Conservative management of a fracture of the greater trochanter of the femur in an adult horse

Manon W. J. Peeters, Andrew G. Wallace, M. Chesworth, D. Berner, Andrew R. Fiske‐Jackson
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Abstract

An 8‐year‐old Warmblood cross mare was presented for further investigation of an acute‐onset lameness of the right hindlimb. Three weeks prior to presentation, the horse was found markedly lame at walk following a fall during exercise. The horse was initially managed with field rest, but the lameness persisted. A marked right hindlimb lameness at trot graded 5/10 was confirmed. Atrophy of the right gluteal musculature was evident, and palpation over the region of the right coxofemoral joint provoked a pain reaction. Nuclear scintigraphy revealed a diffuse area of increased radiopharmaceutical uptake in the right femoral head, neck and greater trochanter. Radiographs identified a complete, slightly displaced fracture of the base of the greater trochanter of the right femur. Ultrasound examination of the proximal femur demonstrated an irregularity of the caudolateral bone surface of the greater trochanter, extending along its attachment to the femur; this was consistent with the radiological findings. On re‐examination, after 9 months of stable rest, the horse was found to be sound when trotted in a straight line on the hard surface. Follow‐up two and a half years after the initial incident reported the horse to be nonlame and at its previous level of work.
成年马股骨大转子骨折的保守治疗
一匹 8 岁的温血杂交母马右后肢急性跛行,前来接受进一步检查。就诊前三周,这匹马在运动中摔倒,走路时明显跛行。起初马匹在野外休息,但跛行症状持续存在。经确认,该马小跑时右后肢明显跛行,评分为 5/10。右侧臀部肌肉明显萎缩,触诊右侧髋股关节区域会引起疼痛反应。核素闪烁扫描显示,右侧股骨头、颈部和大转子处出现放射性药物摄取增加的弥漫区域。X光片显示,右股骨大转子基部有一处完全、轻微移位的骨折。股骨近端超声波检查显示,股骨大转子尾侧骨面不规则,并沿其与股骨的连接处延伸;这与放射学检查结果一致。经过 9 个月的稳定休养后,再次检查时发现该马在硬地面上直线奔跑时没有任何问题。初次事故发生两年半后的随访报告显示,这匹马已不再跛行,并保持了以前的工作水平。
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