Client Education:

This foal fractured the tip of his right front elbow during an incident in which 
he was kicked.  Due to this fracture, he is unable to use his triceps muscles 
and bear weight on this leg.  We suggest repositioning the bone and inserting 
lag screws to stabilize this bone and allow proper elbow joint movement.  This 
will allow him to stand and move the leg without pain and improve stability.  
Immediately after the surgery, the entire forelimb will be bandaged.  We will 
demonstrate this procedure so the client can continue to change bandages daily 
until approximately 2 weeks after the surgery.  This will help to minimize 
contamination and decrease swelling that will occur after the procedure.  We 
will be prescribing antibiotics to be injected intramuscularly for approximately 
48 hours.  Antibiotics prescribed will be a combination of Cetiofur, K-
penicillin and Metronidazole.  The intention is that the antibiotics will combat 
any infection that may occur during placement of the pins and screws that bring 
the fracture together.

Although there may be marked improvement immediately following the surgery, the 
foal must be strictly confined to a stall for six to eight weeks.  This is 
mandatory as any foal let out by itself during this period will most likely want 
to run around because it is feeling much better and possibly re-injure the leg.  
After the six to eight weeks of stall rest, follow-up radiographs will be taken 
to determine the extent of the healing process.  Hand-walking will be 
recommended for the next six to eight weeks if progressive bone healing is 
taking place.

Prognosis for return to normal function is good, provided the therapy described 
above is applied and adequate alignment of the fracture is established prior to 
fixation.  Literature shows there is a 76% chance of return to normal function.  
However, keep in mind this fracture involves the elbow joint and has the 
potential to cause degenerative joint changes similar to arthritis in people.  
Nevertheless, we feel that this risk is minimal and that the patient will return 
to normal function.