization of fractures meaning more and more horses are able to survive leg fractures, but the owner must take certain crucial steps before surgery is attempted to ensure that repair is a possibility.
In the case of a leg fracture, call the veterinarian immediately. The owner will need assistance in immobilizing the limb, and the veterinarian is best equipped to help with this task.
The horse must be calmed before any assessment or treatment of the injury can or should be attempted. A thrashing animal is not only very dangerous to handlers; it may cause more damage to the fracture which may make healing more difficult. The veterinarian will administer tranquilizers and pain medications to facilitate examination and splinting.
Splinting requires immobilization of the limb to the greatest extent possible, without strangulation of soft tissue, above and below the fracture site. Inadequate splinting may cause a point of leverage to exist that exaggerates the movement and displacement of the broken bone pieces. Displacement causes damage to blood supply and inflammation around the injury which can impede the healing process.
A splint consists of soft padding, bandaging material, and a rigid device that extends beyond the nearest joints above and below the fracture. The rigid material may be any object that is stiff and relatively lightweight. The width of the splinting device should be equal to or narrower than the limb at all points of contact. This will help secure the limb firmly against the splint without excess movement or slack underneath the bandage. Splints may be fashioned from two by four lumber, wrapped t-posts, pipe, or any scrap around the barn suitable for the purpose.
To splint a fractured leg, first wrap the splinting device with soft padding that will prevent pressure sores and injury to the skin. Clean strips of blanket or cotton roll bandage may be used. Secure the padding to the splint with duct tape, medical tape, or anything available that does not stretch when applied. This will not contact the skin.
Next, tear two or more strips of porous 2” medical tape if available, duct tape in a pinch, the length of the bandage to be applied. Sections of soft rope can also be used. One end of these “anchors” will be secured to the limb with a band of tape at the lowest point of the bandage, preferably just above another joint before the diameter of the limb increases. If duct tape is used for anchors, it should be reversed to avoid contact of the adhesive with the skin; only the securing band needs “stick” to the skin. Do not cause restriction to blood circulation! The free ends of the anchors should hang below the cast.
Wrap the limb with soft bandaging beyond the nearest joints above and below the fracture, or wrap the entire limb. The more immobilized the limb is, the better. The bandaging is to protect the skin from contact with the splint device and provide compression space for the outer cast. The wrap should be made of breathable, absorbent material. Never use plastic, rubber, or any other waterproof material against the skin. Secure the bandage with pieces of tape, any kind, without going all the way around the leg to avoid a tourniquet effect.
Pull the anchors up and along side the bandage, and secure them with tape. This will keep the cast from sliding off the limb. Add the splinting device to the outside of the leg, wherever it lies most naturally without jabbing the body, and tape it all the way around the leg just tight enough to keep it in place. The final wrap will hold every thing together firmly.
The outer cast should also be made of breathable material. Vetrap works great, but keep in mind that it shrinks with time, so don’t stretch the bandage when applying. With the bandaging underneath, there is room for compression however, so when the cast is complete it should hold the limb securely with little movement and still allow circulation. If non-adhesive casting wrap is used, it may be secured with several bands of adhesive tape.
The horse will not appreciate the cast and will goose step once it is applied. Every effort should be made to keep the animal quiet and calm while moving into the trailer. The horse can throw a cast quite easily if not secured properly or allowed to panic. Move the trailer to the horse rather than the horse to the trailer. Use chest and butt bars to immobilize the horse once trailered. Distraction can be provided with treats or feed. Discuss transportation of the horse with the veterinarian.
Immediate (but safe) transport to a surgeon will help ensure that the fracture avoids further displacement and holds hope for repair and healing.
