In this episode, Alvaro Bonilla, DVM, MS, DACVS, described his preferred approach to removing fractured splint bones: in the standing, sedated horse. He said he started doing this procedure because some clients would opt for the conservative healing route just to avoid the general anesthesia associated with traditional surgical repair. Bonilla explained that in some simple cases, where the fracture is not very displaced, the splint bone will heal by itself. But this conservative approach takes two to three months, and the horse might still require surgery if the bone forms a lot of callus.
“When we started offering the procedure standing, I saw how a lot of clients that were initially hesitant to do the general anesthesia were very keen to do the standing because it reduced not only the anesthesia but also the risks associated with recovery,” he said. “You skip all of those and still perform a procedure with the same quality and very safely.”
Bonilla then described the different types of standing procedures he does depending on the horse’s splint bone fracture type and location. He walked through the steps he takes, from preparation to sedation to bone removal and postoperative protocols, noting that some horses can resume exercise as soon as six to eight weeks after surgery.
Bonilla also summarized some of the literature he’s published on this topic. In one study, he compared the cost, outcomes, and time it takes to perform traditional vs. standing fractured splint bone removal in horses. He found the two procedures take the same amount of time and have similar outcomes, but the standing route costs about $500 less.
Listen to this episode of Daily Vet Life, brought to you by Dechra, to learn more about Dr. Bonilla’s standing approach for removing fractured splint bones.
References
Auffret V, Bonilla AG. Standing Surgical Management of Splint Bone Fractures in 13 Horses: A Comparison to Management Under General Anaesthesia. Vet Comp Orthop Traumatol. 2023 May;36(3):148-156. doi: 10.1055/s-0043-1761241. Epub 2023 Feb 9. PMID: 36758616.
Bonomelli N, Bonilla AG. Standing surgery among equine board certified surgeons: Survey regarding current use and trends. Equine Vet J. 2023 Nov;55(6):1045-1057. doi: 10.1111/evj.13920. Epub 2023 Feb 2. PMID: 36586731.
About Dr. Alvaro Bonilla
Alvaro Bonilla, DVM, MS, DACVS, obtained his veterinary degree in 2005 from the University of Cordoba, followed by two internships in Spain. Then, he moved to Canada where he completed a surgical internship at Milton Equine Hospital, followed by an orthopedic research fellowship at the University of Pennsylvania. After this training, he went to The Ohio State University where he obtained a Master of Science focused on the stifle and subchondral cystic lesions while also completing an equine surgical residency. In 2015, he became a Diplomate of the American College of Veterinary Surgeons. After finishing his residency, Bonilla spent time working at The Ohio State University, the University of Montreal, Charles Sturt University, and Langford Equine Centre before joining the busy surgical team at University of Montreal, where he was exposed to a very high and diverse caseload in soft tissue and orthopedic procedures.
Bonilla joined Tennessee Equine Hospital in 2023, where his main fields of interest are standing arthroscopy and standing surgery, subchondral cystic lesions in the stifle, orthopedic and arthroscopic surgery, sinus surgery, and minimally invasive procedures. Outside of work, he enjoys spending time with family and friends, playing and watching soccer, cooking, and traveling.
Related Reading
- Daily Vet Life: Using Pentosan to Manage Horses With Osteoarthritis
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- Disease Du Jour: Arthroscopy in Horses
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