Treasure’s leg fracture

Olivia Franks, from The Farm Vets at Hampden Veterinary Hospital, shares Treasure’s story to highlight the potential for surgery and encourage owners to plan ahead with their vet in case of a similar emergency.

Treasure, a Huacaya alpaca from Latton Alpacas in Buckinghamshire was born in 2019. In October the same year, she sadly suffered an accident and appeared to have broken one of the bones in her left front leg. We examined her at our site at Aylesbury and x-rayed to confirm that she had indeed sustained a complete fracture of her cannon bone.

A bandage was applied to stabilise the fracture and antibiotic therapy was started while we searched for a surgeon who was able to, and available to, operate on her leg as these types of surgeries on alpacas are not often performed in general practice.

The fracture was open, which means that the skin was broken and the muscles and bones potentially exposed to bacteria. These kinds of fractures are vulnerable to infection which can interfere with fracture healing. The prognosis for recovery was poor but Treasure’s owners wanted to give her every possible chance so we proceeded to surgery approximately a week after the injury was sustained. In a team effort that involved vets from our farm, equine and small animal departments, as well as a visiting specialist orthopaedic surgeon, Bruce Bladon from Donnington Grove Equine Vets, the fracture in Treasure’s leg was surgically repaired using two metal plates to stabilize it, and she was started on powerful antibiotic therapy due to the infection that was present.

Infection takes hold

Her leg was to be kept bandaged for several weeks. Repeat x-rays a week after the surgery showed that the bones were healing moderately well, but the infection had taken hold and the wounds were discharging pus. The wounds began to break down over the next few weeks due to infection, despite antibiotic therapy and the diligent nursing care provided by Treasure’s owner, with regular bandage changes and topical ointments such as honey, which can have antibiotic properties if used appropriately. However, Treasure was using the leg well which gave us hope for an eventual recovery.

Eventually, it was decided that Bruce and his team would remove the plates from Treasure’s leg, as one of the wounds was still open and the plates may have been preventing it from healing.

Due to the severe infection, the plates had to be removed one by one several weeks apart, to reduce the risk of the leg fracturing. By now there was severe osteomyelitis (infection in the bone) present, and the prognosis was guarded. However, we continued management with antibiotics, honey, and nursing care, and repeat radiographs every month.

By the spring, we were happy with the progress made in the bone, but she still had infected wounds discharging pus from the leg. We were able to leave the wounds uncovered and turn her out into a small field, taking appropriate precautions to prevent fly strike.

X-rays reveal recovery

We reviewed Treasure in August, when repeat x-rays showed that she had developed two ‘sequestra’ in the leg, which are pieces of dead bone that can develop in cases of bone infection, and may have been causing the discharging tracts. We were faced with the decision to wait for them to heal on their own, which can take months or years, or operate to remove them, with the potential associated risks of re-fracture. We waited a few months and the discharge from the wounds eventually stopped and they healed over.

Follow-up x-rays this spring showed that the sequestra had indeed healed, and the bone itself had healed too.

Treasure’s owner and I wanted to share this case to highlight the potential for surgical management of limb fractures in camelids, and to encourage owners to plan with their vet for where they might be able to refer cases to promptly, if such an emergency should occur.

Fractures in alpacas can be managed surgically and time is of the essence. The delay before we were able to arrange a surgery may have contributed to the severity of the infection that developed in this case. However, despite her long road to recovery, Treasure has grown into a beautiful hembra (female) and her owners are hoping to breed from her this coming year.