The humerus is the upper arm bone that joins the elbow joint to the shoulder joint. Rarely it can be fractured. The injury is more common in foals, weanlings and yearlings and usually results from trauma, most commonly a fall. I have seen this injury in several young horses that fall down during attempted halter-breaking. In adults, it can occur from a fall or from a kick by a pasture mate.
A different syndrome of stress fracture of the humerus can occur in racing Thoroughbreds.
Diagnosis usually requires x-ray of the upper arm. This can be difficult with small portable x-ray units and a large horse because of the heavy musculature of the upper arm. Ultrasound is also very useful in these cases. Nuclear scintigraphy can be diagnostic for stress fracture.
Treatment ranges from conservative (standing in a stall until the fracture heals) to a variety of surgical repairs. The treatment options depend on the particular nature of the fracture.
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Prognosis & Relevant Factors
There are several types of incomplete fractures of the humerus that may have a decent prognosis with surgery.
There is enough muscle mass that these bones can heal in some cases with stall rest and pain relief as the only treatment. However, complete, displaced fractures have a poor prognosis.
In most cases, the limb is significantly deformed and the horse's prognosis as a riding horse is still poor.
Fractures involving either elbow or shoulder joint have a worse prognosis. The larger the horse, the worse the prognosis. Stress fractures in race horses have a good prognosis with 3-4 months of stall confinement.
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