Novel Fix for Broken Ribs in Neonatal Foals

Due to trunk compression during birth, a common injury in newborn foals is broken ribs. Occurring in as many as one in five neonatal foals, simple rib fractures can usually be treated and will heal with few complications.

Rib fractures are somewhat more common with maiden mares and with difficult births. Male foals account for 75% of cases, and foals of overweight mares are at increased risk. Rib fractures are more likely to occur in Thoroughbreds and other large breeds.

One danger of broken ribs is the possibility that a broken end could puncture the foal’s lung, heart, or another organ. Treatment usually involves stabilizing the fractures and keeping the mare and foal stalled for about three weeks until healing is well established.

Fractures that occur to ribs closer to the foal’s hindquarters can sometimes be left to heal on their own, as they are not as close to vital organs. Ribs toward the forelegs are often repaired surgically to decrease the risk of damage to internal organs or tearing of the diaphragm.

In an affected foal, signs may include groaning, flinching when the ribs are palpated, an audible clicking or grinding noise when the handler gently presses on the rib area, and edema (swelling) over the ribs, in the girth area, or behind the elbows. Handlers can gently run their hands over both sides of the foal’s barrel, checking for asymmetrical areas. Wetting the foal’s coat and slicking it down will make it easier to do a visual check of asymmetrical areas in the foal’s ribcage.

In general, foals with only one or two broken ribs get along better than those with multiple fractures. Prognosis is less positive for foals with five or more broken ribs, and many of these foals do not survive.

Repair of the fractured ribs can be done by wiring the broken bone ends together, though this method may not completely immobilize the break. A more stable repair can be accomplished by using screws and plates; drawbacks are increased cost and a longer period of anesthesia for the foal.

Recently, a technique pioneered at Hagyard Equine Medical Institute in Lexington, Kentucky, is the use of gas-sterilized nylon cable ties which are wider than wire, spreading strain over a larger area of the bone. To repair the fracture, veterinarians can drill small holes in the broken ends of the bone, insert the cable tie through each piece, and tighten the locking tie, cutting the extra nylon near the locking mechanism to minimize irritation to surrounding tissues. Made of an inert substance, the ties will not cause inflammation and will eventually be covered by bony material.