# Hairline fractures - how difficult is it to recognise them??



## viola (22 November 2007)

I will try to make it as short as possible but would really be interested in reading people's experiences on similar cases.

This is about a friend's horse which got kicked while out on a field and was found hopping lame (right front) in the evening. He had traces of blood on the leg just above the knee and a visible cut .
Owner took him to the vets, he had Xrays and scans done as well as joint fluid analysed as due to debris in the wound the vet anticipated infection in the joint itself. The latter proved negative but there seems to be no conclusion from any other procedures/checks!
They see no fracture, no soft tissue damage etc - yet the horse is hopping lame.
They decided to treat it as if there was a hairline fracture there and the horse's leg is now immobilised, wrapped up and he is cross-tied in his stable. He is to go back to the vets in two weeks.

Is this a normal practise??? Two weeks sound awfully long to wait, especially because...this horse has just gotten to the end of the box rest with another injury -left front; tears on deep digital flexor tendon and bad navicular changes- and the vet's prognosis was very poor. They basically suggested PTS when they scanned him.

I had a look at the horse tonight and he is resting his weight on the "navicular" foot holding the "broken" one off the ground.

Is it really so hard to discover fractures?  
	
	
		
		
	


	




Friend isn't sure whether to PTS or not as their vet isn't very helpful in their conclusions, suggestions, prognosis etc. The horse is made comfortable, looks alert and eats well.


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## cellie (22 November 2007)

Seems strange that they cant see a fracture when I had xrays and they could diagnose cannon bone bruise .Could be that the cut is more of a danger than the fracture especially in the knee area .We have just had a horse on our yard with a puncture wound to the knee that had be box rested for 6 weeks not because of the cut but the possibility of infection .I had my horse on rest at the same time for tendon injury and her horse was far more uncomforable than mine.
good luck


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## viola (22 November 2007)

That's interesting as another suggestion was a heavy bruising but they didn't seem to be able to see anything on Xrays.
Would a horse be as lame as not to put a leg down for two days from bruising alone?


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## jhoward (22 November 2007)

as a human that has had one of these they can be hard to spot, and are normally treated like a break, if not worse. give it a chance, and id suggest a 2nd opinion, bad bruising can also be very painful, and treated like a break, dont put the horse down,

bruising itself if very bad can take weeks to mend,


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## Mags Mum (23 November 2007)

Having had a horse with a hairline fracture of the shoulder, these are extremley difficult to see with any swelling present.

The only thing I can suggest is keep the horse as comfortable as possible and wait for the swelling to go down and then re-xray, I waited two weeks and only in the third week deep a star fracture of the elbow show.

Hoping for the best for you.

Edited for terrible spelling 
	
	
		
		
	


	




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## Happy Horse (23 November 2007)

My horse fractured his radius in exactly the same way - a tiny bit of blood just above the knee.  Hairline fractures can be a nightmare to see on xrays straight away but left loose the horse could easily disrupt and shatter the fracture and then there is nothing to be done to save them.

By treating for a possible fracture and re-examining in two weeks the vet in my opinion is doing exactly the right thing.  Once a fracture starts to heal it is easier to spot on xray because the new bone forming at the fracture site is visible on xray.

The navicular problem obviously complicates the issue but if the horse is coping I'd certainly give it the two weeks to see if more information becomes available.  He will probably start weigh bearing on the 'fractured' leg fairly shortly.

If you have any questions feel free to ask.


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## Tierra (23 November 2007)

Been the unfortunate owner of a horse that did end up with a shattered bone in his leg due to an undetected hairline fracture misdiagnosed as heavy bruising 
	
	
		
		
	


	





From what i gather, they are very difficult to spot and it sounds to me like the vet is doing completly the right thing.


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## GreedyGuts (23 November 2007)

Hairline fractures are notoriously difficult to identify because immediately after the injury because there is no displacement or gap between the bones. As time progresses the edges of the broken bone get debrided as the first stage of repair and so the fracture line becomes apparent. Immobilising the leg is crucial to prevent damage in the meantime, although it might be possible to re-radiograph the leg a bit earlier say around 10 days.
The horses comfort in the meantime is very important to prevent overload of the opposite limb. If he is totally non-weightbearing your friend may need to ask her vet about increasing the pain killers he is on.


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## viola (23 November 2007)

Thank you everybody! Don't get me worng - PTS is the last resort and was simply thought of becasue of the severity of injury to the the left front. The vet basically said the horse might not even come back to field soundness not to mention ridden. However, as the rest went on the horse got better and better and the hopes were high.
And then - this "fracture" blow! In a way I am happy to hear that the diagnosis is in fact difficult and that waiting and re-assessing is the thing to do. There was, however, no swelling on the limb/injury area at all.

The boy was comfortable this morning, munching hay and playing with his toy - a ball on a string


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## cellie (23 November 2007)

My horse had about 3  to 5 days then it improved drastically.The other strange thing about bruising is they recommend excercise ie gentle walking out to improve circulation  and build up calcium.It took about 6 weeks to recover then my silly horse tore his tendon being a fool in the field so we had another 13 weeks.The good thing about the bruising is that once the calcium has built up the leg is actually stronger.Let me know how you get on with vet.Good luck.


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## viola (23 November 2007)

Oh dear! It's sometimes neverending with those injuries! 
With the big boy - well, it's a waiting game now (and careful watching of the left fore to see if it manages to take the strain).


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## shadowboy (23 November 2007)

i would get scintigraphy scans done- mine had this and a hairline fracture was discovered.


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## MurphysMinder (25 November 2007)

I agree your vet is doing the right thing.  Our pony had a star fracture whilst out on loan.  Their vet didn't diagnose it at first, pony was being led out for her leg to be hosed and had no support and was not cross tied.  After 4 days they did x-ray but couldn't see a fracture but did put robert jones bandage on and cross tie her.  When we got our vet involved, thank heavens, he spotted the star fracture (on original x ray!) and said we were very lucky she hadn't tried to lie down whilst not cross tied as the bone could well have shattered.  She has made a full recovery, fingers crossed this lad does the same.


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## LauraBR (25 November 2007)

My horse has a suspected fracture at the moment, he is having x-rays on Monday but the vet has already told me that if they don't find anything he will need to be re-x-rayed next week as the optimum time to see fractures is 10 days after the original injury, particularly if they are small hairline type breaks.

Fingers crossed for your friends horse.


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## viola (25 November 2007)

Thank you all for the additional info - friend is waiting as told by the vet and we it's good to hear other horses went through it and came back sound. 
Izt - just saw your other post 
	
	
		
		
	


	




 Big man's leg looks like your boy's now but he also has a thick stick attached so looks rather grotesque.
I hope all goes well with both horses!


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