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Osteomyelitis of the sustentaculum tali in horses: 10 cases (1992–1998)

D. Reese Hand DVM1, Jeffery P. Watkins DVM, MS, DACVS2, Clifford M. Honnas DVM, DACVS3, and Deborah Kemper DVM, DACVIM4,5
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  • 1 Texas Veterinary Medical Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.
  • | 2 Texas Veterinary Medical Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.
  • | 3 Texas Veterinary Medical Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.
  • | 4 Texas Veterinary Medical Center, College of Veterinary Medicine, Texas A&M University, College Station, TX 77843-4475.
  • | 5 Present address is Humphrey, Giacopuzzi, Cox Equine Hospital, 4774 Donlon Rd, Somis, CA 93066.

Abstract

Objective—To determine outcome of horses with osteomyelitis of the sustentaculum tali (ST), with or without associated tarsal sheath tenosynovitis, following surgical débridement and lavage.

Design—Retrospective study.

Animals—10 horses in which a diagnosis of osteomyelitis of the ST had been made on the basis of history, physical examination findings, and results of radiography.

Procedure—Information on results of diagnostic testing, surgical findings, postoperative treatment, and short-term outcome was obtained from the medical records. Long-term follow-up information was obtained through reevaluation of horses at the teaching hospital and telephone conversations with referring veterinarians, owners, and trainers.

Results—Treatment consisted of surgical débridement, intra- and postoperative lavage, and long-term antimicrobial and anti-inflammatory treatment. Eight horses had evidence of involvement of the tarsal sheath. One horse was euthanatized after surgery because of a lack of response to treatment; the other 9 were discharged from the hospital. Severity of lameness had improved, but all still had grade-1 or -2 lameness at the time of discharge. One horse was euthanatized after discharge because of contralateral hind limb laminitis, and another horse was lost to follow- up. Of the remaining 7 horses, 6 returned to their previous use, and 1 was sound but retired for breeding for unrelated reasons.

Conclusions and Clinical Relevance—Results suggest that horses with osteomyelitis of the ST, with or without concomitant tarsal sheath tenosynovitis, can have an excellent to good outcome and may return to their previous use after surgical débridement of affected tissues and lavage of the tarsal sheath. (J Am Vet Med Assoc 2001;219:341–345)

Abstract

Objective—To determine outcome of horses with osteomyelitis of the sustentaculum tali (ST), with or without associated tarsal sheath tenosynovitis, following surgical débridement and lavage.

Design—Retrospective study.

Animals—10 horses in which a diagnosis of osteomyelitis of the ST had been made on the basis of history, physical examination findings, and results of radiography.

Procedure—Information on results of diagnostic testing, surgical findings, postoperative treatment, and short-term outcome was obtained from the medical records. Long-term follow-up information was obtained through reevaluation of horses at the teaching hospital and telephone conversations with referring veterinarians, owners, and trainers.

Results—Treatment consisted of surgical débridement, intra- and postoperative lavage, and long-term antimicrobial and anti-inflammatory treatment. Eight horses had evidence of involvement of the tarsal sheath. One horse was euthanatized after surgery because of a lack of response to treatment; the other 9 were discharged from the hospital. Severity of lameness had improved, but all still had grade-1 or -2 lameness at the time of discharge. One horse was euthanatized after discharge because of contralateral hind limb laminitis, and another horse was lost to follow- up. Of the remaining 7 horses, 6 returned to their previous use, and 1 was sound but retired for breeding for unrelated reasons.

Conclusions and Clinical Relevance—Results suggest that horses with osteomyelitis of the ST, with or without concomitant tarsal sheath tenosynovitis, can have an excellent to good outcome and may return to their previous use after surgical débridement of affected tissues and lavage of the tarsal sheath. (J Am Vet Med Assoc 2001;219:341–345)