Texas Equine Veterinary Association

www.teva-online.org • Page 8 but poor following conservative management. 6,7 A recent review of medical records in eight horses that had fragments removed resulted in all eight horses returning to their intended use. Although this is a small number of horses, fracture fragment removal is recommended based on the positive results of these cases. Additional fractures and Luxation of the shoulder Shoulder luxations and fractures of the greater tubercle, scapular neck and body, and proximal humerus are uncommon, but have been reported. These fractures are usually the result of trauma and lameness can be mild to severe depending on location. If a complete fracture of the scapular neck or body of the scapula is present, horses are usually unable to bear weight. Complete scapula (body and neck) fractures can be treated with open reduction and internal fixation. Incomplete scapula fractures can be treated conservatively with stall rest alone. In an attempt to prevent displacement of incomplete scapula fractures, it is a good idea to tie/cross tie horses to prevent them from displacing the fracture while standing. Greater tubercle fractures can be variably lame. Skyline shoulder radiographs should be taken if a greater tubercle fracture is suspected. Greater tubercle fractures can be treated conservatively, removed, or repaired with screws and tension band wires; treatment modality is dependent upon size, fracture displacement, and chronicity. A recent paper determined removal or internal fixation of greater tubercle fractures was superior to conservative management. 2 Shoulder luxations typically result in a non-weightbearing lameness with a variable amount of muscle atrophy depending on chronicity (Figure 6). Craniocaudal radiographs of the shoulder are necessary for definitive diagnosis and to assure that no concurrent fractures are present. The treatment of choice is closed reduction (Figure 7) in acute cases (24/48 hours); however, chronic cases often require open reduction. 6 Following open reduction, some form of internal fixation will be required to prevent re-luxation; successful shoulder joint has been reported in a miniature horse. 8 Prognosis is dependent on the development of secondary osteoarthritis following reduction. Figure 4. Severe atrophy of the supra and infraspinatus muscles due to a chronic supraglenoid tubercle fracture. Figure 5. Fracture of the supraglenoid tubercle (left) and post-operative image following fracture fragment removal (right). This horse was able to return to barrel racing nine months following removal of the fragment. Figure 6. Craniocaudal (left) and mediolateral (right) radiographs demonstrating luxation of the shoulder joint. (Photo courtesy of Dr. Ashlee Watts, Texas A&M University)

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