What is Fractures of the Stifle?
Fractures of the hind-limb joint, the stifle, can place far more than just the career of a sport or performance horse at risk. Due to the massive size and primary location of the joint, as well as the range of motion it governs, a fractured stifle can have life-threatening consequences for any horse. At the very least, breaks in the stifle are a frequent cause of hind-limb lameness.
Found in the hindquarters of the horse, the stifle (also called the tibial-femoral joint) is a complex joint that comprises four bones, the femur, the tibia, the patella and a remnant fibula, two discs of fibrocartilage (the menisci) and 14 ligaments. One purpose served by joint is to provide the smooth flexion and extension of the hind limbs, enabling an event horse, for example, to propel up and over fences. The other primary purpose of the stifle is so that the horse can comfortably bear its weight on one hind limb at a time; the stifle enables the locking of one joint so that the other may relax. Three ligaments hold the patella in position.
Comparable to the human knee joint, the stifle operates under consistent stress and is also subject to substantial impact. As such, this massive joint is highly prone to injury, and frequently endures painful, long-term conditions such as arthritis. If an injury to the stifle, or any joint, is suspected, contact the horse’s veterinarian immediately. If treated effectively, prognosis ranges from good to guarded. Foals, in particular, recuperate successfully from stifle fractures.
Due to the size and primary location of the stifle, as well as the range of motion it governs, a fracture can have life-threatening consequences for any horse.
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Symptoms of Fractures of the Stifle in Horses
- Change in gait
- Partial weight bearing
- Exercise resistance
- Fluid swelling
- Tissue swelling
Causes of Fractures of the Stifle in Horses
- Direct trauma (such as a kick, or hitting a fence while jumping)
- Advanced age
- Wear and tear
Diagnosis of Fractures of the Stifle in Horses
Of course, a full veterinary examination is essential. Understanding the circumstances behind the injury and observing the horse’s stance and gait will enable the veterinarian to determine if the stifle is broken, or somehow contributing to the lameness in the horse. Due to its size and location, however, it is not possible to get a true picture of the stifle’s condition without the use of imaging technology. X-ray and ultrasound will enable the best possible diagnosis, though stress fractures are unable to be seen without MRI. Expensive imaging tests, such as MRIs and CTs, will depend upon the capacity of the veterinary facility. Occasionally, local anesthetic is injected into the joints to see if the gait or physical stance of the horse improves.
Treatment of Fractures of the Stifle in Horses
The type and size of the fracture will indicate the treatment path. Because of the stifle’s complexity, treatment may not fully cure lameness in the horse.
Depending upon the size and type of the fracture, rest and medication may resolve much of the injury. In other cases, surgery, including implants, screws and plates, may be required to return function to the horse. Tiludronate, a drug that works at the cellular level to slow bone loss, may be given by IV to promote healing within the joint.
Two to six months of rest and stall confinement may be recommended, followed by a controlled exercise program with a focus on strengthening the large muscles that support the stifle. Bone supplements are often given to the horse, along with intra-articular medication to address inflammation and pain.
Recovery of Fractures of the Stifle in Horses
It will be imperative to confine, rest and exercise the horse properly and consistently per veterinary directions. Conditioning and strengthening the muscles around the stifle joint is imperative in order to overcome any weakness.
Osteoarthrosis of the stifle joint may be secondary to the injury, so pain management may be an important piece of the horse’s recovery process. Oral or IV NSAIDS might be prescribed. Alternatively, the horse may benefit from steroid injections given directly into the joint. How closely the horse will return to pre-injury condition will depend upon the age, the severity of the fracture, as well as the overall health of the horse.