CATASTROPHIC LIMB FRACTURES
These are injuries that are not amendable to fracture repair and require euthanasia on humane grounds. Traditionally, displaced fractures above the knee or hock have been poor candidates for surgery and although attempted many times, the success rate is dismal. Horses also respond very poorly to infections within the medulla of the bone and therefore compound bone fractures (where the bone has gone through the skin) carry an extremely poor prognosis and necessitate immediate euthanasia. Therefore, if bone is seen protruding or if there is severe deviation of the limb indicating a displaced fracture, the vet should see the horse immediately.
In cases where there is some displacement of the fracture below the knee or hock (so the cannon or pastern bone is fractured) but there is no external wound, these can be successfully repaired, and also need to be seen by a vet immediately as the fracture requires stabilisation to prevent the fragmented bone piercing the skin, changing the outcome from repair to euthanasia.
In situations where a fracture is suspected by the owner, but there is no visible sign of swelling or displacement, these are not a No. 1 priority as they can be boxed or prevented from moving for several hours without affecting the outcome. If there is swelling that alerts the owner to the site of a potential fracture, a firm bandage can be applied to the limb, incorporating the joint below the area and the joint above the area, to stabilise it. For example, if there is some swelling above the fetlock and the horse is fracture lame, a firm bandage can be applied from the pastern to the knee.
Most traumas with horses are centred around their legs and causing large lacerations that need to be dealt with in a timely fashion but are not necessarily a No. 1 priority. This is because many leg injuries can be dealt with by their owners using basic first aid until the vet can arrive. First aid usually involves cleaning off any major contamination to the wound, applying pressure to stop bleeding and applying a bandage to keep the area from swelling and the tissues from drying out. This may not always be possible, particularly in unhandled horses, but, if possible, they can be moved to a quiet, cleaner environment and left until the vet can arrive.
However, there are traumas that warrant immediate attention, and these would include severe head traumas, especially those where the horse is thrashing on the ground and cannot be settled by gentle words or a towel over the eyes. Any injury where there is uncontrollable blood flow has the potential to be life-threatening and, in these situations, it is vital that there is good, clear, and concise communication between the owner and the vet. A wound that is dripping blood is unlikely to result in death, so if you can count the drops it is less of a concern than a wound where the blood is a steady stream. If possible, firm pressure can be applied to these wounds to slow the flow and encourage the blood vessels to close will help immensely until the vet arrives – but once again, communicating an accurate picture to the vet will allow them to issue some helpful tips.