page_title: Treatment of equine lameness
section_title: Bone
hierarchical_section_title: Treatment of equine lameness / The process of healing / Bone
caption_attribution_description: English: My photo, taken at Kentucky Horse Park, May 2006
context_page_description: The treatment of equine lameness is a complex subject. Lameness in horses has a variety of causes, and treatment must be tailored to the type and degree of injury, as well as the financial capabilities of the owner. Treatment may be applied locally, systemically, or intralesionally, and the strategy for treatment may change as healing progresses. The end goal is to reduce the pain and inflammation associated with injury, to encourage the injured tissue to heal with normal structure and function, and to ultimately return the horse to the highest level of performance possible following recovery.
context_section_description: Bone heals by formation of a callus over the defective area. Speed and quality of healing is directly related to the blood supply and fracture stability. Rest is required immediately following injury to reduce movement of the fracture site. Stability may be improved through use of surgical implants or casting, depending on the location of extent of the fracture. Shock wave therapy is sometimes employed in the case of splint bone fracture or stress fractures to the cannon bones, to improve blood flow to the area. Fractures within a joint, such as chip fractures in the knee, hock, or fetlock, require arthroscopic surgery to prevent secondary arthritis of that joint.
  In some cases, the callus may place pressure on surrounding soft tissue structures. The callus of a splint bone fracture can push on the adjacent suspensory ligament, leading to lameness from secondary suspensory desmitis. Treatment usually involves the removal of the offending callus.
  On average, bone heals better than soft tissue. It requires less time to heal and, unlike soft tissue which is always weaker after healing, bone heals to 100% strength. However, fracture healing in horses is complicated by their size, flightiness, and desire to stand. Horses are at risk of re-injury of the fracture site, especially when trying to rise after lying down, or when recovering from anesthesia following fracture repair. Forced recumbency is not an option for horses, making healing more difficult. Weight bearing on a single front or hind limb increases the likelihood of support limb laminitis. Additionally, the cost of casting or surgical fixation makes treatment financially unattainable for some owners. While limb fractures are no longer a death-sentence for horses, it is still considered a very serious injury. In general, a horse is more likely to survive if it is small in stature and has a good temperament that will tolerate the months of inactivity required for healing. Fractures that are open, comminuted (very fragmented), or located higher on the limb tend to have a poorer prognosis.
caption: The act of standing can place considerable strain on a fracture site.
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