There are many complicated factors in this decision. Probably the biggest factor is the horse's temperment. Horses are prey animals, and as such, they are flighty and prone to panic.
One of racing's most famous breakdowns, Ruffian, was taken into surgery and her leg pinned back together. But it was all for naught when she came out of anesthesia in a panic and thrashed her leg to pieces. The first requirement is a calm phlegmatic temper than can stand weeks or even months in a sling without fighting it.
The next factor is where the break is and how bad it is. Horses are very large animals on very slender legs. The front end carries roughly 80% of their weight and the back end about 20%.
Their feet are so small in relation to their size that carrying more weight on one side than the other, or more on the back than usual, during the months of their recovery, can cause them to road founder in the good leg or bow the opposite tendon. So if the break is severe enough that they will be in a ... more.
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