Injury in horses encompasses a range of physical traumas that can affect various tissues and structures, including bones, muscles, tendons, and ligaments. These injuries can arise from numerous causes, such as accidents, overexertion, or improper handling. Common types of equine injuries include fractures, sprains, strains, and lacerations. The management and treatment of these injuries require an understanding of equine anatomy and biomechanics, as well as appropriate veterinary care. This page collects peer-reviewed research studies and scholarly articles that explore the causes, diagnosis, treatment, and prevention of injuries in horses, providing insights into their impact on equine health and performance.
Busch NA, Ranu HS, Silver IA.Evidence indicating that comparison of a particular animal trace with a population average is an insufficient test of the health of a limb is presented. The methodology involves representing each of three recorded force components (vertical, lateral, and transverse) as a Fourier-Legendre series; the coefficients in the series represent the trace. A history for the horse is built by accumulating the coefficients (along with pertinent experimental data such as date, sex, weight, height, and in the case of race horses the date of last race) over a long duration. Then, on each subsequent recording...
Riley CB, Yovich JV.Fractures of the patella in the horse are infrequently reported
in the literature. Most of these have been associated with trauma
or sudden forceful contraction of the quadriceps resulting in an
avulsion fracture of the patella (Parks and Wyn-Jones 1988).
There have been few reports of fractures associated with des-
motomy of the medial patellar ligament to correct upward
fixation of the patella (Wright and Rose 1989; Gibson ef ul1989).
This paper describes one such case including the radiographic
findings before the desmotomy, after fracture of the patella and
after arthroscopic trea...
Shoemaker RS, Martin GS, Hillmann DJ, Haynes PF, McClure JR, Schneiter HL.Two horses became acutely lame following a fall during strenuous exercise and were diagnosed as having disruption of the caudal component of the reciprocal apparatus. Clinical signs consisted of lameness of the right pelvic limb, characterized by flexion of the hock and simultaneous extension of the stifle. Radiography revealed an avulsion fracture from the supracondylar tuberosity and fossa of the distal portion of the femur in one horse. Clinical and radiographic findings indicated avulsion of the lateral origin of the gastrocnemius and superficial digital flexor muscles. Treatment consisted...
Martin BB, Nunamaker DM, Evans LH, Orsini JA, Palmer SE.Circumferential wiring was used to repair 12 mid-body fractures and four large basilar fractures of proximal sesamoid bones in 15 horses. Eighteen-gauge stainless steel wire was placed around both fragments in five horses, and through the proximal fragment and around the distal fragment in 10 horses. The horses were returned to work when they were clinically sound and fracture healing was evident radiographically. Eleven horses resumed athletic performance, three horses were used as breeding animals, and one horse was retired. Five horses performed at an athletic level equal to or better than ...
Dittmer H.Injuries are relatively rare in horse riding compared to other sports, but when they occur they are rather severe and dangerous: about 40% of the injured suffer from fractures, for instance and only 15% from sprains. About 20% have to be admitted to the hospital. Roughly 30% of the injuries involve the arm and 7.5%-10% the spine. The head is injured in 20%, the brain in 8% and the lower extremity in only about 20%. That means that the majority of injuries involve the upper half of the body. One quarter of all lethal sport injuries are caused by horse riding.
Dik KJ.Common soft tissue disorders of the equine carpus are fluctuating or firm soft tissue swellings, wounds and draining tracts. Survey radiography may show the size, position and origin of the swellings and reveals soft tissue calcification, accumulation of air and radiopaque foreign material. Contrast radiography enables accurate visualization of the size, shape, position and origin of fluctuating soft tissue swellings, demonstrates abnormal intersynovial communication and allows precise demonstration of the extent of puncture wounds and draining tracts. Ultrasonography allows differentiation be...
Thurmon JC.The peculiarities of the equine species present a number of unique situations that must be addressed when horses are anesthetized. Perhaps the most troublesome situation is related to the horse's size. Though the horse's large lungs are responsible in part for its sustainable athletic ability, they are detrimental to effective ventilation when the horse is anesthetized and placed in a recumbent position. Of major concern is depression of ventilation and cardiovascular function. Hypercapnia and hypoxemia usually result from hypoventilation, and with time all anesthetized horses suffer from some...
Snyder JR, Pascoe JR, Olander HJ, Hinds DM, Young R, Tyler WS.Ten horses were euthanatized before, during, or after surgery to correct severe volvulus of the large colon. At surgery, the colonic serosa changed from blue-gray, blue or purple toward a more normal pink in seven horses after the volvulus was corrected. The mucosa consistently remained black or dark red. Results of postmortem colonic microangiography revealed perfusion of the serosa and the circular and longitudinal muscle layers, but mucosal perfusion was limited by thrombosis in the muscularis mucosae and submucosa. There was evidence of thrombosis of the mesenteric colic vessels in six hor...
Wilson DG.Injuries involving full-thickness skin wounds are common in large animals. Skin grafting can shorten the healing time and improve the cosmetic result. Techniques that have been used successfully in the management of full-thickness skin wounds include full-thickness skin grafts, split-thickness skin grafts, tunnel grafts, pinch/punch grafts, and immediate split-thickness skin grafts. The technical aspects of each of these procedures are detailed and representative cases are presented.
Meschter CL, Gilbert M, Krook L, Maylin G, Corradino R.Phenylbutazone, a non-steroidal anti-inflammatory drug known to produce intestinal erosions, was administered intravenously (13.46 mg/kg bodyweight) to 12 horses which were killed after 24, 48, 72 and 96 h. Eight untreated horses served as controls. Annular erosions in the duodenum and mucosal necrosis in the colon were seen after 48 h which progressed in severity. The erosions were characterised by sloughing of the surface epithelium, subepithelial cleft and bleb formation, necrosis of the lamina propria, degeneration of the walls of subsurface capillaries and microthrombosis. Large numbers o...
Bertone AL, Stashak TS, Smith FW, Norrdin RW.In nine horses (18 forelimbs), a 3 cm section of superficial digital flexor tendon was removed and the tendons were repaired with immobilization for 6 weeks and (1) no suture (n = 6); (2) a double locking loop tenorrhaphy with carbon fiber (n = 6); or (3) a double locking loop tenorrhaphy with size 2 nylon suture (n = 6). Clinical assessment, gross evaluation, morphometry, histology, and mechanical testing were performed on two limbs from each treatment group at weeks 6, 12, and 24. At weeks 6 and 12, the unsutured tissue was less mature than the tissue sutured with nylon. By week 24, the carb...
Barr AR, Sinnott MJ, Denny HR.The clinical signs and radiographic appearance of 19 cases of fracture of the accessory carpal bone of horses are described. In 17 cases the fractures were in the frontal plane and occurred palmar to the groove on the lateral aspect of the bone. In six cases radiographs taken six months to three years after the fracture occurred showed no evidence of bony union; nevertheless, these and five other horses for which follow-up information was available for up to seven years all became sound, and seven of them returned to competitive activity.
Ferraro GL.Thoroughbred racehorses are susceptible to any and all of the commonly described conditions that affect soundness in the horse. This discussion does not include every conceivable ailment or orthopedic condition that afflicts these animals. Rather, it confines itself to a few specific conditions of the racing Thoroughbred that are either unique to their particular endeavor or so overwhelmingly important to a successful racing career that they must, of necessity, be discussed.
Genovese RL, Rantanen NW, Simpson BS, Simpson DM.A method to quantitate as well as to document SDFT pathology has been described. This report indicates that computer-assisted evaluation of SDFT damage can improve the accuracy of prognosis in clinical practice. It would appear that a 3.8 severity rating is a limit past which prognosis for successful racing starts to worsen rapidly.
Pool RR, Meagher DM.Many lesions of the musculoskeletal system of racing horses are either acute traumatic lesions or are chronic biomechanically induced lesions that become suddenly unstable and provoke acute clinical signs. The latter lesions along with those of DJD are much more common and are of much greater overall economic importance to the racing industry than are the acute traumatic injuries. Chronic biomechanical lesions occur at predictable sites and are the result of an imbalance between repetitive microtrauma sustained in athletic performance and adaptive repair mechanisms of skeletal tissues. The dis...
Honnas CM, Snyder JR, Meagher DM, Ragle CA.Traumatic disruption of the suspensory apparatus is a catastrophic injury in the horse. Although this injury has been described in the adult, little information is available in the foal. This paper describes 3 foals with metacarpophalangeal joint instability caused by traumatic disruption of the suspensory apparatus. Two foals had biaxial proximal sesamoid fractures in a single forelimb, and 1 foal had avulsion of the distal sesamoidean ligaments in 1 forelimb plus biaxial proximal sesamoid fractures in the other forelimb. The foals with single forelimb involvement were managed with splints, a...
Palmer SE.Lameness of the Standardbred racehorse is a function of rigorous training programs, year-round racing schedules, hard racetrack surfaces, and the draft load. In this article, principles of lameness diagnosis and treatment are reviewed, with emphasis upon common or unique problems of the trotter and pacer. The role of physical therapy as an adjunct to medical and surgical treatment of lameness is described. Options for management of chronic pain are discussed, and a limited glossary of descriptive terms that are unique to harness racing is provided.
Smith BL, Auer JA, Watkins JP.Four horses, 2 to 17 years old, were treated for unilateral avulsion fractures of the tibial tuberosity. Two horses were treated successfully with tension band wiring or plating in combination with lag screw fixation. One horse was euthanatized because of implant failure during recovery and one was euthanatized on day 11 because a longitudinal fracture of the tibial tuberosity occurred through the plane of the screws used for stabilization.
Easley KJ, Stashak TS, Smith FW, Van Slyke G.Thirty-six superficial digital flexor tendons from nine fresh equine cadavers were transected and sutured with size 2 monofilament nylon. Nine tendons were repaired with each of four suture patterns: single-locking loop, double-locking loop, triple-locking loop, or three-loop pulley. The times required for application, tensile strengths, resistance to distraction (gap), and modes of failure were analyzed. The mean times required were: single-locking loop, 3 mins, 15 secs; double-locking loop, 4 mins, 15 secs; triple-locking loop, 10 mins, 50 secs; and three-loop pulley, 4 mins. The double-lock...
Reeves MJ, Vansteenhouse J, Stashak TS, Yovich JV, Cockerell G.A study was undertaken to evaluate the significance and mechanism of reperfusion injury in the equine large colon following 1 h of haemorrhagic strangulation obstruction (HSO) or ischaemic strangulation obstruction (ISO) and to assess the effect of treatment with dimethyl sulphoxide (DMSO). ISO or HSO were created 40 cm from the pelvic flexure and maintained for 60 mins under general anaesthesia. Normal saline or 20 per cent DMSO (1 g/kg bodyweight) was administered intravenously 10 mins prior to the end of the ischaemic period. Four groups of four horses in a 2 x 2 factorial design were used....
de Loës M.A prospective study of acute injuries from sports and physical exercise was carried out during 1 year in a total population of a municipality with 31,620 inhabitants. The medical treatment and the services required for the injuries have been calculated and related to the total consumption of medical care in the municipality. A total of 571 injuries (17% of all injuries) occurred in 28 different sports: 65% of the injured were males. Sports injuries accounted for 3% of all acute visits and there were altogether 1,083 outpatient visits, which yields a mean of 1.9 visits per injury. Related to th...
Symons J.Pressure boots are applied to hind limbs of showjumping horses with the intent to enhance jumping form. Manufacturers claim acupressure points enhance proprioception of hind limbs. With this increased awareness, horses are expected to retract their hind limbs to clear jump rails. This research aimed to investigate a more direct, mechanical effect of pressure boots on hind limb biomechanics. Cadaveric hind limbs ( = 6) were mechanically loaded in axial compression (3 cycles at 0.25 Hz, displacement control ~3300 N) with (2 trials) and without (2 trials) a pressure boot applied. During mechanica...
Scheidegger E, Geissbühlerl U, Doherr MG, Lang J.Bone scintigraphy is a very sensitive diagnostic tool to detect elevated bone metabolism. In cases of fractures and fissure fractures, the radiopharmaceutical uptake in the bone is said to be increased within a few hours after the injury. In this retrospective study, the scintigraphic uptake characteristics at the fracture site of 36 horses with radiographically confirmed fractures or fissure fractures were evaluated. Uptake ratios between the fracture region and adjacent normal bone or soft tissue activity respectively were calculated and compared to different anamnestic and radiographic data...
Davidson EJ, Martin BB.Stress fracture of the scapula in two horses is described. Both horses had a history of acute lameness after strenuous exercise. Using elective nuclear scintigraphy focal increased radiopharmaceutical uptake in the affected scapula consistent with a fracture was identified. Standing radiography was nondiagnostic in both horses. Ultrasonographic findings in one horse were consistent with a minimally displaced incomplete fracture. Both horses were treated conservatively and returned to train and race successfully postinjury. Veterinary
McConnico RS.There is no way to prepare for every situation that arises in a disaster. By working closely with other producers and agricultural leaders, however, horse owners can lessen the impact of a disaster on their operation. Preparation and detailed planning are the most important aspects of flood-related injury prevention. Encouraging animal owners and caretakers to have an evacuation plan and dispersing knowledge about local and regional disaster authorities are critical for a successful disaster response. Educational programs on future disaster response empower communities to care for their people...
Hennessy SE, Muurlink MA, Anderson GA, Puksmann TN, Whitton RC.To evaluate the long-term racing prognosis for Thoroughbred racehorses with displaced versus non-displaced fractures of the pelvis identified by scintigraphy. Methods: Retrospective case analysis. Methods: Medical records of 31 Thoroughbred racehorses presenting to the University of Melbourne Equine Centre with fractures of the pelvis that were identified by scintigraphy were reviewed. Pelvic fracture site was determined and defined as displaced or non-displaced based on ultrasound and/or radiographic findings. Race records were analysed for each horse, with a minimum of 24 months' follow-up, ...
Johnson JE, Ryan GD.Soft tissue lesions are often secondary to equine carpal injury. The clinical and pathological nature of soft tissue changes following carpal trauma are varied. This report describes a case of intersynovial fistula between the radial carpal joint and the common digital extensor tendon sheath. The differential diagnosis and pathological features of equine soft tissue carpal injuries are discussed.
Mätz K, Gerhards H, Heider HJ, Drommer W.Bilateral blindness was diagnosed in a 5-year-old Hanoverian gelding presented for evaluation of a corneal opacity in one eye. About 12 months prior to the examination, the gelding had fallen head over, hitting his head and the cornea. Clinical and electroretinographic findings as well as pathohistologic and ultrastructural lesions of both eyes including the optic nerves are presented. Ophthalmoscopically visible pigment disruption of the non-tapetal fundus adjacent to the optic discs correlated morphologically with foci of degeneration and atrophy of the retina, whereas ophthalmoscopically vi...
Stewart RH.Traumatic injury to the central nervous system causes immediate damage and sets in motion a complex series of pathophysiologic events that result in further neuronal injury. This secondary damage seems to be related to changes in blood flow and pressure on a systemic, regional, and microvascular level. Currently, there is evidence that these changes are, in part, mediated by endogenous opioids and arachidonic acid metabolites, namely thromboxane A2. Medical management is generally designed to intervene at one or more stages in this secondary cascade of events. Further research should lead us t...
Suann CJ, Horney FD.Circumcision (or reefing operation) was performed on an aged pony stallion to remove excessive granulation tissue involving the preputial integument following an injury and subsequent paraphimosis. Postoperative swelling of the penis and prepuce was reduced daily with gentle massage. Initially, an improvised suspensory was used to support the penis postoperatively. The pony was able to voluntarily retract its penis six months following surgery.
Yovich JV, Aanes WA.A fracture of the caudal portion of the greater tubercle of the humerus was diagnosed in a 16-month-old Thoroughbred filly. Initially the fracture caused severe lameness. Radiography of the affected shoulder revealed the fracture fragment to be extra-articular, with a surrounding bony callus and no evidence of joint disease. After 5 weeks rest in a stall and 11 months at pasture, the filly was trained and raced without lameness.
Spurlock GH.Seemingly, propagation of a dorsal cortical fracture in the third metacarpal bone developed after continued race performance in 2 horses. Historically, both horses had intermittent lameness that had responded to nonsteroidal anti-inflammatory drugs and brief rest periods. However, lameness in both horses had increased in severity. Radiography revealed a dorsal cortical fracture of the third metacarpal bone, with propagation of the fracture plane proximally. Fractures were incomplete and healed with stall rest in both horses.
Pilsworth RC, Shepherd MC, Herinckx BM, Holmes MA.During a two year period, sagittal fractures of the wing of the ilium were diagnosed in 10 Thoroughbred horses. All were spontaneous fractures sustained during normal exercise in training and racing, with no history of inciting trauma. When ultrasound scans of the surface of the pelvis were performed, the fracture was clearly visible as a discontinuity of the sacral wing of the ilium. In 3 horses, an irregular contour suggestive of periosteal callus was seen in the vicinity of the acute fracture. All horses examined by gamma scintigraphy had a focal increase in uptake of isotope just lateral t...
Martin BB, Nunamaker DM, Evans LH, Orsini JA, Palmer SE.Circumferential wiring was used to repair 12 mid-body fractures and four large basilar fractures of proximal sesamoid bones in 15 horses. Eighteen-gauge stainless steel wire was placed around both fragments in five horses, and through the proximal fragment and around the distal fragment in 10 horses. The horses were returned to work when they were clinically sound and fracture healing was evident radiographically. Eleven horses resumed athletic performance, three horses were used as breeding animals, and one horse was retired. Five horses performed at an athletic level equal to or better than ...
Koljonen V, Söderlund T, Mäkisalo H, Gissler M.Contacts between humans and animals inevitably involve encounters possibly resulting in the human being injured. During the period of 2000 to 2014 almost 90 people died in this kind of conflict in Finland. Of these deaths, one third were associated with horses. In addition, over the same period 85 people died in traffic accidents in which an animal was hit by a car. Accidents requiring hospitalization occurred for approx. 8 000 people.
Parker RA, Bladon BM, Parkin TD, Fraser BS.Increased radio-isotope uptake (IRU) in the subchondral bone of the plantaro-lateral condyle of the third metatarsus (MTIII) is a commonly reported scintigraphic finding and potential cause of lameness in UK Thoroughbred racehorses in training and has not been fully documented. Objective: To characterise lameness attributable to IRU of the subchondral bone of MTIII, compare the scintigraphic findings of these horses with a normal population and evaluate the use of scintigraphy as an indicator of prognosis. Objective: IRU will be in significantly higher in horses with subchondral bone injury an...
Rebhun WC.Most ocular and orbital injuries or acute ocular inflammation in horses result in similar signs of adnexal swelling, photophobia, blepharospasm, and lacrimation. It is hoped that detailed examination and the suggestions in this article will enable veterinarians attending horses having ocular emergencies to arrive at a correct diagnosis and appropriate therapy.
Rapp HJ, Weinreuter S.Etiology, diagnosis and therapy of the luxation of the shoulder joint in the horse are described. The traumatic luxation is diagnosed by physical examination and radiography. Without complicating changings (like fractures) and in case of early correction the prognosis is good.
Gelatt KN.Traumatic iridocyclitis and hyphema in the horse usually follow blunt blows to the orbit and eye. The condition is characterized by miosis, ocular hypotony, ciliary flush, swelling of the iris, and hemorrhage with excessive fibrin in the anterior chamber which permits from 2 to 6 weeks. Vigorous treatment with mydriatics, topical and systemic corticosteroids is recommended. Possible complications include anterior and posterior synechiae, cataracts, and fibropupillary membranes.
Perkins NR, Frazer GS.Topics addressed in this article include complications of castration, scrotal and inguinal hernias, torsion of the spermatic cord, traumatic injuries to the external genitalia, and posthumous collection of spermatozoa. A concise overview of the clinical management of emergency cases is provided.
Cervantes C, Madison JB, Ackerman N, Reed WO.Between January 1985 and May 1989, 53 Thoroughbred horses (mean age 3.2 years) were surgically treated for dorsal cortical fractures of the third metacarpal bone (MC III). All horses were treated with cortical drilling through the fracture line (osteostixis). Diagnosis of the fractures was confirmed by xeroradiography. Lifetime racing records were obtained for all horses. Forty-seven horses returned to racing after surgery (89%). The mean time between surgery and the first race was 6.8 months. Horses had a mean of 10.9 starts before surgery and 16.1 starts after surgery. The mean earnings per ...
Lang HM, Panizzi L, Smyth TT, Plaxton AE, Lohmann KL, Barber SM.Records were reviewed for 2 horses with partial glossectomy, 1 traumatic and 1 elective. According to long-term follow-up by telephone, both horses had recovered well, experiencing only temporary difficulty while eating, and went on to be ridden successfully using mouth bits. Partial glossectomy, therefore, had a favorable prognosis in 2 performance horses. Les dossiers ont été examinés pour 2 chevaux ayant subi une glossectomie partielle, 1 étant une glossectomie traumatique et 1 étant une glossectomie non urgente. Selon le suivi à long terme par téléphone, les deux chevaux se sont b...
Molnar R, Barber SM, Pharr JW, Panizzi L, Plaxton A.A Quarter horse gelding sustained fracture and displacement of spinous processes T2-T10. Radiographic evidence of healing was seen 3 mo following injury, and at 2 years post-injury all spinous processes had healed and undergone partial re-alignment. This re-alignment has not been reported before. Un hongre Quarter horse a subi une fracture et un déplacement des apophyses épineuses T2–T10. Les preuves radiographiques de la guérison ont été observées 3 mois après la blessure et 2 ans après la blessure toutes les apophyses épineuses avaient guéri et subi un réalignement partiel. Ce ...
van Veen L, de Greef RJ.A non-displaced radialfracture of a horse was,diagnosed. The horse had an open fracture resulting from external trauma. A diagnosis was made on radiographs taken 48h after trauma. The horse was treated conservatively by box rest and Robert-Jones bandages. After 7 days the wound was opened to let the wound drainage necrotic material and small sequesters and was washed every other day. After 7 weeks, radiographs showed complete consolidation. Four months after the injury the horse was back to work at his former level and is still working two years after the incident.
Honnas CM, Snyder JR, Meagher DM, Ragle CA.Traumatic disruption of the suspensory apparatus is a catastrophic injury in the horse. Although this injury has been described in the adult, little information is available in the foal. This paper describes 3 foals with metacarpophalangeal joint instability caused by traumatic disruption of the suspensory apparatus. Two foals had biaxial proximal sesamoid fractures in a single forelimb, and 1 foal had avulsion of the distal sesamoidean ligaments in 1 forelimb plus biaxial proximal sesamoid fractures in the other forelimb. The foals with single forelimb involvement were managed with splints, a...
Dik KJ.The radiological interpretation of periosteal new bone formation in the horse induced by trauma is described and illustrated by some casereports. The better the margins of the new bone can be defined the lesser the activity. The greater the density of the new bone, the longer the duration of time since injury.
Freeman DE.Wounds of the esophagus and trachea are uncommon, but closed wounds can be difficult to diagnose and treat. Esophageal wounds are the more serious and can be life-threatening; however, appropriate surgical and medical treatment applied without delay can be successful in some cases, especially in full-thickness longitudinal wounds. Tracheal wounds are usually less severe, but the high risk of iatrogenic injuries to the trachea should be recognized. Also, tracheal injuries can limit the athletic potential of a horse.
Denoix JM.Equine diagnostic sonography was initially used for the diagnosis and documentation of tendon injuries. Since 1990, this technique, along with radiography, has become an indispensable imaging procedure for the diagnosis of equine joint injuries. Sonography provides precise diagnostic information on the synovial membrane and fluid, the articular cartilage, subchondral bone and joint margins, the ligaments and menisci, and the anatomical structures involved in periarticular swelling or enlargement. Improvements in ultrasound machines and better superficial and deep image resolution allow us to e...
Schutten KJ.A 12-year-old Standardbred mare was diagnosed with a ruptured prepubic tendon 1 month prepartum. The mare was treated with analgesia, stall rest, and an abdominal support wrap that was tightened daily. Both a live foal born 1 month later and the mare are doing well. Poulinage réussi par une jument Standardbred ayant une rupture du tendon prépubien. Un mois avant la parturition, une rupture du tendon prépubien a été diagnostiquée chez une jument Standardbred âgée de 12 ans. La jument a été traitée à l’aide d’analgésiques, d’un repos en stalles et d’un pansement de soutien r...
Beroza GA, Gentile DG, Goodness P, Charles R.A Robert Jones bandage modified to include a steel walking bar frame and, in one case, side-supporting bars, was applied as a splinting device in 4 horses with hindlimb fractures (3 tarsal and 1 middle phalangeal). The modification was used as an adjunct to previous casting therapies or as a means for handling casting failures or soft tissue problems encountered during the casting period. This means of stabilization is easily adapted to replace a problematic cast in various clinical settings, is easily applied in the standing patient, is easily changed and adjusted on a regular basis, has mini...
Morgan JM, Galuppo LD.Management of fractures in the field starts with successful assessment and stabilization of the patient by the practitioner on the front lines. A careful examination is vital to succesful patient management. This includes identifying the fracture location and severity, evaluating skin integrity and potential contamination of the fracture, and treating any ongoing hemorrhage, hypovolemia or stress. Appropriate application of splints in the field will minimize ongoing tissue damage and improve patient comfort. This ultimately aids further assessment, facilitates referral, and improves opportunit...