Conservative management of a fracture of the greater trochanter of the femur in an adult horse

An 8-year-old Warmblood cross mare was presented for further investigation of an acute-onset lameness of the right hindlimb. Three weeks prior to presentation, the horse was found markedly lame at walk following a fall during exercise. The horse was initially managed with field rest, but the lameness persisted. A marked right hindlimb lameness at trot graded 5/10 was confirmed. Atrophy of the right gluteal musculature was evident, and palpation over the region of the right coxofemoral joint provoked a pain reaction. Nuclear scintigraphy revealed a diffuse area of increased radiopharmaceutical uptake in the right femoral head, neck and greater trochanter. Radiographs identified a complete, slightly displaced fracture of the base of the greater trochanter of the right femur. Ultrasound examination of the proximal femur demonstrated an irregularity of the caudolateral bone surface of the greater trochanter, extending along its attachment to the femur; this was consistent with the radiological findings. On re-examination, after 9 months of stable rest, the horse was found to be sound when trotted in a straight line on the hard surface. Follow-up two and a half years after the initial incident reported the horse to be nonlame and at its previous level of work.