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Equine Limb Fractures: What's the Prognosis?

Pet Column for the week of March 27, 2009

Office of Public Engagement
2001 S. Lincoln Ave.
Urbana, Illinois 61802
Phone: 217/333-2907
Ashley Mitek
Information Specialist

Up until the 2006 Preakness Stakes, it was nearly set in stone that if a horse breaks a leg, its future is not bright. But then came Barbaro, the thoroughbred predicted to win the Preakness that year. After shattering its right hind limb in several places and undergoing five hours of surgery, its story offered hope that perhaps not all fractured limbs are beyond repair.

Even before Barbaro's accident received considerable attention from the media, equine surgeons have been successfully treating certain bone fractures. As far as giving a prognosis of a horse with a broken leg, "It usually depends on what bones are broken," says Dr. Elysia Schaefer, an equine surgery resident at the University of Illinois Veterinary Teaching Hospital. For example, a break in one of the smaller, more distal bones in a horse's leg may be repaired by placing a few screws during surgery.

However, "with fractures higher up, those bones are much harder to fix," notes Dr. Schaefer. She explains that the musculature in that area is much more extensive and just gaining access to the surgical site can be difficult. It is also much harder to stabilize the area, as most orthopedic surgeons want to immobilize the joints both above and below the fracture sight for several weeks after surgery.

In general, injuries occurring on the racetrack involve the lower limb. Barbaro's injury was such an example, and so too was Eight Belles', the filly that collapsed after winning the 2008 Kentucky Derby. Eight Belles also illustrates another issue that complicates track injuries. The average thoroughbred weighs approximately 1,000 pounds and can travel at speeds up to 40 mph. If a horse sustains an injury while barreling down the track, a simple fracture can quite quickly lead to a catastrophic injury or cause a shift in stride that affects other limbs.

Some speculate that in Eight Belles' case, in which both of her front ankles were broken, one leg was injured and then the change in weight bearing may have caused the other to fracture. Dr. Schaefer also adds that, "compound fractures do not have a very good prognosis due to the high risk of infection." If a bone breaks through the skin, it is termed a "compound" fracture. This is what happened to Eight Belles and was why her prognosis was bleak.

While the location of the fracture, and its severity all play a role in whether or not surgery may be feasible, there is one other issue that equine surgeons have to contend with: recovery. Explaining to a horse that it needs to remain calm and not sprint back to its stall after surgery is not easy. To prevent a horse from undoing its surgeon's hard work, many horses awake on a soft air mattress, or in the case of Barbaro, come out of anesthesia while suspended in a pool of water.

On a final note, dogs and cats can quite easily live with three legs, but horses are a different story. "It's not very feasible," says Dr. Schaefer, but "there are a couple of horses with artificial limbs and some miniatures can do quite well."