Proximal Splint Bone Fractures

Proximal splint bone fractures are, unfortunately, fairly common.  They generally occur as a result of a wound or infection. These types of fractures are considered to be traumatic in origin, meaning that they are the result of some sort of injury. Exercise and weight bearing pressure can cause biomechanical injuries as well. Fractured splint bones that do not receive proper treatment may cause ongoing infections and possibly, sequestrum formation (dead bone fragment).  The placement of splint bones makes them especially susceptible to trauma. The treatment of proximal splint bone fractures will vary depending on a number of factors.

The severity of the fracture will play a part in how it is treated. Commonly utilized treatment options include metallic implant stabilization, screw fixation, plate fixation and PRP therapy. The prognosis for a proximal splint bone fracture is good if it is adequately treated early. However, if osteomyelitis or chronic infectious arthritis manages to develop, a positive outcome is unfortunately not assured. A horse may end up having problems, potentially very serious ones. It is thus extremely important that a horse’s owner make sure that the horse receives immediate care, if they suspect a problem. A failure to do so can jeopardize a horse’s health.

A horse that develops a proximal splint bone fracture will experience pain in the proximal splint bone which is a lower limb bone located alongside the cannon bones. A horse that suffers from this type of injury will experience a great deal of pain and possibly lameness. If an owner notices that their horse is exhibiting these types of symptoms, he or she needs to have them checked out sooner rather than later. Swelling is often quite common with this type of injury. It fact, it will be one of the most noticeable of all the symptoms a horse exhibits. Heat and draining tracts might also be present.

There are a number of ways to treat a proximal splint bone fracture. Placing the limb in a full cast for a period of 4 to 6 weeks and following it up with bandaging is one option. Surgery is also a possibility. If the bone has healed but a large callus has developed, it may be necessary to have it removed.  Internal fixation is also an option if a significant amount of the splint bone has to be removed.  PRP therapy may be used in conjunction with any of the aforementioned. It may be used for the purpose of increasing the speed in which the fracture heals, whether it is post surgery or before a horse is cast and then bandaged. In addition to expediting the healing of soft tissue healing, PRP therapy is known to do the same for bone injuries.

Horses are susceptible to proximal splint bone fractures, especially young horses. This is because splint bones are pretty easy to fracture. A great deal of concussion work by younger horses can result in these bones fracturing. Care and attention must thus be paid to avoid such injuries as much as possible. If such an injury can not be avoided, proper and speedy care is required.

Causes 

As mentioned above, proximal splint bone fractures typically have a traumatic origin. The bone has been wounded in some way. This may be due to a direct blow to the bone. Because this type of fracture often breaks open, bone infections are quite common. If the skin is not broken, pieces of broken bone may eventually break it and draining tracts may develop.

Overuse can also cause proximal splint bone fractures, especially amongst young horses. As mentioned above, concussion work by young horses can result in fractures of the splint bones.

While it’s certainly is not possible to completely prevent injuries from occurring, special effort should be made to prevent injuries as much as possible. Becoming knowledgeable about the types of risks certain horses (breed and function) face and then creating safeguards to limit or prevent those types of injuries a horse is most susceptible to is recommended.

An owner that educates him or herself about the most common causes of proximal splint bone fractures and then takes measures to decrease the likelihood that their horse will develop them is wise. The fewer injuries a horse sustains, the better.

Symptoms 

A horse that suffers a proximal splint bone fracture will often exhibit a number of symptoms. Because some of these symptoms can be the result of something other then a proximal splint bone fracture, it is important that a final diagnosis be made by a veterinarian, who has the proper knowledge, tools and equipment at his or her disposal.

With that being said, one of the most common symptoms associated with a proximal splint bone fracture is lameness, though it may not necessarily be severe. This may show itself when the horse trots, when it is circling or when doing fast work. The horse may also point the foot of the leg which is fractured.

Inflammation will be present as well. Upon palpitation, there will be heat, evidence of swelling and a pain response from the horse. Overtime, if a large callus forms, the leg may appear bigger then normal.

Diagnosis

When attempting to determine whether or not a horse has a proximal splint bone fracture, a veterinarian will first observe the behavior of the horse. He or she will be looking for abnormal gait, lameness, foot pointing, etc. The doctor will also visually inspect the leg to see whether it is misshapen or inflamed. He or she will then palpitate the leg, checking for heat, inflammation and a pain response.

After the aforementioned, a complete radiographic and x-ray examination will be given, including that of the tarsal and distal carpel. The vet may also choose to use Contrast radiography. He or she will also take a look at the joints to determine whether or not those near the wound have become contaminated.

After it has been determined that a horse has indeed suffered a proximal splint bone fracture, the extent of the injury will need to be determined. Once the latter has occurred, the veterinarian will be able to develop an appropriate course of care. In the next section, we will discuss how to treat this type of injury, specifically how PRP (Platelet Rich Plasma) is becoming an increasingly popular way to aid in the healing of proximal splint bone fractures.

Treatment

There are a variety of treatments appropriate for proximal splint bone fractures. The treatment determined to be most appropriate will depend on the severity of the injury. In some cases, a full limb cast is necessary. Other times, bandaging will suffice. In still other instances, surgery is required. PRP therapy is an option that an increasing number of veterinarians are using to help speed up the healing process. PRP is being used more and more not only to treat animals but also human beings. It has been used for decades in the field of dentistry and now is used to speed up the healing of soft tissue and bone injuries in horses.

PRP stands for Platelet Rich Plasma. This is a treatment that utilizes a horse’s (or person’s) own blood platelets and to jumpstart the healing process. Platelets contain growth factor proteins which are crucial to the body’s ability to heal itself. When an injury has occurred, the body will send growth factors to the area. When PRP therapy is utilized, a concentrated amount of platelets and thus growth factors is injected into the injury site. As a result, the person gets the benefit of the growth factors but many times over. This helps to significantly speed up the healing process.

PRP therapy is a good treatment option for Proximal splint bone fractures when it is used alongside other forms of care, i.e., bandaging, casting, surgery, etc. It can help lessen the amount of time it takes the injury to heal, perhaps significantly. It wouldn’t be appropriate to strictly use PRP therapy because fractures need special care and protection that the therapy can’t offer on its own. However, again, its use can be very beneficial, in conjunction with traditional treatments, i.e., surgery, bandaging and casting.

Though human beings and horses are different in many ways, there are many, important similarities. PRP has been used to help some of the world’s best athletes (Alex Rodrigquez, Tiger Woods and Troy Polamalu to name a few), return from serious injuries much faster than anyone believed possible and not only return but perform at a high level. The treatment is proving to be able to help horses heal from injuries in a similar manner.

When a horse undergoes PRP therapy, it will typically be administered at a clinic, though a veterinarian can perform the procedure at a farm or wherever the horse is being housed. He or she will prep the horse. This will typically involve the administering of a nerve block and sedation. The vet will draw about 52 mLs of blood from a standing horse. 8mls of an anticoagulant solution will be mixed with the blood. The blood is then placed in a centrifuge machine where it is spun until all of its components are separated. Blood consist of red and white blood cells, plasma and platelets. Once the blood’s components have been separated, the platelets are removed and injected into the injured area. Ultrasound guidance is not typically needed. The procedure takes very little time and is minimally invasive.

A horse undergoing PRP therapy should not feel any pain, partly because the procedure is not painful and also because of the administration of sedation and the nerve block. Veterinarians have the option of using PRP sprays and gels if they would rather not use an autologous blood PRP treatment.

After a horse has been administered PRP, it will need to rest because of the treatment and perhaps more so because of the seriousness of the injury.  Fractures, especially severe ones, will require rest and bandaging.  Additional applications of PRP may be necessary if the vet determines that additional ones are required.

There are few complications associated with PRP therapy. This is because it uses the horse’s own blood platelets. The horse’s body won’t reject the platelets and the likelihood of complications is thus minimal.


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