Objective—To evaluate the outcome of horses with
large fragments of the extensor process of the distal
phalanx that were removed by use of arthrotomy.
Animals—14 horses with large fragments of the
extensor process of the distal phalanx.
Procedure—Medical records for horses with large
fragments of the extensor process that were
removed by use of arthrotomy were reviewed. Data
retrieved from medical records included signalment,
use of horse, affected limb, lameness history, lameness
examination findings, radiographic findings, surgical
technique, and outcome. Follow-up evaluation
was obtained by telephone interview.
Results—Most affected horses were < 5 years old
and had a history of chronic lameness. Lameness
grade ranged from 1/5 to 4/5. Fragments involved 20
to 45% of the dorsopalmar articular surface of the distal
phalanx. Eight of 14 horses had a successful outcome.
Outcome was not associated with age, duration
or severity of lameness, or fragment size.
Conclusions and Clinical Relevance—Despite
involvement of a large portion of the articular surface
and use of arthrotomy, joint instability and permanent
soft tissue injury was not a problem in most horses.
Outcome may be improved by selection of horses
with lameness of < 2 years' duration and careful management
after surgery. A fair prognosis may be anticipated
for removal of large fragments of the extensor
process via arthrotomy. (J Am Vet Med Assoc 2000;
Objective—To determine the clinical applications, short and long-term survival, and complications of using transfixation pin casts for treatment of comminuted phalangeal fractures in adult horses.
Design—Retrospective case series.
Procedures—Medical records were reviewed to obtain information regarding signalment, fracture location, treatment methods, complications, and short-term survival (discharge from hospital). Long-term follow-up information was obtained via contact with owners or trainers.
Results—12 fractures were in a hind limb, and 8 were in a forelimb. Fourteen fractures occurred in a middle phalanx, and 6 occurred in a proximal phalanx. Eleven fractures were treated with internal fixation combined with transfixation pin casts, and 9 fractures were treated with transfixation pin casts alone. Transfixation pin casts were maintained for a mean of 52 days (median, 49 days; range, 1 to 131 days). Fourteen (70%) horses were discharged from the hospital, whereas 6 (30%) were euthanized during the treatment period. Reasons for euthanasia included secondary fracture of the third metacarpal or metatarsal bone, avascularity of the distal aspect of the limb associated with an open fracture, and displacement of the fracture after transfixation pin cast removal. A significantly greater number of horses was discharged from the hospital when the transfixation pin cast was maintained for > 40 days, compared with those in which the transfixation pin cast was maintained for < 40 days.
Conclusions and Clinical Relevance—Results suggested that horses should be maintained in a transfixation pin cast for a minimum of 40 days, as this was associated with an increase in short-term survival without an increased risk of catastrophic failure.
Objective—To assess the long-term clinical outcome
of horses with distal tarsal osteoarthritis (OA) in which
a 3-drill-tract technique was used to induce arthrodesis
of the affected joints, identify any preoperative or
operative factors associated with outcome, and
describe any complications associated with the technique.
Procedure—Medical records were reviewed for information
on signalment, use, history, physical and
lameness examination findings, surgical technique,
and postoperative care. Radiographs were examined,
and severity of OA was graded. Follow-up information
was obtained through telephone interviews with
owners at least 13 months after the procedure.
Results—32 (59%) horses had a successful outcome,
6 (11%) improved but were not sound after
surgery, and 16 (30%) did not improve following
surgery. Outcome was negatively associated with the
previous use of intra-articular injections. Few postoperative
complications were evident.
Conclusions and Clinical Relevance—Results suggest
that distal tarsal OA in horses can be successfully
treated by means of distal tarsal arthrodesis with
a 3-drill-tract technique. Horses with advanced distal
tarsal OA are likely to have poorer outcomes, and the
procedure will likely be of minimal benefit in horses
with concomitant causes of hind limb lameness prior
to surgery and in horses with preexisting proximal
intertarsal joint disease. (J Am Vet Med Assoc 2003;