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Update, Nicky Corrigan's fractured femur - rays of hope?- advice please

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  • Update, Nicky Corrigan's fractured femur - rays of hope?- advice please

    The fracture is of the third trochanter. I finally got a good look at what that piece is here http://users.skynet.be/Road_Rebel/St...osteologie.pdf

    it;'s not associated with a joint which sounds good but I guess it does protrude specifically BECAUSE the process is attached to such a strong gluteal muscle.

    has anyone had any experience with an avulsion fracture of the third trochanter?

    Any suggestions about things that will support healing? calcification of the bone? reattachment? anything?
    Last edited by tisor; Aug. 16, 2012, 02:59 PM.
  • Original Poster


    wow, I hear crickets. So that's not good.

    How about this: Does anyone know where i can rent shockwave equipment?


    • #3
      Sorry I have no experience with any of that but so sorry you are having to deal with it. I hope your horse heals quickly!

      Member of the ILMD[FN]HP Clique, The Florida Clique, OMGiH I loff my mares, and the Bareback Riders clique!


      • #4
        Best wishes for your horse. I wish I had good advice or knowledge on this subject but I don't.

        It would be nice if you could keep us posted with what you learn. It looks pretty scary to have a fracture on the femur. Is it a small fracture? Will it require surgery? How was it diagnosed?

        Sorry for just questions and no answers.
        "Random capitAlization really Makes my day." -- AndNirina


        • #5
          Originally posted by PeteyPie View Post
          Best wishes for your horse. I wish I had good advice or knowledge on this subject but I don't.

          It would be nice if you could keep us posted with what you learn. It looks pretty scary to have a fracture on the femur. Is it a small fracture? Will it require surgery? How was it diagnosed?

          Sorry for just questions and no answers.
          Just found your original post so ignore my questions. They are mostly answered there!
          "Random capitAlization really Makes my day." -- AndNirina


          • #6
            Your location might help other COTHers help you find a treatment protocol, or possibly someone who has familiarity with this type of injury.
            Proud member of the "Don't rush to kill wildlife" clique!


            • Original Poster

              Oh I assumed my location was posted. I'm in San Francisco, horse is in Petaluma 45 min North of San Francisco

              fracture is an avulsion fracture of third trochanter which is NOT in the joint but an insertion point for a gluteal muscle


              • #8
                Surgical reattachment is really the only option. I am sorry, but in humans this is the only treatment that has relative success. Otherwise there is a litany of complications and conditions that will prevent the fracture from ever healing.

                While in humans these fractures can heal rapidly without surgery, the patient is required to keep the limb immobile for 3 weeks of more. That is impossible for a horse.

                I would get the horse to Davis and get a true orthopaedic consultation.


                • #9
                  From OP's previous thread on this horse, it sounds as if he is/was at Davis for the diagnosis etc


                  • Original Poster


                    Yes this was diagnosed at Davis using Ultrasound, bone scan and xray. The vet said that they can't correct it surgically because the gluteal muscle will pull out any screws or plates.


                    • Original Poster

                      I have the hardest time even finding ANY literature abouyt this fracture because it's so rare.

                      But I just read this and it gave me hope - which might be bad:


                      Fracture or Enthesopathy of the Third Trochanter
                      of the Femur

                      Fracture of the third trochanter of the femur is a
                      relatively unusual injury, resulting in acute-onset,
                      severe lameness that often improves quite
                      rapidly with box rest. In a lean, poorly muscled
                      horse it may be possible to elicit pain by palpation,
                      but in a well-muscled warmblood type this is usually
                      not possible. There are no particular gait characteristics.
                      Nuclear scintigraphy is particularly valuable
                      for tentative diagnosis of a fracture.
                      There is intense, focal IRU (Fig. 16). Diagnosis
                      may be confirmed radiographically, but good-quality
                      radiographs can only be achieved under general anesthesia.
                      Fractures are often longitudinal, occurring
                      at the base of the trochanter. There is usually
                      minimal displacement. Diagnostic ultrasonography
                      has not been useful in my experience in helping
                      to confirm the presence of a fracture. It is possible
                      that some horses with IRU in the region of the third
                      trochanter have enthesopathy of the attachment of
                      the superficial gluteal muscles, but I have not been
                      able to confirm this ultrasonographically. Treatment
                      is box rest for 2 mo, followed by walking exercise
                      for another month. Healing may occur by
                      either osseous or fibrous union. Prognosis is good


                      • #12
                        Don't forget these authors are real people, find contact information & call/email until you get a reply, ask if vet will look at your case

                        Have case history ready to fax, attach to email etc - do you already have the Davis results on CD etc?


                        • Original Poster

                          I just got off the phone with my horse's normal vet. He hasn't seen many of these cases either. It just IS super rare. BUT, he said he'd have suggested TWO months stall and then out to pasture. we're going to do three months and take a look. he's also in favor of shockwave and PRP.

                          The question is whether it heals through ossification (bone creation and fusion) or by the fibrous union mentioned in that extract. Fibrous won't be as strong and is also the more likely way it will heal. Odds are greater that we won't be able to jump him ever (still so heartbreaking - he never even started) but he also might. we just have to see how it heals.

                          He also said that id I just turned him out on pasture it would heal, but we want it to heal "right".

                          So... fingers crossed?

                          Here is his xray btw, you can really see it top left



                          • #14
                            Originally posted by tisor View Post
                            Yes this was diagnosed at Davis using Ultrasound, bone scan and xray. The vet said that they can't correct it surgically because the gluteal muscle will pull out any screws or plates.
                            What if they used botox to relax the muscle while it heals? Botox is used for relaxing spastic or tight muscles for people.
                            "The captive bolt is not a proper tool for slaughter of equids they regain consciousness 30 seconds after being struck fully aware they are being vivisected." Dr Friedlander DVM & frmr Chief USDA Insp


                            • #15
                              Originally posted by alto View Post
                              Don't forget these authors are real people, find contact information & call/email until you get a reply, ask if vet will look at your case

                              Have case history ready to fax, attach to email etc - do you already have the Davis results on CD etc?
                              This. Totally.

                              Consult the experts, don't just read what they've published. TALK to them.


                              • #16
                                My TB gelding fractured his third trochanter a few years ago when he had a trailer accident. He was diagnosed on bone scan as he had a persistant, grade 3 lameness that would not block out wth nerve blocks. In his case we did 2 months stall rest, then 2 months small paddock. We also shockwaved and injected local steroids. He healed fully from that injury. The prognosis is actually quite good for these with stall rest, etc as is horses the fragments tend to not displace much. We actually bone scanned him again later as he was lame from a suspensory injury and before we did surgery we wanted to confirm the femur had healed. It was fully healed on the second bone scan


                                • Original Poster

                                  oh i like the sound of that jr eventer. does your horse lie down a lot? i'm worried that will be an issue.

                                  and ptwonet i like the sound of botox! why not! has anyone done this succefully? wouldnt he then be in danger of pulling some other thing that would have to replace that muscle?

                                  and yes, i have the DVDs from davis and am sending those to local vets.


                                  • #18
                                    I saw your original post but have not been able to post on COTH (new computer glitch) until recently.

                                    Yes, my mare fractured her femur. I will find the actual location.

                                    In a stall for 6 months. She was smart. Would only lay down with her good leg underneath her.

                                    It was a crapshoot...but, she recovered to full soundness. No bute, nothing that could mask the problem for her and I believe that allowed her to be careful.

                                    Was terrified she'd founder on the opposite hind as for the first month, she would keep the fractured leg literally off the ground for much of the day.

                                    I'll check the exact location and get back to you.
                                    www.littlebullrun@aol.com See Little Bull Run's stallions at:
                                    "Argosy" - YouTube and "Boleem" - YouTube
                                    Boleem @ 1993 National Dressage Symposium - YouTube


                                    • #19
                                      Ugh. I so totally feel for you. My horse has an avulsion fracture of the proximal suspensory origin and he's on stall rest.

                                      I'm in Santa Rosa so close to you. Curious who you work with locally. Have you talked to Tom Yarbrough? He's a surgeon and that guy is da bomb for challenging stuff. Worth getting him on the phone and picking his brain.

                                      I've been hauling my lame horse down to Riverside to see Dr. Smith and do shockwave. He comes up from GGF once a week. Anyway, he's another source of info and very good.

                                      As far as other support goes, the advice I got was to test my hay & get a nutritional consult and make sure my horse's diet was as balanced as possible, to support his body's ability to heal itself. I'm also giving him the herb comfrey, which is also known as 'boneset' or 'knit bone' per another consult.

                                      PM me if you want. Maybe we can form a North Bay support group, LOL.

                                      PS, be sure to ask about the difference between radial and focused shockwave and which is best for your horse.
                                      Last edited by Watermark Farm; Sep. 13, 2012, 07:18 PM.


                                      • #20
                                        Sorry just saw this.
                                        Yes my guy laid down a lot! He is a very, very mellow gelding who loves to sleep and eat, and eat while laying down Really with this injury the vets were not concerned with him laying down. We were concerned with recovering him from anesthesia if it wasn't healed (since anethesia recovery can be very rough) but the second bone scan 6 months after the initial one showed it was fully healed. He returned to full work from this injury. Unfortunately his suspensories did not hold up but that is a different story!