Q: My 6-year-old mare suffered a pelvic fracture from a pasture accident five months ago. My veterinarian examined her and prescribed stall rest. What timeframe can I expect for starting light exercise and how can I tell if she is ready? Should I expect to ride her again? Dawn

A:  Most pelvic fractures have a good prognosis for healing and return to athletic function. Hairline or incomplete fractures of the ileum or ischium heal relatively quickly in 90-120 days with stall rest and small paddock confinement. These horses usually return to normal function.

Displaced fractures and avulsion fractures, where muscle attachments have pulled pieces of bone off of the main structure, need more time for the muscle attachments and bone fragments to heal back to the main bony frame. Generally, the greater the displacement of fragments, the longer the healing time and poorer the prognosis. These horses might need longer confinement time and a slower return to work with more variable results. Assess any obstruction of the pelvic canal in a mare that might be bred.

Fractures of the acetabulum or hip joint have a poor prognosis. Interruption of the normal cartilage surface in these weight-bearing joints typically results in osteoarthritis, which horses tolerate very poorly. Surgery is not successful.

A definitive diagnosis is the best tool for managing these fractures. It will predict prognosis and provide a way to assess healing. Rectal examination can provide a lot of information. Radiographs are not as useful in that the more powerful equipment needed for the pelvis requires general anesthesia, from which these horses recover poorly. A better evaluation is nuclear scintigraphy, but that requires access to a specialized facility. A fairly accurate evaluation can be obtained with rectal and/or transcutaneous (through the skin) ultrasound. This is also a good method to evaluate healing.

In general, expect at least five to six months for healing. Assessment of bony union, muscle healing, and pain are the guidelines for increasing activity. Begin with stall confinement for two to three months in most cases, followed by an equal time in a small paddock. Veterinary evaluation will help you determine the appropriate convalescent protocol.

About the Author

Brad Jackman, DVM, MS, Dipl. ACVS

Brad Jackman, DVM, MS, Dipl. ACVS, is the owner and CEO of Pioneer Equine Hospital in Oakdale, Calif., where he and his team specialize in the care of the equine athlete. The practice includes a full-service equine hospital and is recognized as a leader in equine lameness and surgery. As a surgeon, Jackman helps treat and care for a wide variety of horse health issues and injuries. He is also an active committee member of the American Association of Equine Practitioners and enjoys being involved in the recruitment and development of veterinary students.

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