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1.
The case histories of four horses with osteomyelitis involving the metacarpal and metatarsal bones are reviewed and the surgical treatments discussed. The horses recovered after curettage of all infected tissue and post operative drainage. The role of antibiotics in treatment is considered and reference is made to the acute treatment of deep wounds to avoid osteomyelitis.  相似文献   

2.
Eleven horses with unilateral distension of the sheath are reported with emphasis on the use of plain and contrast radiography in diagnosis. Six had associated bony abnormalities of the sustentaculum tali, and two of these showed destructive or mixed destructive and proliferative lesions resulting from osteomyelitis. One horse had a fracture of the sustentaculum. In three horses proliferative changes were found. Bony changes were best demonstrated on a dorsomedial-plantarolateral oblique view. Contrast radiography of the tarsal sheath was performed in five cases without, and two horses with, associated bony lesions. In five cases ballooning with or without folding of the proximal aspect of the sheath was demonstrated. Additional band-like filling defects (two cases), triangular filling defect (one case), nodular intra-tendovaginal masses (two cases), or an extra-tendovaginal mass (one case) were noticed. The remaining two horses showed a semicircular collar shape dilation of the proximal aspect of the sheath. Contrast radiography appeared to be a helpful tool for the examination of tarsal sheath lesions. Two horses with associated bony changes were destroyed immediately after diagnosis, one failed to recover following surgical intervention and in three horses the outcome was unsatisfactory after conservative treatment. Three horses without associated bony lesions recovered completely after conservative treatment. One was operated on subsequently; the results are promising but the outcome of this case is not yet known. One was sold shortly after diagnosis and lost to follow up.  相似文献   

3.
Comparison of subchondral bone density determined by quantitative computed tomography (CT) with gross and histopathologic changes have not been made in horses. The goal of this study was to determine if mean quantitative CT density and mean voxel standard deviation are associated with the presence and severity of osteochondral lesions in the palmar aspect of the distal third metacarpal bone in racing horses. Metacarpophalangeal joints from nine racehorses were imaged using CT and scored for gross damage. Four-millimeter-thick sagittal and 30 degrees palmar dorsal plane sections were cut, decalcified and stained with hematoxylin and eosin from the distal third metacarpal bone. Microscopic osteochondral lesions and subchondral remodeling were scored on a scale of 0-3. Percent subchondral bone, expressed as the ratio of bone volume to tissue volume, was also measured. Mean quantitative CT density and mean voxel standard deviation were measured from three-dimensional models of CT images comparable with histologic sections. Mean quantitative CT density was not associated with lesion severity or number of lesions. A weak correlation between mean quantitative CT density and gross score was found, but mean quantitative CT density was not predictive for gross score. Mean voxel standard deviation was not correlated with gross or histopathologic measures, but was predictive of mild osteochondral lesions. Results support the association of subchondral remodeling with the development of palmar metacarpal lesions. However, there was not a strong correlation between mean quantitative CT density or mean voxel standard deviation and histopathologic lesions of the distal third metacarpal bone.  相似文献   

4.
Medical records of 28 horses with osteomyelitis of the calcaneus were reviewed to evaluate signalment, history, diagnostic and treatment methods, outcome, and long-term follow-up information. Trauma was the most commonly reported cause (24). Physical examination revealed lameness in 27 horses, and 22 (79%) had a wound or draining tract over the plantar aspect of the calcaneus. Radiography of all horses was done prior to the initiation of treatment, and follow-up radiography was done on 20 horses. The most common radiographic findings were soft tissue swelling (25), bony lysis of the calcaneus (17), bone fragments or sequestra from the tuber calcis (13), and periosteal new bone production or bony lysis of the sustentaculum tali (5). Association could not be found between initial radiographic findings and eventual outcome of the case. Positive bacterial cultures were obtained from 13 horses. A wide variety of gram-positive, gram-negative, and anaerobic organisms were isolated. Fourteen of the 15 isolates, for which susceptibilities were reported, were susceptible to penicillin, gentamicin, or trimethoprim sulfamethoxazole. Twenty-six of the 28 horses diagnosed as having osteomyelitis of the calcaneus were treated; 16 horses were treated with surgical debridement in addition to antimicrobial treatment, and 10 horses were treated with antimicrobial agents, anti-inflammatory drugs, or supportive wound care. There was no significant difference in survival rate of horses treated surgically and those treated conservatively. Six horses that were treated were later euthanatized for problems associated with chronic osteomyelitis, and 2 horses died or were euthanatized for unrelated problems. Eighteen horses (64%) were alive at last follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

5.
We report the use of low-field standing magnetic resonance imaging in the standing horse for the diagnosis of osseous lesions in the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joint that were not apparent using standard radiography. Thirteen horses were studied and all had thickening of the subchondral bone plate and abnormal signal intensity in the adjacent spongiosa in either the condyles of metacarpal/metatarsal III or the proximal phalanx or both. Abnormalities were characterized by diffuse decreased signal intensity on T1-weighting adjacent to the subchondral bone and within the spongiosa in at least two imaging planes; in the absence of increases in signal intensity in fat-suppressed images, this change was interpreted as bone sclerosis. Nine horses also had a diffuse decreased signal intensity on T2*-weighting in the same areas and five had a diffuse increase in signal intensity in fat-suppressed images in conjunction with a decrease in signal intensity on T1- and T2*-weighted images; the increase in signal intensity in fat-suppressed images was interpreted as fluid accumulation. Five horses had a focal area of change in signal intensity within the subchondral bone with apparent loss of definition between the subchondral bone and the articular cartilage. Eleven horses were available for follow up, of which eight were sound and three remained lame. We conclude that lameness originating from the MCP or MTP joint may be associated with osseous damage in horses of any signalment in the absence of radiographic changes.  相似文献   

6.
Four horses were examined because of chronic forelimb lameness. In all horses, the cause of the lameness was localized to the metacarpus by means of physical examination and diagnostic anesthesia, and radiography of the affected limb revealed a small exostosis of the second metacarpal bone. Magnetic resonance imaging revealed suspensory desmitis in the region of this exostosis in all 4 horses. In addition, an abnormal area of low signal intensity, suggestive of an adhesion, was seen between the exostosis and the suspensory ligament. In all horses, an adhesion between the suspensory ligament and the exostosis on the second metacarpal bone was identified and transected at surgery, and the exostosis and distal portion of the second metacarpal bone were removed. All horses were able to return to their previous athletic use following a 6-month rest and rehabilitation program for treatment of the suspensory desmitis. Findings in these horses suggest that adhesions between the suspensory ligament and an exostosis of the second metacarpal bone may be a cause of chronic or recurrent forelimb lameness in horses.  相似文献   

7.
Reasons for performing study: The aetiology of temporohyoid osteoarthropathy (THO) is unknown; both primary infectious and degenerative causes have been suggested. Hypothesis: There is a significant association between increasing age and severity of temporohyoid joint degeneration. To examine the histopathology of the temporohyoid articulation in aged horses and to compare the appearance of the joint with computed tomography (CT) and peripheral quantitative CT (pQCT). Methods: pQCT scans of the temporohyoid articulations were obtained bilaterally from 31 horses (range age 1–44 years) post mortem and images were graded by 2 blinded observers on 2 occasions for the presence of osteophytes, irregularity of the joint surface and mineralisation. Eight heads had been examined previously by CT, with the images similarly graded for the shape and density of the proximal stylohyoid bones, bone proliferation surrounding the joint, mineralisation of the tympanohyoid cartilage and the relationship of the petrous temporal bone to the stylohyoid bone. Sixteen temporohyoid joints were then evaluated histologically. Results: There was significant association between the mean pQCT degeneration score and age (rho = 0.75; P<0.0001), between the pQCT and CT score (rho = 0.63; P = 0.01) and between the degenerative changes identified within each temporohyoid joint within each horse (rho = 0.81; P<0.0001). Age‐associated changes included the development of a club shape by the proximal stylohyoid bone, rounding of the synostosis with the petrous temporal bone and extension of osteophytes from the petrous temporal bone to envelope the stylohyoid head and bridge the joint. In no horse was there any evidence of osteomyelitis within the petrous temporal bone, stylohyoid bone or tympanohyoid cartilage. Conclusions: This study provides evidence that age is associated with increasing severity of degenerative changes in the equine temporohyoid joint and that similar changes are commonly found bilaterally. Potential relevance: The changes identified appear similar, albeit milder to the changes reported in horses with THO, suggesting that degenerative, rather than infectious causes may underlie the aetiology of THO. Future work should be directed at examining the histopathology of clinical THO cases.  相似文献   

8.
OBJECTIVE: To evaluate clinical findings, complications, and outcome of horses and foals with third metacarpal, third metatarsal, or phalangeal fractures that were treated with transfixation casting. DESIGN: Retrospective case series. Animals-29 adult horses and 8 foals with fractures of the third metacarpal or metatarsal bone or the proximal or middle phalanx. PROCEDURES: Medical records were reviewed, and follow-up information was obtained. Data were analyzed by use of logistic regression models for survival, fracture healing, return to intended use, pin loosening, pin hole lysis, and complications associated with pins. RESULTS: In 27 of 35 (77%) horses, the fracture healed and the horse survived, including 10 of 15 third metacarpal or metatarsal bone fractures, 11 of 12 proximal phalanx fractures, and 6 of 8 middle phalanx fractures. Four adult horses sustained a fracture through a pin hole. One horse sustained a pathologic unicortical fracture secondary to a pin hole infec-tion. Increasing body weight, fracture involving 2 joints, nondiaphyseal fracture location, and increasing duration until radiographic union were associated with horses not returning to their intended use. After adjusting for body weight, pin loosening was associated with di-aphyseal pin location, pin hole lysis was associated with number of days with a transfixation cast, and pin complications were associated with hand insertion of pins. CONCLUSIONS AND CLINICAL RELEVANCE: Results indicated that transfixation casting can be successful in managing fractures distal to the carpus or tarsus in horses. This technique is most suitable for comminuted fractures of the proximal phalanx but can be used for third metacarpal, third metatarsal, or middle phalanx fractures, with or without internal fixation.  相似文献   

9.
A 4-year-old Arab mare was diagnosed with disseminated cryptococcosis, including osteomyelitis of the proximal phalanx of the left hind limb, osteomyelitis with associated soft tissue granuloma of a rib and disseminated, large cryptococcal nodules in the lungs. The lesion in the dorsoproximal aspect of the proximal phalanx had a large area of cortical lysis with spiculated periosteal new bone and extensive soft tissue swelling. The affected rib had a pathological fracture. Cryptococcal osteomyelitis has not been previously reported in horses but should be considered as a differential diagnosis, particularly in endemic regions.  相似文献   

10.
Reasons for performing study: There is limited information on magnetic resonance imaging (MRI) findings in the carpus and proximal metacarpal region of lame horses. Objectives: To document MRI findings in horses with lameness localised to the carpus and/or proximal metacarpal region. Methods: Clinical records of horses that underwent MRI of the carpus and/or proximal metacarpal region at the Animal Health Trust between January 2003 and September 2010 were reviewed. Magnetic resonance images of all horses and available radiographs, ultrasonographic and scintigraphic images were assessed. When possible, MRI findings were related to the results of other diagnostic imaging techniques. Results: Seventy‐two MR studies of 58 lame limbs in 50 horses from a broad range of work disciplines and ages were reviewed. The most commonly detected primary abnormality was decreased signal intensity in T1‐ and T2‐weighted images in the medial aspect of the carpal bones and/or the proximomedial aspect of the metacarpal bones (n = 29). Nine horses had syndesmopathy between the second and third metacarpal bones. In 6 horses the primary abnormalities were identified in the palmar cortex of the third metacarpal bone (McIII). Significant abnormalities of the suspensory ligament (SL) with associated lesions in the adjacent palmar cortex of the McIII were seen in 4 limbs. Ligament and associated osseous abnormalities between the second and third carpal bones and second and third metacarpal bones were detected in 4 limbs. Conclusions and potential relevance: Magnetic resonance imaging enabled diagnosis of a variety of lesions not detected by conventional imaging in horses from a wide range of work disciplines. The distribution of injury types differed considerably from previous studies.  相似文献   

11.
OBJECTIVE: To evaluate in vitro holding power and associated microstructural and thermal damage from placement of positive-profile transfixation pins in the diaphysis and metaphysis of the equine third metacarpal bone. SAMPLE POPULATION: Third metacarpal bones from 30 pairs of adult equine cadavers. PROCEDURE: Centrally threaded positive-profile transfixation pins were placed in the diaphysis of 1 metacarpal bone and the metaphysis of the opposite metacarpal bone of 15 pairs of bones. Tensile force at failure for axial extraction was measured with a materials testing system. An additional 15 pairs of metacarpal bones were tested similarly following cyclic loading. Microstructural damage was evaluated via scanning electron microscopy in another 6 pairs of metacarpal bones, 2 pairs in each of the following 3 groups: metacarpal bones with tapped holes and without transfixation pin placement, metacarpal bones following transfixation pin placement, and metacarpal bones following transfixation pin placement and cyclic loading. Temperature of the hardware was measured with a surface thermocouple in 12 additional metacarpal bones warmed to 38 C. RESULTS: The diaphysis provided significantly greater resistance to axial extraction than the metaphysis. There were no significant temperature differences between diaphyseal and metaphyseal placement. Microstructural damage was limited to occasional microfractures seen only in cortical bone of diaphyseal and metaphyseal locations. Microfractures originated during drilling and tapping but did not worsen following transfixation pin placement or cyclic loading. CONCLUSIONS AND CLINICAL RELEVANCE: Centrally threaded, positive-profile transfixation pins have greater resistance to axial extraction in the diaphysis than in the metaphysis of equine third metacarpal bone in vitro. This information may be used to create more stable external skeletal fixation in horses with fractures.  相似文献   

12.
Medial patellar desmotomy has been considered a benign surgical treatment in horses with suspected upward fixation of the patella. Our clinic has previously observed radiographic changes in the equine stifle following medial patellar desmotomy but preoperative radiographs were not made and the changes therefore could not be directly associated with the desmotomy. In this report we describe a case with normal stifle radiographs before medial patellar desmotomy. Radiographs made 3 months later demonstrated degeneration of the patella with enthesophytes, osteolysis and bone fragments. It is hypothesized that the lesion developed as a result of lateral rotation of the patella creating stress concentration in the subchondral bone of the distal articular surface of the patella. The pathogenesis of the patellar lesion is thought to be similar to the "gull wing" lesion on the distal palmar aspect of the third metacarpal bone. We recommend a more prudent approach to medial patellar desmotomy in the horse.  相似文献   

13.
Review of 121 bone scintigrams obtained on racing Thoroughbred horses with clinical histories indicative of forelimb lameness revealed 3 scintigraphic patterns of stress-induced trauma to the dorsal cortex of the third metacarpal bone: (1) focal, intense uptake associated with recent stress fracture; (2) regional uptake of varying intensity or a mixed pattern of uptake associated with chronic stress fracture; and (3) diffuse, mild to moderate uptake associated with periostitis (bucked shins). The latter scintigraphic pattern appeared to be an exaggerated manifestation of the normal remodeling process evident in immature horses (2 to 3 years old). Scintigraphy was most helpful in identifying radiographically occult stress fractures, determining the extent of cortical involvement before surgical intervention in cases of chronic stress fractures, and monitoring the fracture healing process.  相似文献   

14.
OBJECTIVE: To determine clinical findings in and outcome of horses with fractures of the second or fourth metacarpal or metatarsal bone that underwent segmental ostectomy, leaving the proximal and distal portions of the bone undisturbed. DESIGN: Retrospective case series. ANIMALS: 17 horses. PROCEDURES: Medical records were reviewed, and information on signalment, affected bone, lesion type, surgical procedure, amount of bone removed, and surgical and postsurgical complications was obtained. Follow-up information was obtained through telephone conversations with owners, trainers, and referring veterinarians. RESULTS: One horse had a fracture involving the distal third of the second metacarpal bone; 13 had fractures involving the middle third of the second metacarpal bone (n = 4), fourth metacarpal bone (5), or fourth metatarsal bone (4); and 3 had fractures involving the proximal third of the second (2) or fourth (1) metacarpal bone. Affected portions of the bones were surgically resected, leaving the proximal and distal portions undisturbed. All horses returned to previous performance levels without evidence of lameness. Cosmetic results were good to excellent. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that horses with a complicated injury of the proximal, middle, or distal portion of the second or fourth metacarpal or metatarsal bone may be successfully treated by means of segmental ostectomy of the abnormal portion of the bone.  相似文献   

15.
A one‐month‐old Quarter Horse colt presented with progressive gait abnormalities and weakness. The foal was ataxic at presentation. Radiography identified focal endplate irregularities and lysis at C6–7. Radiographic diagnosis was discospondylitis. Computed tomographic myelography was performed immediately following euthanasia and identified an extradural compressive spinal cord lesion corresponding to the site of discospondylitis. Post mortem examination findings included abscess formation at the C6–7 intervertebral space with osteomyelitis extending into the adjacent physes and subchondral bone of caudal C6 and cranial C7. The vertebral abscess extended into the ventral spinal canal at C6–7 and was identified as the cause of extradural spinal cord compression. Salmonella sp. was cultured and isolated from purulent exudate at the intervertebral space. Computed tomographic myelography has not been previously reported for assessment of discospondylitis in horses and was successful at accurately characterising spinal cord compression in addition to osteolytic changes associated with discospondylitis.  相似文献   

16.
Comminuted first phalanx fractures were diagnosed in 30 horses. One leg was involved in each horse. Five horses were presented with open fractures. Nine horses had a portion of intact cortex (strut) extending from the proximal to distal joint. Ten horses were euthanized, including one with an open fracture, without treatment. The remaining 20 horses were treated by open reduction with a neutralization plate (8 horses, including one with an open fracture), open reduction with lag screw fixation (3 horses), lag screw fixation through stab incisions (2 horses), external coaptation with a cast (3 horses), and external skeletal fixation using a weight supporting shoe (4 horses, including 3 with open fractures).
Thirteen horses were euthanized following treatment because of persistent infection (9), chronic lameness (2), and third metacarpal bone fractures (2). Seven horses survived longer than 1 year after treatment. Six were lame and used as breeding animals, and one horse went on to race successfully. All four horses with open fractures that were treated were subsequently euthanized.
Significantly more horses with an intact strut of bone survived after treatment (4 of 7 [57%]) when compared to horses without an intact strut of bone that were treated (3 of 13 [23%]) (p < 0.05).
Invasive surgical approaches used for the repair of comminuted first phalanx fractures in this study were associated with an unacceptable infection rate (55%). Techniques involving less trauma to the compromised soft tissue around the fracture should afford a better chance for a successful outcome.  相似文献   

17.
This study documented the normal histologic features of the equine metacarpal and metatarsal periosteum and characterized its osteogenic response to surgical manipulation. Two periosteal flaps were elevated from the dorsomedial matacarpal and metatarsal diaphysis in each of three limbs of four yearling and four adult lightbreed horses. The superficial metacarpal cortex under the flap was resected with a bone chisel in one-half of the horses and was undisturbed in the remainder. One periosteal flap in each limb was excised and the other flap was replaced and secured by sutures. All limbs in the horses were radiographed at regular intervals postoperatively. Horses were killed either 30 or 120 days after surgery. Periosteal bone production occurred only at treatment sites of young horses treated by periosteal flap replacement and was limited to approximately 50% of these sites, as determined by radiography and microradiography. Cortical abrasion resulted in an increased incidence of bone production in the periosteum adjacent to the flap perimeter. The histologic features of the periosteum were similar to those reported in other species; young horses had active osteogenesis referable to appositional growth and adults had an inactive periosteum. Histologically, osteogenesis induced by surgery resembled accentuated appositional growth in both yearlings and adults. In the horse, the cambial (osteogenic) layer is included in sharply elevated periosteal flaps. It should be removed in surgical procedures where bone production is to be avoided, and preserved where osteogenesis is desired.  相似文献   

18.
Foot pain is a common presenting complaint in Warmblood horses. The aim of this retrospective, cross‐sectional study was to determine the spectrum of foot lesions detected by magnetic resonance imaging (MRI) in Warmblood horses used for dressage, jumping, and eventing. The medical records of 550 Warmblood horses with foot pain that were scanned using standing MRI were reviewed and the following data were recorded: signalment, occupation, lameness, diagnostic analgesia, imaging results, treatments, and follow‐up assessments. Associations between standing MRI lesions and chronic lameness following treatment were tested. Abnormalities of the navicular bone (409 horses, 74%), distal interphalangeal joint (362 horses, 65%), and deep digital flexor (DDF) tendon (260 horses, 47%) occurred with the highest frequency. The following abnormalities were significantly associated (P < .05) with chronic lameness following conservative therapy: moderate to severe MRI lesions in the trabecular bone of the navicular bone, mild or severe erosions of the flexor surface of the navicular bone, moderate sagittal/parasagittal DDF tendinopathies, and moderate collateral sesamoidean desmopathies. Also, identification of concurrent lesions of the DDF tendon, navicular bone, navicular bursa, and distal sesamoidean impar ligament was associated with chronic lameness after conservative therapy. Development of effective treatment options for foot lesions that respond poorly to conservative therapy is necessary.  相似文献   

19.
High‐field MRI of the proximal metacarpal/metatarsal region has been associated with great diagnostic potential and clinical reports of standing low‐field MRI of the forelimb suggest the same. To better understand diagnostic outcomes with standing low‐field MRI of the proximal suspensory region, a prospective survey study was conducted and users of a widely available system questioned on their experience, operating procedures, and interpretation of standing low‐field MRI findings. Response data included scores on a modified Likert scale from which weighted ratings were calculated for statistical analyses. Depending on the question, responses were obtained from 17 to 29 of the 38 invited facilities. Users indicated that standing low‐field MRI was most frequently performed in the face of equivocal diagnostic findings; compared to Sports horses, general purpose riding horses were thought less likely to have detectable abnormalities and standing low‐field MRI was rated most useful for the detection of primary bone pathology in the proximal metacarpal region. Standing low‐field MRI signal change involving both the suspensory ligament and adjacent bone concurrently was rated most relevant and abnormalities solely affecting the muscle/adipose tissue bundles least relevant for diagnosing suspensory ligament injury. Transverse scans and in decreasing order T1‐weighted gradient echo, short‐tau inversion recovery FSE, T2*‐weighted gradient echo, and T2‐weighted FSE sequences were most frequently acquired and judged most useful by the majority of users experienced in imaging of the target area. This survey supports the relevant impact of standing low‐field MRI on clinical case management, particularly in the context of imaging the proximal metacarpal region.  相似文献   

20.
Objective —To describe incomplete oblique sagittal dorsal cortical fractures of the equine third metacarpal bone, their surgical repair, and subsequent performance of the horses.
Study Design —Retrospective examination of medical records and racing performance.
Animal Population —Six Thoroughbred race horses, 2 to 4 years of age.
Methods —Radiographic confirmation of all fractures preceded general anesthesia and surgical correction. Three fractures were treated by intracortical compression using screws placed in lag fashion, and five fractures were treated by osteostixis. Race records were reviewed for each horse to determine performance after surgery.
Results —Fractures were best observed on palmarodorsal radiographic projections. Three horses treated by intracortical compression returned to racing, but fracture recurred in one horse and was treated by osteostixis. This horse and the other three horses treated by osteostixis raced after surgery.
Conclusions —Horses with incomplete oblique sagittal fractures of the dorsal cortex of the third metacarpal bone can race after surgical management of the fracture by screws placed in lag fashion or osteostixis. The authors' preferred surgical procedure for managing this fracture is osteostixis.
Clinical Relevance —Palmarodorsal radiographic projections of the third metacarpal bone are recommended in young Thoroughbred race horses suspected of having dorsal metacarpal stress fractures.  相似文献   

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