Tubman first came to us on a dark winters evening in January 2008.  He had been hunting that afternoon and on his canter home had suddenly become extremely lame on his left fore limb.  He was immediately rushed to the Peasebrook Equine Clinic for evaluation.  On arrival Tubman was not able to weight bear on his left fore limb and was very painful around his pastern.  His pastern joint and fetlock joint were also swollen.   

X-rays were taken straightway and revealed a fracture of his long pastern bone (P1).  The fracture extended from the articular surface of his fetlock joint, right down to the articular surface of his pastern joint. 

 This type of fracture is known as a saggital P1 fracture and can only be corrected surgically.  This was discussed with the owner and scheduled for the following day.  Overnight, Tubman was kept comfortable with intravenous pain relief and with the application of a large support bandage (known as a Robert-Jones bandage) and a splint.   

The following day, Tubman was prepared for his surgery.  He was starved of food prior to his anaesthetic and began a course of prophylactic intravenous antibiotics.  He was given his premedication, which included potent pain relief in the form of anti-inflammatories and morphine.   

Tubman is a very large hunter and therefore presented somewhat more of an anaesthetic risk than a more average sized horse, particularly in conjunction with the pastern fracture.  His knock down went extremely smoothly however in our purpose built, padded knock down box and no extra strain was put on his fracture site.  He was then carefully moved by hoist to the theatre table. 

 As with all surgeries the surgical site was made completely sterile prior to making an incision.  The surgery involved screwing the two fractured pieces of bone back together by internal fixation using a ‘lag screw’ technique.  Several cortical screws were used throughout the length of the bone. 

After making a stab incision, a hole is made in the bone using a high-speed drill, driven by high-pressure gas.  A thread was then made in each hole before each screw was placed.  Several x-rays were taken throughout surgery to ensure correct placement of each screw.

The two pieces of bone came back together well and his anaesthetic was excellent.  Although the two fractured pieces of bone were fixed by screws, the limb was also placed in a cast for extra support.  Tubman was then hoisted into our padded recovery box where he had a very smooth and quiet recovery. 

Tubman remained hospitalised whilst he was in a cast and was monitored very closely.  Tubman was also cross-tied to prevent him from lying down, as this would have put extra strain on the fracture site.  Although this may seem a little unfair, horses actually tolerate this extremely well and it really helps to reduce the risk of the fracture site re-fracturing, which would be a disaster.  Tubman was also kept on potent pain relief and prophylactic antibiotics. 

A week later Tubman’s cast was removed and he was placed once again into a Robert-Jones bandage.  His left fore fetlock and pastern joint were both medicated two weeks postoperatively, to help to reduce the inflammation in these joints.  Tubman was then discharged and was cross-tied at home.  We changed his Robert-Jones bandage once a week and he remained on potent pain relief. 

Every week Tubman’s comfort levels continued to improve.  Repeat x-rays were taken 6 weeks post-operatively and they showed that the fracture was healing well.  Tubman’s bandage was removed at this stage and after a further week he was removed from his crossties.

Tubman then began a rehabilitation programme of hand walking and turn out in a small paddock, prior to eventually being brought back into work.  Tubman has now made a complete recovery and is looking forward to going hunting next season!