Modified Thomas splint-cast combination for the management of limb fractures in small equids.
Authors: Ladefoged Søren, Grulke Sigrid, Busoni Valeria, Serteyn Didier, Salciccia Alexandra, Verwilghen Denis
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Modified Thomas Splint-Cast Combination for Fracture Management in Small Equids Between 2001 and 2012, Ladefoged and colleagues reviewed 13 cases (9 horses and 4 donkeys) treated with a modified Thomas splint-cast combination for various limb fractures, including tibial, ulnar, metatarsal and other long bone injuries, to evaluate whether external coaptation could provide a viable alternative to surgical intervention in small equids without performance demands. Of the 12 animals with adequate follow-up data (>6 months post-discharge), 8 (67%) achieved pasture soundness and fracture recovery, though 6 developed permanent external limb deformation. This retrospective case series demonstrates that external coaptation using a modified Thomas splint-cast combination represents a pragmatic salvage option for select small equid fracture cases, particularly donkeys and horses maintained for breeding or leisure rather than ridden work, although owners must have realistic expectations about cosmetic outcomes and long-term limb conformation. Practitioners considering this approach should factor in the relatively good functional recovery rate against the high likelihood of visible bony callus formation and potential chronic dimensional changes in the affected limb. For equine teams managing resource-limited cases or clients opposed to surgery, this technique warrants consideration as part of the conservative management toolkit, provided fracture location, animal age, and realistic use expectations are carefully matched to this treatment modality.
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Practical Takeaways
- •MTSCC is a viable non-surgical option for managing long bone fractures in small equids (horses and donkeys) when pasture soundness is the goal, not return to work
- •Owners must understand this is a salvage procedure with 67% success rate for pasture soundness, but expect cosmetic limb deformation in about half of cases
- •External coaptation with this technique can avoid surgical costs and complications, making it practical for non-athletic animals when owner compliance with management is good
Key Findings
- •Modified Thomas splint-cast combination achieved pasture soundness in 8 of 12 equids (67%) with long bone fractures followed for >6 months
- •Treatment successfully managed fractures in both horses and donkeys without surgical intervention
- •Six equids (50%) developed obvious external limb deformation despite functional recovery
- •Technique is suitable only for small equids without athletic expectations and represents a salvage procedure