Over 80% of front leg lameness in horses are due to problems below the fetlock, so if you have a horse that is lame on the front end, chances are the foot is involved. However, lameness can occur in the elbow. If there is swelling or pain while manipulating the elbow, finding the source of the pain is much easier. If not, then using local anesthetic in the elbow joint to numb or deaden the area is usually required to prove the source of lameness is in the elbow joint. And because of the large amount of muscles around the elbow, you really cannot feel any swelling that may be in the elbow joint. If the horse is sound after blocking or numbing the elbow joint with local anesthetic, then the next step is to x-ray the elbow. Fractures of the ulna are not uncommon and this is the bone at the back of the elbow. Horses with fractures are usually lame with swelling and the horse will have a dropped-elbow appearance. The elbow joint can also luxate or subluxate although Dr. Chad Marsh indicates in the Remuda magazine that this is an uncommon event. Some horses can also have cystic lesions in the bones that make up the elbow joint, which can cause lameness. And horses can develop arthritis in the elbow as they get older, and that can be a cause of lameness.
In most cases of lameness originating from the elbow, x-rays can determine the cause and the best therapy for the condition. Some fractures require surgery as do some of the cystic problems in the joint. Some of the cases of arthritis in the elbow will respond to cortisone injections directly in the joint. Some of the fractures around the elbow can heal with a splint and rest while others will require surgery.
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