Treatment methods of long bone fractures in equines : comparing Swedish and foreign experience

Sammanfattning: The treatment of long bone fractures in horses remains to be a challenge for equine veterinarians, since it is necessary to succeed treating an animal sometimes weighing over 500kg that will have to endure fracture repair procedures and rehabilitation for at least 3 months and manage the resulting complications. The objective of this study is to investigate and shed light over some of the treatment techniques for long bone fractures in equines, and to sample new data from a questionnaire, answered by experienced equine surgeons in Sweden, summarising the obtained results with the already existing research. In a literature review, this work starts by describing bone anatomy and physiology, gradually narrowing down to long bones. Then the different types of bone fractures are discussed, both in regards to their aetiology, impact and classification. This is followed by the mechanisms of bone healing through which bone fractures are healed. Further, this work investigates the most common and current treatment techniques of long bone fractures in equines. Various treatment techniques are reviewed, such as the internal and the external fixation, as well as the advantages and the disadvantages of every respective technique. Furthermore, the factors that affect long bone fracture repair are described, as well as the biomechanics of the strain forces that need to be counteracted for successful fracture treatment. Finally, the literature study describes the various complications that may follow bone fracture repair post-operatively or during the rehabilitation phase. In addition, the study encompasses a questionnaire that was sent to 20 Swedish senior equine surgeons, asking questions about long bone fracture treatment. Some of them replied to the questionnaire, elucidating on how the different types of long bone fractures are dealt with in Sweden, thus helping the study to exhibit the current practices of equine orthopaedic surgery, as they are adapted to the Swedish realities, including the animal welfare norms. The results of the survey showed that veterinarians who heavily rely on surgical treatment do tend to have a lesser need to resort to euthanasia, than other veterinarians, who do not apply osteosynthesis as their primary treatment. Moreover, there seems to be a general correlation between the orthopaedic practices applied by equine surgeons in Sweden and the ones described in foreign literature, with the distinction that the Swedish veterinary policy applies conservative treatment as standard, unless the fracture is displaced.