I’ve got a special edition today of Tuesdays with Tony this week. I listened in on the recording of the fabulous podcast, Straight From The Horse Doctor’s Mouth with special guest Dr. John Peloso talking about broken legs in horses. I’m going to give my blog readers a sneak peak into the interview. I know, it’s awfully generous of me. You may send your fan letters to my people at Springhill Equine. Canned Tuna can also be sent there as a token of your appreciation. Back to the podcast. I’m quite fond of the hosts as they provide me with food, shelter, and chin scratches. Justin Long and Dr. Lacher discuss a wide variety of horse topics, and even this wise cat learns something during every episode. While listening to this recording I learned breaking your leg isn’t always a death sentence for horses. Guess that Far Side cartoon got it wrong. 

There’s broken, and then there’s Broken

First thing I learned is that “broken” means a few different things to Docs. There’s cracked, there’s broken in two pieces, there’s broken in a whole bunch of pieces, and there’s broken and poking through the skin. These are huge sweeping generalizations, but in general cracked, and broken in two (or maybe three) pieces is better, and means you can at least start the conversation about fixing the fracture. Broken in a whole bunch of pieces, and broken and poking through the skin are really, really bad. 

This comes down to why broken legs in horses are so much worse than broken legs in cats, dogs, or even humans. Horses have to stand on those crazy sticks they call legs. If the stick is broken in too many pieces, the surgeon can’t get it back close enough to normal for the horse to be able to stand on it. Sticking out of the skin is bad for two reasons: these are usually difficult to get back to that standable stick, and that bone is now really likely to get infected since horses live in bacteria and fungus-infested environments. They aren’t like us cats who stay clean no matter what! No amount of antibiotics can win the war against the amount of bacteria on a horse leg bone that’s been in dirt. In fact, it’s really hard to do with humans, too! 

Which bone is it?

Okay, so we know that how it’s broken matters, but which bone it is also matters a whole lot. Once again these are generalities, because horses are horses and at the end of the day they’ll do what they dang well please. They’re like cats that way. I respect it. The big bones above the elbow and the stifle simply can’t be fixed with the available bone fixing stuff. Apparently there isn’t horse broken bone hardware. All of the things surgeons use are adapted from humans. I don’t know if you’ve compared the average horse to the average human lately, but there’s a wee bit of a size difference. No human plate, screw, or pin can stand up to the enormous pressures the humerus and femur have to handle on a horse. Don’t get me started on shoulders, and pelvises, pelvii, whatever the plural for pelvis is. These areas are hard to get to due to muscles and nerves, and they’re both pretty darn thin. That means you can’t just plate them. The screws won’t hold. This means fractures above the elbows and stifles are just plain bad no matter how you slice them. 

This brings me to the area between the knees or hocks, and elbows or stifles. The radius up front and the tibia behind. These bones are shockingly easy to crack with a well-placed kick from another horse. The design flaws horses have are so numerous. It’s still shocking even though I see it every day here at the clinic. If these bones are broken, broken, as in look at x-ray and go, ‘wow that’s busted’ from across the room, that’s bad. You probably didn’t need me to tell you that. However, if they’re just cracked then there’s a shot they can heal! The trick is to convince the horse to be really quiet for about 6 weeks while that bone heals. No running, jumping, bucking, or cavorting. The best scenario here is what’s called a tie line. For this the horse is tied from somewhere high in the stall so they can’t lay down. It makes for a long 6 weeks, but the act of laying down and getting up puts an unbelievable amount of strain on those bones. It’s enough to make a cracked one shatter, and then there’s only one answer. 

Finally, the lower leg. Splint bones are easy. Those barely count as a fracture and generally heal with minimal help from anyone but Mother Nature and Time. Cannon bones are a little like the radius and tibia. If it’s a crack, it will heal. Bonus down here: surgeons can put a screw in there to stabilize things making them heal faster, and better. However, if it’s shattered, that’s really bad. Pastern bones are similar. Cracks: goood. Shatter: bad. The problem is that pasterns like to shatter. Coffin bones, despite their name, handle fractures pretty well, as long as the joint isn’t involved. The hoof capsule acts like a cast for these fractures, locking them in place. 

The Horse Factor

My biggest take away from my listen in was how much the horse itself matters. A quiet horse who isn’t looking for trouble has a way better shot than the horse trying to jump over the stall door on day 2 of stall rest. Now my Docs have pharmaceutical assistance for this, but the better behaved the horse, the better the chances. This next one seems obvious. The smaller the horse, the better the chances. Horses under 600 pounds do the best. Again, physics. All that weight on those tiny sticks. Such a bad design.

Moral of the story: broken legs can still be really bad, but not always! Oh and horses have some serious design flaws. If you find your horse non-weight bearing on a leg, or really swollen, Don’t Panic!!! Call my awesome Docs. They’ll evaluate things, figure out what’s going on, and help formulate the right plan for your horse. And as with all things horse, the sooner, the better. Everything gets harder to fix with time.  

Until next week,

~Tony

P.S. The Broken Bone episode of the podcast comes out on October 1st, and you can find it on my Podcast Page. There are fifty-something other episodes to keep you busy until it comes out!