Severe Comminuted and Spiral Tibial Fracture Managed with a Cross-tied Cast in a Pony

In the horse, diaphyseal tibial fractures are generally comminuted, spiral, and open; they are related to a high-energy accident, which makes them, in general, a catastrophic injury. The major comminution and the open component make of this fracture a real challenge when surgically repaired. For the owner, the costly treatment and the often poor prognosis are two major factors to consider, particularly when dealing with an adult horse. We describe the case of a severe comminuted and spiral, closed fracture of the tibia, with diaphyseal and distal metaphyseal involvement in a pleasure pony. The owner could not afford a surgical intervention, but he refused categorically to euthanize the animal. Considering the closed status of the fracture, a conservative treatment option was offered as a very last option. The tibial fracture was managed successfully with a cross-tied cast.