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1.
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. DESIGN: Retrospective study. 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.  相似文献   

2.
OBJECTIVE: To develop a technique for arthroscopic excision of apical sesamoid fracture fragments using electrocautery probes. ANIMALS OR SAMPLE POPULATION: A total of 18 Standardbred horses. METHODS: Arthroscopic removal of apical sesamoid fracture fragments using both hook and loop electrocautery probes was performed on 18 Standardbred horses. The fracture fragments were approached using either an ipsilateral (3) or contralateral (15) arthroscopic triangulation technique. Distension of the metacarpo- (metatarso)-phalangeal joints was achieved using a 1.5% glycine solution. Under arthroscopic guidance, both the suspensory and intersesamoidean ligament attachments to the abaxial and the axial margins of the apical fragment were transected using a hook electrocautery probe. Subsequently, the palmar (plantar) soft tissue attachments to the apical fragment were transected with a loop electrocautery probe. Once freed of soft tissue attachments, the apical fragment was removed with Ferris-Smith intervertebral disc rongeur. The arthroscopic portals were closed in a routine manner. RESULTS: Horse ages ranged from 2 to 8 years (median, 2.5 years). Eighteen apical sesamoid fracture fragments were removed from the left (8) and right (8) hind limbs and the left (1) and right (1) forelimbs. Apical fragments occured in 15 lateral and 3 medial proximal sesamoid bones. No major complications occurred during or after surgery. The electrocautery probes permitted an easy and precise dissection of all soft tissue attachments to the apical sesamoid fracture fragments in all horses. Follow-up time was 7 to 44 months (median, 26 months); 10 of 14 horses returned to racing. Seven of nine horses that raced before surgery raced again and three of five that had not raced before surgery, raced afterwards. CONCLUSION: Arthroscopic excision of apical sesamoid fracture fragments can be accomplished arthroscopically using electrocautery probes. CLINICAL RELEVANCE: Arthroscopic electrosurgery is an efficient and safe alternative for intra-articular dissection in horses.  相似文献   

3.
Granulation tissue masses arising from the axial surface of the arytenoid cartilage in 25 horses were excised using a contact neodymium:yttrium aluminum garnet laser. A technique that eliminated the need for general anesthesia or laryngotomy was developed for transen-doscopic removal of the masses in standing horses. Nineteen racehorses made abnormal upper respiratory tract noises or their performance was decreased, whereas six horses not used for racing had a history of stertor (five horses) or epistaxis after nasogastric intubation (one horse). Thoroughbreds were significantly (p = .0126) overrepresented compared with the hospital population. The granulation tissue masses were successfully excised and the defect healed in all 25 horses, although a second excision of granulation tissue regrowth was necessary in four horses. In 21 horses, the underlying chondrosis did not progress appreciably. In four horses with preexisting moderate arytenoid cartilage thickening and concurrent laryn-geal abnormalities, the surgery site healed but the underlying chondrosis progressed substantially. Twelve of 19 (63%) racehorses returned to race at least three times after the surgery. Of the 19 racehorses, five had only slight arytenoid cartilage involvement whereas 14 had moderate cartilage thickening or concurrent laryngeal pathology. All five horses with slight apparent arytenoid cartilage involvement and no concurrent laryngeal pathology returned to racing. Seven of the 14 horses (50%) with moderate underlying cartilage thickening or concurrent laryngeal pathology returned to racing. The six horses not used for racing returned to their previous activity without further respiratory problems.  相似文献   

4.
A 1 cm defect was created in the proximal medial cortex of 12 tibiae, cancellous bone was removed from the site, and the bones were fractured by loading in torsion. The fractures did not occur through the donor sites and the fracture patterns and loads to fracture were similar for the treated tibiae and their untreated mates. Cancellous bone was harvested from the proximal medial aspect of both tibiae in nine adult horses. The soft tissue wounds were monitored for more than 10 days in seven horses and healing of the osseous defects was evaluated radiographically at regular intervals to month 6 in two horses. The site provided convenient access with the horses in lateral or dorsal recumbency, the anatomic landmarks were reliable, and the surgical procedure was simple and short. Complications occurred in only three incisions.  相似文献   

5.
Chondroid masses were successfully removed from the guttural pouches of 2 horses, using an endoscope, a snare, and a vacuum pump. This technique is an alternative to surgical removal of chondroid masses in patients when basic lavage of the affected guttural pouch is ineffective. Complications were not encountered. Advantages of this snare technique include avoidance of surgery and its potential complications, minimal recovery time, and minimal expense.  相似文献   

6.
Open drainage was used to treat 26 horses with persistent or severe septic arthritis/tenosynovitis. Infected synovial structures were drained through a small (3 cm) arthrotomy incision that was left open and protected by a sterile bandage. Joint lavage was performed in all 26 horses. In addition to systemic antibiotics, 23 of these horses were also treated with intra-articular antibiotics; amikacin (17 horses), gentamycin (2 horses), cefazolin (2 horses), and 2 horses were injected at different times with gentamycin and amikacin. The infection was eliminated from the involved synovial structures in 25 of 26 horses; 24 survived and were released from the hospital. The arthrotomy incisions healed by granulation in 16 horses; in 9 horses the arthrotomy incision was sutured closed once the infection was eliminated. Seventeen horses returned to soundness and resumed athletic function. Open drainage was an effective method of achieving chronic drainage from a joint or tendon sheath. It is indicated in horses that have established intra-synovial infections or in horses that do not respond to joint lavage through needles.  相似文献   

7.
Reasons for performing the study: A minimally invasive arthroscopic technique for removal of fractures of the lateral malleolus of the tibia is considered to be beneficial but data to this effect are required. Hypothesis: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically feasible, provides a comprehensive evaluation of the tarsocrural joint and enables removal of remote comminuted fragments and disrupted short collateral ligaments. The technique is associated with low patient morbidity, requires only short periods of hospitalisation and affords a good prognosis to affected horses. Methods: The case records of all horses that underwent arthroscopic removal of a fractured lateral malleolus of the tibia, admitted to a referral hospital, were evaluated retrospectively. Follow‐up information was obtained from race records and by telephone questionnaire. Results: Fractures were successfully removed arthroscopically in all cases following dissection from the short lateral collateral ligaments. Significant post operative complications occurred in only one horse. All other horses recovered well from surgery and of 22 horses with long‐term follow‐up, 18 returned to their previous use. Conclusion: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically demanding, but can be performed with minimal complications and with low patient morbidity and short periods of hospitalisation. The majority of horses are able to successfully return to work following the procedure. Potential relevance: The advantages of arthroscopic removal compared to removal via arthrotomy make this the technique of choice for treatment of fractures of the lateral malleolus of the tibia.  相似文献   

8.
A 25 year old Arabian gelding (case 1) presented for a large mandibular swelling involving the caudal aspect of the left horizontal mandible and a 14 year old Quarter Horse gelding (case 2) presented for a soft tissue swelling on the labial mucosa adjacent to 304. Both horses were bright and alert on presentation. Computed tomography allowed for further characterization regarding the extent of bone penetration within the lesions. This facilitated surgical planning and resection in Case 2. Histopathology of both masses diagnosed fibrosarcomas. Case 1 was humanely euthanized due to the severity of bone involvement and the grave prognosis. Case 2 underwent a left subtotal rostral hemimandibulectomy that proved to be successful in complete resection of the fibrosarcoma with a comfortable and cosmetic post-operative outcome. Surgeries that were once deemed radical should be considered for the treatment of neoplastic masses involving the soft tissues and bony structures of the oral cavity. With the aid of computed tomography, assessment of tumor penetration into deeper tissues can be achieved, thus facilitating complete surgical excision.  相似文献   

9.
Twelve horses with a history of a unilateral malodorous nasal discharge were examined clinically, endoscopically and radiographically. The head of one of the horses was examined by computed tomography. Tissue samples were taken for microbiology from four of the horses and for histology from three. The conchal necrosis was unilateral in 11 of the horses and bilateral in the other, and no particular concha was affected more than the others. The affected tissue was removed transendoscopically with a polypectomy snare while the horses were sedated and standing. Mild disinfectants were used locally in six of the horses. After the removal of all the necrotic tissue, the affected concha healed without any complications in all 12 horses.  相似文献   

10.
The objective of this case report is to describe the diagnostic and surgical techniques for removal of a metallic foreign body in the tongue of three adult horses. The three horses were presented for evaluation and treatment of dysphagia and marked hypersalivation of 3–5 days duration. Radiographs of the head revealed the presence of a metallic foreign body in the tongue of each horse. The foreign bodies could be precisely localised under general anaesthesia using palpation and lingual ultrasonography and/or lingual radiography in combination with a forceps as a marker. The foreign bodies were successfully removed using laparoscopic instruments creating minimal soft tissue trauma. The use of long (43 cm) small laparoscopic (5 mm) instruments enabled good visualisation of the surgical field, providing optimal conditions for successful minimally invasive surgical treatment of horses with foreign bodies in the tongue. The three horses made uneventful recoveries and 12 months after surgery were eating normally and could be ridden with a bit as per usual routine. It was concluded that using long laparoscopic instruments in combination with palpation, ultrasonography and/or radiography allowed removal of the foreign body creating minimal soft tissue trauma and allowing optimal conditions for a fast recovery.  相似文献   

11.
Over an 8-year period, 14 horses were admitted to the New York State College of Veterinary Medicine for evaluation of fistulous withers. Of the 14 horses, 11 were treated surgically and 3 were not treated. Surgical techniques involved radical excision of the affected soft tissue and spinous processes of affected vertebrae. Recurrence rate was 30%, and these horses required additional surgery to resolve the problem.  相似文献   

12.
Osteochondral defects of the lateral trochlear ridge of the distal femur were identified in 15 joints of 10 horses. Lesions were bilateral in five horses and unilateral in five horses. Thirteen of these 15 defects were treated by curettage through a craniolateral femoropatellar arthrotomy. Subcutaneous seroma formation and partial skin dehiscence occurred in nine stifles. Lameness attributable to the stifle joint was no longer apparent at 6 and 12 months after surgery. The normal subchondral bony contour of the lateral trochlear ridge was altered in all joints after surgery. The subchondral bone was uniformly increased in density in all joints, and six lateral trochlear ridges had small focal radiolucent regions within the subchondral bone, which suggested that complete removal of the original lesion had not been achieved. Healing of the surgical site between 2 weeks and 14 months was evaluated in four joints. Granulation tissue from mesenchymal elements in subchondral marrow spaces gradually filled the defects with fibrocartilage.  相似文献   

13.
Fourteen shoulder joints in 12 dogs were treated arthroscopically for osteochondrosis. The arthroscopic procedure included removal of all osteochondral flaps and curettage of the edges of the subchondral defect. Histological examination of biopsy samples from eight joints revealed synovitis in all cases. Arthroscopic surgery of shoulder osteochondrosis in the dog proved to be a less time consuming procedure than arthrotomy with minimal soft tissue trauma and allowed a rapid return to function of the patients.  相似文献   

14.
Six young horses presented with a rapidly expanding maxillary mass with concurrent nasal discharge. All horses had a nonpainful firm unilateral facial swelling centred over the maxillary sinuses, accompanied by mucopurulent nasal discharge. Diagnostic imaging revealed an infiltrative nasomaxillary mass with cheek tooth involvement, diagnosed as odontogenic myxoma. The tooth involvement included missing, malformed and/or displaced dental precursors or unerupted teeth. Due to the rapid expansion and extent of the masses, and the poor prognosis reported for surgical excision, euthanasia was recommended and performed in all cases. Macroscopically, a soft oedematous tissue with a grey to green colour was seen in the regions of missing, malformed or displaced dental precursors or unerupted teeth. Histologically, this tissue consisted of spindle shaped cells surrounded by an abundant homogenous pale stroma, rich in acid mucopolysaccharides. Immunohistochemistry was positive for actin and the mesenchymal marker vimentin. The cheek tooth involvement identified in the described cases resembled what is previously reported in odontogenic myxoma in children and young adults. Even in man, maxillary odontogenic myxoma represents a therapeutic challenge due to the invasiveness of the lesions and radical surgical excision is recommended. Treatment is further complicated by sinonasal involvement. Surgery was not attempted in the cases presented here due to the extent of the lesions and the risk of recurrence. Clinicians should be aware of this rare condition when presented with young horses with sinonasal neoplasia.  相似文献   

15.
A study of 57 cutaneous melanocytic tumors from 53 horses revealed 4 distinct clinical syndromes: melanocytic nevus, dermal melanoma, dermal melanomatosis, and anaplastic malignant melanoma. Melanocytic nevus and anaplastic melanoma each had histopathologic features that distinguished them from dermal melanoma and dermal melanomatosis. Dermal melanoma and dermal melanomatosis were histologically similar but could be differentiated by their clinical features. Melanocytic nevi were diagnosed in 29 horses with an average age of 5 years; they were solitary, superficial masses that occurred in both grey and nongrey horses, and in which surgical excision was generally curative. Dermal melanomas were diagnosed in 20 horses with an average age of 13 years; all horses of known coat color were grey. Eight horses with an average age of 7 years had 1 or 2 discrete dermal melanomas. Follow-up information was available for 6 horses; metastases occurred in 2 horses, and surgical excision was apparently curative in 4 horses. Dermal melanomatosis was diagnosed in 12 grey horses with an average age of 17 years; all 6 of these horses evaluated had internal metastases. In 2 aged nongrey horses with anaplastic malignant melanoma, the tumors metastasized within 1 year of diagnosis. Two tumors with features of both melanocytic nevus and dermal melanoma remained unclassified.  相似文献   

16.
A new bioabsorbable implant composed of poly-L-lactic acid was used to repair the severed digital flexor tendons of four horses. The limbs were immobilised with distal casts which were changed after six to eight weeks and removed after 12 to 16 weeks. The horses were followed clinically and ultrasonographically for from seven to 19 months after the surgery. The ultrasonographic examination after the cast had been removed showed that the implants had been well incorporated into scar tissue. Two of the horses were mildly lame at the trot seven months after the surgery, but had returned to work after 12 months. The other two horses are still lame. No complications were observed with the implant.  相似文献   

17.
Three basic techniques (and one modified technique) were developed, allowing successful excision of subepiglottic cysts in 10 horses (5 Standardbreds, 4 Thoroughbreds, and 1 Quarter Horse; mean age, 3.5 years) via peroral approach. This approach eliminated the need for laryngotomy or pharyngotomy and reduced postoperative care. None of the cysts redeveloped. Clinical signs of disease before surgery included respiratory noise, exercise intolerance, coughing, and dysphagia and were eliminated in all horses except one that raced successfully, but in which some respiratory noise was detected. Peroral subepiglottic cyst excision was performed on anesthetized horses that were positioned in lateral recumbency and intubated via the nares and trachea. General anesthesia allowed careful intraoral palpation and endoscopic visualization of the oropharynx on a television monitor. Custom-designed instruments, including a guide tube, cyst snare, and long grasping forceps, facilitated either laser or snare, or laser and snare cyst excision. Hemorrhage was negligible in all horses. Initial attempts to develop a technique to submucosally excise subepiglottic cysts through a transnasal transendoscopic approach in conscious horses, using a contact neodymium:yttrium aluminum garnet laser, were unsuccessful. In each of 3 horses, the cyst was inadvertently penetrated before it could be excised, causing it to collapse and disappear beneath the soft palate. Postoperative complications were excessive subepiglottic swelling after laser excision (n = 1 horse), which resolved completely in response to anti-inflammatory treatment, and subepiglottic cicatrix formation after snare excision (n = 1 horse), which required surgical excision of the cicatrix.  相似文献   

18.
Microwave thermographs were recorded from 77 normal horses. In 51% the lowest temperature was recorded in the mid-metacarpal region, and in 41% it was in the distal metacarpal region. The mean temperature of the normal limbs ranged from 25.04 to 37.4 degrees C. Maximum temperature differences between symmetrical points in both forelimbs ranged from 0 to 5.33 degrees C and differences in mean limb temperatures between both forelimbs ranged from 0 to 2.91 degrees C. In 48 horses with acute (less than 4 weeks' duration) injury of the superficial digital flexor tendon (SDFT) (36 unilateral, 12 bilateral) and 12 horses with acute injury of the soft tissues of the palmar metacarpal region other than the SDFT (all unilateral) 66% of forelimbs had acute SDFT injury, and 50% of those with other soft tissue injuries, had elevations of the temperature in the mid- or distal metacarpal region. Abnormal values for mean limb temperature, difference in mean limb temperature and maximum temperature difference between locations in opposite forelimbs were detected in 75% of the horses with SDFT injury and in only 16% of the horses with other soft tissue injury. The sensitivity of microwave thermography for the detection of SDFT injury was 81% and the specificity 74%. When 30 horses in National Hunt training were examined weekly for 5 weeks, 2 horses sustained SDFT injury during that period. The microwave thermographs recorded from these 2 horses, at 1 and 2 weeks before the onset of clinical signs, were abnormal. However, 16 horses which did not develop tendon injury also displayed thermographic abnormalities.  相似文献   

19.
Clinical and radiological features of 16 horses with fractures of the lateral malleolus of the tibia are reported. The paper describes surgical techniques used, results obtained and discusses justification for removal. Fourteen fractures were unilateral and two bilateral. There was no left:right disparity. The history included a known traumatic incident in 14 cases. All animals had a tarsocrural joint effusion and 10 had palpable thickening of the lateral collateral ligaments. Crepitus was also palpable in 10 horses. The fracture was identified in all dorsoplantar and 14 of 18 dorsomedial-plantarolateral oblique radiographic projections. Nine fractures were simple and 9 comminuted. All fractures were removed via a tarsocrural arthrotomy. Approaches were dorsolateral in 14 joints, plantarolateral in 3 and dorsolateral and plantarolateral in 1. After an ascending exercise programme horses returned to work 6 months after surgery: 15 horses were free of lameness after 17-62 months, with 13 animals performing at a level similar to pre-injury standard.  相似文献   

20.
OBJECTIVE: To describe a technique of contact neodymium:yttrium-aluminum-garnet (Nd:YAG) laser-assisted excision of progressive ethmoid hematoma (PEH) in horses, to determine the recurrence rate of clinical signs of PEH in horses with follow-up time of a minimum of 12 months, and to compare this result with reported results achieved by using conventional techniques. DESIGN: Retrospective study. ANIMALS: 21 horses with 26 PEH. PROCEDURE: Medical records of all horses with PEH treated by Nd:YAG laser excision from December 1986 through August 1996 were analyzed. Twenty-one horses underwent unilateral (18 surgeries) or bilateral (14) frontonasal bone flap with excision of the mass, using an Nd:YAG laser. One horse with bilateral PEH underwent a unilateral bone flap twice, 1 year apart. RESULTS: 1 horse died. Four of 20 horses with followup times of 12 months or longer had recurrence of PEH. The PEH recurrence rate was 20% (5/25 PEH). Three of 6 horses with bilateral lesions had recurrence of PEH. Recurrence rate for horses that had bilateral PEH (3/6 horses) was greater than for horses with unilateral PEH (1/14 horses). CLINICAL IMPLICATIONS: Treatment of PEH by Nd:YAG laser excision through a frontonasal bone flap results in a recurrence rate comparable with that reported for conventional techniques. Horses with bilateral lesions are more likely to have a recurrence of PEH.  相似文献   

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