Management of orthopedic emergencies

Abstract

Initial management of injuries includes safely gaining control of the animal and assessing and treating systemic shock. If hemorrhage is life threatening, it must be controlled. If the limb is nonfunctional it should be stabilized. Any open orthopedic injury should be treated by cleaning the tissues, protecting the exposed tissues, and administering systemic antibiotics. A commercial splint is available (Equine Regular Leg Saver Splint, Kimzey Welding Works, Woodland, CA) that can immobilize and relieve weightbearing for cases of phalangeal fracture, flexor tendon rupture, fetlock breakdown, and lower joint luxations/subluxations. Hock and carpal luxation and radius fracture in foals can be stabilized by wooden or metal splint incorporation in a bandage. Tibial fractures can be stabilized with a modified Thomas splint. Injuries that expose a joint or infectious arthritis require emergency diagnosis of joint involvement, and subsequent joint lavage, intra-articular antibiotics, and systemic antibiotics. For further treatment of septic arthritis, the cases can be referred to a hospital for joint drainage. The appropriate emergency treatment of these injuries is often the determining factor in whether the injury remains in a condition that can be successfully repaired.