Q: My friend’s horse has been diagnosed with a fractured pelvis, yet the horse is not having surgery. Is this normal?
A: Pelvic fractures are challenging to handle in horses, not just because of the horse’s size but because of the heavy muscling and tissue that surround the pelvic area. This makes surgical intervention such as pinning and plating a poor option for horses. The good news is that due to the strength of these tissues surrounding the pelvis, the tissues alone are normally sufficient to help stabilise the area if the horse is kept relaxed and quiet enough.
According to the Kentucky Equine Research Centre, pelvic fractures are far more common than we realise. They can be caused by stress or trauma from training, slips and falls, a kick from another horse, or struggling while being cast in the stable.
In a study first published in 2010, researchers Rutkowski and Richardson reviewed the histories of 100 horses with pelvic fractures. The good news from the study is that there seems to be no significant relationship between the severity of the symptoms such as pain, swelling, loss of muscle, crepitus (the sound or sensation produced by friction between bone and cartilage) and skeletal asymmetry, and the long-term recovery of the horse. Their results encourage horse owners, like your friend, to give their horses a chance to recover from an injury of this nature. Simple fractures with no displacement of bones show a good chance of full recovery, with more than 75% of horses returning to the competition arena or even being used for breeding purposes. The bad news, however, is that should the fracture be complex or involve the acetabulum (the ‘socket’ of the pelvis in which the femur sits to form the hip joint), there is a good chance of the horse developing chronic osteoarthritis, and then recovery to competition level is unlikely.
Therefore it is entirely normal that surgery is not being attempted in your friend’s horse. Sometimes surgery is required to clean up the joint or sites of the fracture, if fragments of bone are a problem for instance, but this is relatively uncommon. The initial treatment in most cases is usually box rest and limited movement.
The average recommendation for box rest time varies between two and nine months, depending on the nature and severity of the fracture. Hand-walking is the preferred way to initiate movement in the horse. Vets are likely to treat horses symptomatically to manage the pain and inflammation, with long-term recommendations being made for treatment of arthritis in certain instances.
Answered by Mandy Schroder