Pelvic Fractures

Pelvic fractures are something that can cause a great amount of angst; the following summary is a synopsis of how veterinarians deal with this injury. Pelvic fractures are usually caused by a traumatic event that will leave your horse acutely non-weight bearing lame. There are several different areas that the pelvis can fracture in the horse, however, the diagnosis and treatment are quite similar. The main clinical signs your veterinarian will look for is asymmetry of the hindquarters due to soft-tissue swelling, hematoma, or muscle atrophy. Also, the horse will likely hold their foot in an abnormal position with their hock held underneath them and their toe pointed out. However, it can be very difficult to get a definitive diagnosis, as there is a lot of musculature overlying the osseous portion of the pelvis. Rectal palpation can allow a veterinarian to very carefully perceive any displacements, asymmetries, or crepitus, especially with movement of the affected limb. Ultrasound can be performed percutaneously and/or transrectally to help identify discontinuities of the cortical surface of the bone. It can also help veterinarians perceive the extent of soft tissue damage and swelling of the affected area. Ultrasound can also help monitor the progression of healing occurring within the area over time. The ultrasound image to the right is an example of an ischiatic table fracture. The two sets of arrows are highlighting the fractured corticalsurface of the bone, as the two edges are displaced from each other. The main disadvantage to ultrasound is that the entire pelvis cannot be viewed. Radiographs can be used to help figure out the complete osseous involvement of a pelvic fracture. However, these images can be very difficult to obtain due to the large amount of overlying soft tissue that the machine has to shoot through. Unfortunately, to get a definitive diagnosis with radiographs most horses have to be put under general anesthesia and placed in dorsal recumbency to get the appropriate radiographic views. The risk of the horse causing further damage when recovering from general anesthesia leave most veterinarians and owners very hesitant to go this far for a diagnosis. Nuclear scintigraphy can be a beneficial imaging modality, but works best in an older fracture, and may not provide complete osseous detail of the fracture site. Once diagnosed, the horse owner has a consequential decision to make about continuing with treatment.