KENNETT SQUARE, Pa. -- Kentucky Derby winner Barbaro took a big step toward survival last night - standing on all-fours after hours of surgery to repair the right rear leg shattered in Saturday's running of the Preakness Stakes.
But Dr. Dean Richardson, who oversaw the four-hour procedure as chief of surgery at the George D. Widener Hospital for Large Animals at New Bolton Center, said the horse's chances remained a "coin toss" with the possibility of infection, refracture or other maladies.
After Barbaro awoke from anesthesia, he practically "jogged" into his stall, standing without assistance, doctors said.
"I felt much more relieved watching him walk into the stall than I did when I was loading him up in the ambulance yesterday," Barbaro's trainer, Michael Matz, said at a news conference after the operation.
"Barbaro decided to jump up and down a few times. He even had Michael worried," Richardson said, referring to the trainer.
Barbaro's long pastern bone was shattered into more than 20 pieces, and Richardson said surgeons had to insert 23 screws to help fuse the joint in the horse's right hind leg.
If recovery goes well, he said, it will take "many, many months" before there is any prospect of Barbaro having a new career standing at stud.
Richardson said the injury occurred first in the cannon bone, a common break that usually indicates pre-existing damage. But in Barbaro's case, he said, there was no reason to suspect that the horse was injured before the race.
Before the surgery, Richardson's assessment of Barbaro's injury was grim, describing the three fractures and dislocation suffered in early strides out of the gate at Pimlico Race Course in Baltimore as "very unusual" and "catastrophic."
"You do not see this severe an injury," he said just before beginning the surgery about 12:40 p.m. with a team of six other doctors and nurses. "Most horses would typically be put down at the racetrack."
He and Barbara Dallap, an emergency clinician at the hospital and faculty member at the University of Pennsylvania School of Veterinary Medicine, said the jockey and emergency staff at Pimlico gave Barbaro a fighting chance.
When the 3-year-old colt suddenly began limping seconds out of the starting gate, jockey Edgar Prado gracefully reined him in. Matz raced to his aid, followed by veterinary staff members who helped load the horse into an equine ambulance that immediately headed for the Pennsylvania hospital.
"Barbaro basically received excellent care on site at the time of injury," Dallap said. "He arrived safely and was unloaded uneventfully. He's been extremely brave and well-behaved."
Despite his apparent mobility, Barbaro is wearing a cast that covers his injured leg to the hock. It will remain on for up to 10 days, and Barbaro will be confined to a stall as recovery continues.
Doctors faced the challenge of repairing fractures to the cannon, long pastern and sesamoid bones in Barbaro's leg, and a dislocated fetlock joint.
While a broken leg may be a relatively minor injury for humans, many horses cannot recover. Because they weigh 1,200 to 1,300 pounds and have to bear it with the legs of a ballerina, as racing fans often say, they need all four to walk and function fully.
After lying on a table under general anesthesia during four hours of surgery, Barbaro was moved with a harness from the table to a pool where horses wake up. The water reduces the risk that the horse will try to move and thus reinjure itself.
But after being lifted from the pool, Barbaro surprised staff members by walking into his stall.
"This is the absolute first step in any case like this," Richardson said.
Looking tired but relaxed, Matz praised the doctor and his staff.
Veterinarians were reluctant to speak about Barbaro's prospects for recovery and said the number of things that could go wrong is almost innumerable.
"There are horses that just don't make it for very strange reasons," said Dr. David Nunamaker, an orthopedic surgeon at the veterinary hospital.
After such "catastrophic" fractures, horses can face infection, a second fracture or a "nonunion," in which the fused bone does not heal. Other complications could include the failure of other limbs and lack of blood flow to the leg.
Despite Barbaro's apparent desire to walk last night, the specialists will try to keep him still during the long recovery.
"That's relatively easy for people," said Dr. Corinne Sweeney, associate dean for the Kennett Square facility, also called the New Bolton Center. "But horses spend too much time on their feet and are often too inclined to move around.
"A human who understands the gravity of the situation can be confined," she said, referring to patients who may need a long period of bed rest. "But this is a horse that doesn't understand the need to stand still."
If the fracture heals, Barbaro would live out his life with little mobility in the right hind leg. The bone will be fused, doctors said, making it clear that the horse's racing career is over.
Veterinarians were uncertain whether Barbaro could heal enough to become a stud.
"Two weeks ago, we were on cloud nine," Matz said. "This game has a way of humbling you."