Equine musculoskeletal trauma: Assessment and stabilization (Proceedings)

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Equine musculoskeletal trauma: Assessment and stabilization (Proceedings)

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Aug 01, 2008

Types of musculoskeletal trauma

• Wounds and lacerations

• Skin

• Deep structures (tendon, ligament, joint, bone)

• Vascular injury

• Nerve injury

• Fracture

Patient assessment

• Horses may be frantic and distressed following trauma

• Use appropriate restraint to keep you and your patient safe during assessment

• Use sedation

o Most equine sedatives also provide analgesia as well as provide chemical restraint

o Will decrease horse's anxiety for thorough assessment

• Anatomy

o Knowledge of anatomy is critical to appropriate assessment

o Appropriate identification of affected structures

o Determines necessity of immediate treatment

o Will dictate method of stabilization for transport

o Anatomic relationships very important

• Integument

• Muscle

• Vascular and nerve

• Tendon/ligament

• Synovial structures: joints, tendon sheaths, bursa

• Bone

o Location, location, location

• Small wounds in the wrong location can be life-threatening

• Based on location some fractures cannot be repaired

Integument

• Lacerations and wounds

o When involving only the skin, subcutaneous tissue and fascia they usually will heal well

o Some may require extensive wound care management long term

• Burns

o As in human burn patients these require extensive management locally and systemically

Muscle

• Muscle damage is confined to the areas above the carpus and tarsus

• Not necessarily life or performance threatening unless extensive

• Myositis can be a bigger concern than direct trauma

o Clostridial Myositis

Vascular injury

• Laceration of large vessels can result in exsanguination

• Damage to major blood supply to the limb can result in loss of the limb – either by transection or blunt trauma

Nerve injury

• Loss of sensation

o Can return over time

• Loss of function

o Can lose function of a limb which is life-threatening

• Examples: suprascapular, radial, or femoral nerve paralysis

Tendons and ligaments

• Major supporting structures of the lower limb

• Injury can be life and performance threatening

• Transection of the major tendons and ligaments can have a diagnostic stance when weight bearing

o Deep digital flexor tendon

• Toe flips up

o Superficial digital flexor tendon