Fractures of the Elbow in Horses

There are several kinds of fractures, which include the incomplete fracture, complete fracture, and compound fracture. An incomplete fracture is a crack or split in the bone, and is very common in horses used for racing or jumping. A complete fracture is one that is broken all the way through. In some cases, the bone may be broken into several pieces, which would be considered a comminuted fracture. The most serious fracture is the compound fracture in which the bone actually penetrates the skin. This is a serious emergency and can be life threatening if you do not get help from an equine veterinary professional right away.

Elbow fractures are common, especially in foals, and are usually caused by an injury or stress fracture. Besides the four kinds of fractures, there are six different types of elbow fractures, which includes Type 1a, type 1b, type 2, type 3, type 4, and type 5. This kind of injury in horses is extremely critical because it is the ulna and olecranon that bears weight, allowing your horse to stand. When the olecranon or ulna are damaged, the muscles (triceps) that hold the elbow straight are unable to function, leaving your horse lame. Some of the treatments involve surgical reconstruction and long term stall rest. In some cases, a metal plate will be placed in your horse’s leg to stabilize the fracture.

Fractures of the elbow in the horse is a serious condition due to the difficulty in treatment. The most common elbow fracture involves the ulna and the olecranon (point of the elbow).

Your horse’s symptoms may vary depending on the type of break as well as the age and health of your horse. However, the most common symptoms are:

• Extreme swelling of upper leg
• Dropped elbow
• Cannot bear weight on the affected leg
• Strange angle or shape of the leg
• Shock (rapid heart rate, anxiousness, and sweating
• Open sores or bleeding from the affected area if the bone penetrates the skin

Types

• Type 1a does not include the joint
• Type 1b includes a small part of the joint
• Type 2 includes the tip of the olecranon
• Type 3 involves the entire olecranon
• Type 4 is multiple fractures involving the joint and olecranon
• Type 5 involves the joint, olecranon, and ulna

You may not know the cause of the fracture, but the most commonly reported causes include:

• Accidental (direct or indirect trauma)
• Being kicked by another horse
• Stress fracture from long term stress on the bone (racing, jumping)
• Previous fracture
• Infection or disease that has damaged the bone

Diagnosis includes your horse’s history, immunization records, and a physical assessment. The veterinarian will assess your horse from a distance first to watch for attitude, conformation, stance, behavior, and abnormal movements. The veterinarian will then do a thorough close-up examination including a body condition assessment. The veterinarian may do a brief lameness examination if your horse is able, but with a severe break and obvious pain, having your horse mobile is not recommended.

In addition, there are certain laboratory tests that need to be performed such as a complete blood count, chemistry panel, urinalysis, and fecal examination. Perhaps the most essential test are radiographs to get a look at the bones involved as a way to determine which type of elbow fracture your horse has. In many situations, the veterinarian may need a CT scan, MRI, or ultrasound for more detailed views of the bones, muscles, and tissue damage.

The first thing the veterinarian will do after getting a good look at the fracture site is to stabilize the leg to prevent more injury and pain. Medication for pain may be given at this time to calm your horse and relieve some of the inflammation. If surgery is required, the veterinarian will admit your horse to the hospital and get started on the process.

Stabilizing the Leg

If the break is a minor one such as with type one and hairline (incomplete) fractures, an external cast or splint will be used to keep the bones from moving. Other types of fractures will need to be aligned and then fixed into position. This may include external plates, screws, or pins, depending on the area and severity of the break. Severe fractures will need surgical repair

Surgical Repair

Some of the surgical options include internal fixation with bone plates and screws or metal rods inserted into the bone. Although these types of surgery are expensive, they offer a much higher success rate and faster recovery time.

Medications

The veterinarian will prescribe NSAIDS for pain and inflammation, corticosteroids for inflammation, and an antibiotic to prevent infection if there is any risk.

Unfortunately, some horses have to be euthanized because the fracture is too severe or the horse is not healthy. However, with fast treatment, any break may be repairable. When your horse returns home the convalescence time may be extensive. Your veterinarian will provide detailed instructions on stall rest, medication administration, and return to activity. Often, the return will be slow with careful attention needed to the reaction of your horse as he resumes exercise. Your veterinarian may suggest he return to evaluate your horse the first time exercise is attempted.