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1.
Transection of the accessory ligament of the deep digital flexor muscle (distal check ligament desmotomy) was completed in 44 horses using an ultrasound-guided technique. The technique used real-time ultrasound with a 7.5 MHz transducer to observe the dissection and isolation of the check ligament through a 1 to 1.5 cm incision and to check for complete transection of the check ligament. The technique was effective in correcting flexural deformity of the distal inter-phalangeal joint and the metacarpophalangeal joint in all but three horses. Check ligament desmotomy at a young age (median, 6 months) resulted in more horses with normal foot conformation than when surgery was completed at an older age (median, 12 months). Age at surgery had no effect on subsequent appearance of the surgical site. Based on the authors experience this technique reduced immediate postoperative wound morbidity.  相似文献   

2.
A variety of methods are described for managing distal limb flexural deformities in the foal, including intravenous oxytetracycline and splint or cast use. This case series describes a novel technique that creates an ‘active tension‐extension splint’ by wiring the toe into a custom‐made fibreglass splint and therefore into active extension. A dorsal fibreglass splint is made by halving a cast that is set around the affected leg with padding underneath it, so that it is sculpted to a more appropriate anatomical shape. Cerclage wire is placed through the toe and the dorsal aspect of the splint, then tightened to pull the limb into active extension. Foals with distal limb flexural deformities that were treated in this way were followed up by examination of hospital records and telephone questionnaire. Records were examined for 13 foals treated between 2004 and 2010. One foal developed septic osteitis of the distal phalanx due to suspected laminar penetration; other post operative complications seen were bandage sores and minor cosmetic scarring. Out of 10 foals where follow‐up by questionnaire was available, 8 had complete resolution of their deformity following active tension‐extension splinting, one required inferior check ligament desmotomy for complete correction and one had carpal flexural deformities that did not resolve. All that survived to adulthood are sound and have achieved their intended purpose. This previously unpublished technique using a wire through the toe to create an active tension‐extension splint has a high success rate for correction of congenital flexural deformities affecting the distal interphalangeal and metacarpo‐/metatarsophalangeal joints in the foal. The majority of post operative complications are minor and easily managed. This is a simple technique that can improve the management of neonatal distal limb deformities both in a hospital situation and for equine practitioners in the field.  相似文献   

3.
Objective Determine the long‐term outcome for Thoroughbreds undergoing desmotomy of the accessory ligament of the deep digital flexor tendon (DAL‐DDFT) for type 1 flexural deformity of the distal interphalangeal joint (DIPJ). Design Retrospective matched cohort study Procedure Medical records were retrieved over a 17‐year period for Thoroughbreds that underwent DAL‐DDFT for type 1 flexural deformity. Long‐term outcome was determined by analysis of race records and comparison with maternal siblings. Comparisons between cases and controls included 2‐year‐old, 3‐year‐old and total career performance data. Results There were 46 cases of DAL‐DDFT. The mean age at surgery was 151 days (median 118, range 2–562); 48% of case horses and 77% of 90 controls started in a race. For case horses that did race, the time to first race, total number of starts and prize money per race were not significantly different to maternal siblings. Age at the time of surgery did not alter the likelihood of starting a race. Conclusion Thoroughbreds undergoing DAL‐DDFT for type 1 flexural deformity of the DIPJ are less likely to race when compared with their maternal siblings. For those that do race, the time to first race, total races and earnings per race are not different from controls. There is no evidence to suggest that age at the time of surgery influences the likelihood of racing.  相似文献   

4.
Hospital records of 29 horses treated by desmotomy ofthe accessory ligament of the deep digital flexor tendon for correction of acquired flexural deformity of the distal interphalangeal joint in one or both forelimbs were reviewed and evaluated retrospectively. Information on correction of the deformity, cosmetic appearance of the surgery site, and current use of the horses was obtained by interviews with the owners.At the time of surgery, 27 horses were less than one year old and two horses were more than one year old. Eleven months to five years after surgery, 26 horses had normal appearance of the hoof and limb, and 26 horses had acceptable cosmetic appearance of the surgery site due to no or minimal scarring. At the time of interview, all but two of the 11 horses more than three years old were in full training.It is concluded that desmotomy of the accessory ligament of the deep digital flexor tendon is an effective and cosmetically acceptable treatment for acquired flexural deformity of the distal interphalangeal joint in the horse.  相似文献   

5.
Objective This study documents the results of non-surgical treatment and treatment by superior check desmotomy in Thoroughbred racehorses with superficial digital flexor (SDF) tendonitis. Design A prospective study was made of 124 thoroughbred racehorses with unilateral or bilateral SDF tendonitis. Procedure The flexor tendons were assessed by physical and ultrasonographic examination before treatment, and the lesions detected in affected tendons were characterised according to lesion type, length and cross-sectional area. Ninety three horses were managed non-surgically and 31 by superior check desmotomy. Recurrent or new injuries were defined as injuries affecting a previously injured superficial digital flexor tendon, the contralateral SDF tendon, or the suspensory ligament (interosseous muscle) in either forelimb. Results No statistically significant difference was found in ultrasonographic lesion severity between treatment groups. Horses managed by superior check desmotomy were 1.3 times more likely to complete five or more races than horses managed non-surgically (95% confidence limits 0.93–1.82). Horses treated surgically were 1.2 times more likely to develop recurrent or new injuries after returning to training than horses managed non-surgically (95% CL 0.95–1.55). Horses under-going superior check desmotomy were 5.5 times more likely to develop suspensory desmitis than horses treated non-surgically (95% CL 1.13–26.4). There was no difference in the time to recurrent or new injury between treatment groups. Conclusion There was no statistically significant difference between treatment groups in the proportions of horses able to complete five or more races after an episode of superficial digital flexor tendonitis. Superior check desmotomy did not appear to offer an advantage over non-surgical treatment in preventing recurrent or new injuries in Thoroughbred racehorses. Horses undergoing superior check desmotomy appeared to be at greater risk of developing suspensery ligament injuries than horses managed non-surgically.  相似文献   

6.
Medical records of 38 horses less than 1 year of age and diagnosed as having a fracture of the femoral diaphysis, metaphysis or distal physis were evaluated. Twenty-six foals had fractures of the femoral diaphysis or metaphysis with the most common fracture configuration being comminuted. Twelve foals had distal physeal fractures with the most common fracture configuration being a Salter-Harris type II. Twenty-one foals with fractures of the capital femoral physis, neck or greater trochanter during the same time period were excluded from this study. Surgical repair was attempted in 16 diaphyseal and 2 distal physeal fractures. Most of the diaphyseal fractures were repaired by placing plates on the lateral and cranial surfaces of the bone. Dynamic condylar screw plates or angle blade plates were used for increased bone purchase in 4 foals with short distal fragments. Five foals with distal physeal fractures were treated; 2 were surgically treated by placing an angle blade plate on the lateral cortex, and 3 foals with minimally displaced distal physeal fractures were managed with stall confinement. Eight of the 16 surgically repaired diaphyseal fractures healed. Fracture location and configuration was not a determinant of outcome, but the mean age of foals with successfully repaired diaphyseal fractures was 2 months compared with 4 months for the unsuccessful cases, indicating that the age and size of the foal was important. Long-term follow up revealed that 6 of the 8 successfully repaired diaphyseal fractures had no residual effects of the fracture observed during performance of the horse for its intended use. Only 1 of the 2 surgically repaired distal physeal fractures healed, but this horse was eventually killed because of unthriftiness related to a malabsorption syndrome. Some form of complication developed in 13 of the 18 surgically repaired fractures. Infection was the primary cause of failure. The greatest determinant associated with infection was the inability to control post-surgical seroma formation.  相似文献   

7.
Objective: To report outcome after desmotomy of the accessory ligament of the deep digital flexor tendon (ALDDFT) in adult horses (≥2 years) for treatment of desmitis of the ALDDFT or flexural deformity of the distal interphalangeal joint (FDDIJ). Study Design: Case series. Animals: Horses with desmitis of the ALDDFT (n=9) and FDDIJ (n=15). Methods: Records (April 1996–July 2008) of 24 adult horses (mean age, 6.7 years) that had ALDDFT desmotomy were reviewed. Follow‐up data was obtained 12–120 months after desmotomy. Results: Outcome was available for 22 horses; 18 (82%; 6 of 8 horses with desmitis of the ALDDFT and 12 of 14 with FDDIJ) returned to their intended use within 6–24 months (mean, 12 months). Conclusion: In mature horses, ALDDFT desmotomy resulted in successful return to intended use in most horses with ALDDFT desmitis (75%) or FDDIJ (86%).  相似文献   

8.
A condition characterised by osteochondral fragmentation of the distal aspect of the patella in 15 horses is described. The problem was unilateral in six horses and bilateral in nine. There were eight Quarterhorses, three Thoroughbreds, two American Saddlebreds, one American Paint and one Warmblood-Thoroughbred cross. A previous medial patellar desmotomy had been performed on 12 of the 15 horses. The condition manifested as hindlimb lameness and stiffness ranging from mild to severe. There was fibrous thickening in the stifle area in the 12 cases with a previous medial patellar desmotomy, and synovial effusion in seven of 12 cases. Synovial effusion was present in two of the three cases in which a previous medial patellar desmotomy was not performed. The radiographic changes included bony fragmentation, spurring (with or without an associated subchondral defect), subchondral roughening and subchondral lysis of the distal aspect of the patella. All horses were treated with arthroscopic surgery. The lesions at arthroscopy varied from flaking, fissuring, undermining or fragmentation of the articular cartilage to fragmentation or lysis of the bone at the distal aspect of the patella. The subchondral bone was involved in all cases that had a previous medial patellar desmotomy. Of the 12 horses that had a previous medial patellar desmotomy, eight became sound at their intended use, one was sold in training without problems, one is in early training without problems, one never improved and one is in convalescence. Of the three that did not have a patellar desmotomy, two performed their intended use well but one was unsatisfactory.  相似文献   

9.
Reasons for performing study: It has been suggested that the success of gastric bypass surgery in foals for the treatment of gastric outflow obstruction is poor. However, few reports exist evaluating the long‐term prognosis of these cases. Objectives: To determine the long‐term success of foals, including racing records, surgically treated for gastric outflow obstruction secondary to gastroduodenal ulceration. Methods: Medical records of foals undergoing surgical treatment of gastric outflow obstruction secondary to gastroduodenal ulceration were evaluated for clinical information. Owners, trainers and race records were evaluated regarding long‐term survival and racing success. Results and conclusions: Sixteen foals were included in the study, all treated with a gastrojejunostomy. All foals survived to immediate discharge from the hospital; 8 survived to racing age, with 7 of those entering training and 3 actually racing. Foals that did not survive to racing age had various post operative complications. The success rate for these foals appears somewhat better than that previously reported. Potential relevance: Gastrojejunostomy for the treatment of gastric outflow obstruction, secondary to gastric ulceration, is a valid treatment option for foals.  相似文献   

10.
OBJECTIVE: To determine the clinical characteristics and outcome of foals with septic osteitis of the distal phalanx. DESIGN: Retrospective case series. ANIMALS: 22 foals. PROCEDURES: Information obtained from medical records included signalment; clinical, laboratory, and radiographic findings; treatment method; and outcome. Foals included in the study had lameness referable to the foot, radiographic evidence of localized lysis or focal loss of bone density of the distal phalanx, and suppurative discharge or necrosis of the affected bone evident at surgery. Foals with a history or evidence of penetrating wounds or subsolar abscessation were excluded. RESULTS: Mean age of foals at initial evaluation was 40.8 days (range, 3 to 122 days). Twenty-one (95%) foals had lameness as the primary complaint. Lesions consistent with septic osteitis of the distal phalanx localized to specific areas of the bone on the basis of radiographic and surgical findings were located on the solar margin or toe (14/22 [64%]), extensor process (5/22 [23%]), and palmar or plantar process (3/22 [13%]). Hind limbs (18/26 [69%] affected limbs) were more frequently affected. Two foals had > 1 affected limb, 2 had additional sites of osteomyelitis, and 4 had concurrent septic arthritis. Surgical debridement and regional antimicrobial perfusion were performed during general anesthesia. Extensor process lesions were not debrided. Nineteen of 22 (86%) foals survived to be discharged from hospital, and 16 horses reached racing age. Eleven of 16 had race starts, of which 8 had official race starts and 3 had unofficial race starts. CONCLUSIONS AND CLINICAL RELEVANCE: Septic osteitis of the distal phalanx should be considered as a source of lameness in foals with signs referable to the foot and does not necessarily preclude a career in racing. Although infection may occur secondary to bacterial penetration of the hoof or sole, the distal phalanx should also be considered as a potential site for hematogenous septic arthritis or osteomyelitis in foals.  相似文献   

11.
Objective: To report a tenoscopic technique using monopolar electrosurgery to transect the accessory ligament of superficial digital flexor muscle (AL‐SDFM) and outcome in 33 horses. Study Design: Case series. Animals: Horses (n=33). Methods: Medical files and surgery video recordings of horses that had AL‐SDFM desmotomy performed by tenoscopy with monopolar electrosurgical electrodes were reviewed. Results: Of 33 horses, 24 were Standardbred racehorses with surgery performed bilaterally for superficial digital flexor tendonitis and 9 horses had flexural deformity. Severe (n=6) and mild (6) intrathecal hemorrhage was the most common intraoperative complication. Large intrathecal vessels including the nutrient artery were successfully electrocoagulated and AL‐SDFM transection was completed. Clear/serosanguinous drainage from skin incisions was observed for 4.3±3.3 days (mean, SD). Protracted wound drainage for >4 days occurred in 10 horses, principally in the group treated for flexural deformities (P=.01). Conclusions: Sixty‐four AL‐SDFM were transected under tenoscopic observation using monopolar electrodes. Electrocoagulation of large intrathecal vessels, including the nutrient artery, was possible in all cases and allowed completion of desmotomy. Postoperative wound care was similar to routine tenoscopy in most (70%) horses. Aseptic protracted wound drainage was observed in 30% of horses (principally those with flexural deformity), and led to a prolonged hospitalization.  相似文献   

12.
Fractures of the distal phalanx of the forelimb were diagnosed in 5 colts and 3 fillies ranging in age from 2 weeks to 5 1/2 months at the time of fracture. Three fractures entered the distal interphalangeal joint and 6 fractures (one foal had bilateral fractures) were nonarticular. All foals with articular fractures became sound with conservative treatment. Four of 5 foals with nonarticular fractures became sound with conservative treatment and 1 foal developed separation of the hoof at the coronary band after application of acrylic around the hoof. On the basis of our observations in these foals, sagittal articular and nonarticular distal phalangeal fractures in foals should be treated conservatively. Foals so treated would have an excellent prognosis for return to soundness.  相似文献   

13.
The medical records of 20 horses admitted to the veterinary medical center with a diagnosis of brachygnathia over a 10-year period (1979 to 1989) were reviewed. The study included 18 foals and 2 adult horses. Males were affected 5.7 times more frequently than females. The amount of disparity between the mandible and premaxilla varied between 0.75 and 3 cm. Sixteen foals were treated surgically with the temporary application of premaxillary tension band devices. Thirteen of the 16 surgical cases were available for follow-up evaluation. All of the surgically treated animals had improved incisive occlusion, and 6 foals had complete resolution of the deformity with corrections ranging from 0.75 to 2.5 cm. Complete correction of the malocclusion was more likely to occur if foals were treated when they were less than or equal to 6 months old. The average amount of correction achieved in foals treated when they were less than or equal to 6 months old was 1.5 cm. (range, 0.75 to 2.5 cm). Foals treated, when they were 7 to 12 months old, had an average of 0.6 cm of reduction in the malocclusion (range, 0.25 to 1 cm). Implant failure was the most common complication and occurred in 9 of the 13 foals treated surgically.  相似文献   

14.
A 4-month-old colt with stage I flexural deformity of the distal interphalangeal joint was diagnosed as having a type IV nondisplaced fracture of the extensor process of the 3rd phalanx. An inferior check ligament desmotomy and internal fixation of the fracture were performed. Favorable long-term results for internal fixation of extensor process fractures are presented.  相似文献   

15.
Carpal flexural deformities (CFD) are frequently encountered in the horse, with both congenital and acquired forms described. The success of surgical correction of CFD, both in terms of the ability to achieve a straight palmar carpal angle and the impact on future athletic performance, requires further investigation. OBJECTIVE: To report the surgical management and outcome of treatment of flexural deformity of the carpus in 72 horses up to 12 months of age. METHOD: Information was obtained from the medical records of horses surgically treated for CFD and through follow-up contact with owners. At the time of examination each case was graded on the severity of the flexural deformity as grade 1, 2, or 3, in order of ascending severity. Surgical treatment consisted of tenotomy of the ulnaris lateralis and flexor carpi ulnaris muscles. Re-assessment of the palmar carpal angle was made in the immediate postoperative period and again from at least 8 months after surgery via telephone contact with owners and/or breeders. A successful outcome was defined as achievement of a straight palmar carpal angle. Long term outcome was assessed in terms of fullfilment of intended use for horses reaching 3 years of age at the time of the study. RESULTS: A total of 135 surgical procedures were performed on 72 horses. A successful outcome was recorded in 111 limbs (82%). Excluding cases lost to follow-up, surgical correction was more successful in restoring a straight palmar carpal angle in grade 1 limbs (25/25, 100%) compared to grade 2 limbs (78/87, 89%) and grade 3 limbs (8/14, 57%). For those horses that had reached 3 years of age, 26 of 36 Thoroughbreds started in a race (72%) and 12 of 14 non-Thoroughbreds fulfilled their intended use (86%). CONCLUSION: Tenotomy of the ulnaris lateralis and flexor carpi ulnaris tendons for treatment of grade 1 and 2 CFD's has an excellent prognosis for restoration of a straight palmar carpal angle and for intended athletic pursuit of the horse. In cases of grade 3 CFD, the prognosis following surgery is guarded, especially in neonates. Horses treated in this study were up to 12 months of age, indicating that this deformity may not always be self-limiting as previously thought, and treatment may be required for successful resolution of flexural deformity of the carpus in older animals. The results of this study will help veterinarians to make recommendations regarding the surgical treatment of CFDs.  相似文献   

16.
OBJECTIVE: To identify factors affecting the prognosis for survival and athletic use in foals with septic arthritis. DESIGN: Retrospective study. ANIMALS: 93 foals with septic arthritis. PROCEDURE: Medical records were reviewed to obtain clinical findings, laboratory test results, radiographic findings, treatment method, and outcome. Race records for Thoroughbreds and Standardbreds were evaluated to determine whether foals subsequently raced and whether they raced successfully. RESULTS: 43 foals had 1 affected joint, 44 foals had multiple affected joints, and number of affected joints was not recorded for 6 foals. The femoropatellar and tarsocrural joints were most commonly affected. Osteomyelitis or degenerative joint disease were detected in 59% (46/78) of foals. Failure of passive transfer, pneumonia, and enteritis were common. Foals were treated with lavage, lavage and intra-articular administration of antibiotics, lavage and arthroscopic debridement with or without partial synovectomy, or lavage and arthrotomy to debride infected bone and systemic administration of antibiotics. Seventy-three foals survived to be discharged from hospital, and approximately a third raced. Isolation of Salmonella spp from synovial fluid was associated with an unfavorable prognosis for survival and multisystem disease was associated with an unfavorable prognosis for survival and ability to race; other variables were not significantly associated with survival and ability to race. CONCLUSIONS AND CLINICAL RELEVANCE: With treatment, the prognosis for survival of foals with septic arthritis was favorable, whereas prognosis for ability to race was unfavorable. Multisystem disease, isolation of Salmonella spp from synovial fluid, involvement of multiple joints, and synovial fluid neutrophil count > or = 95% at admission may be of prognostic value.  相似文献   

17.
Summary Bilateral superior check ligament desmotomy was performed on 31 Thoroughbred and 17 Standardbred horses as the sole method of treatment for superficial digital flexor tendonitis. Horses resumed racing between 6 and 19 months after surgery. Horses that were able to compete in 5 or more races without injury to the tendon again were considered to have had a successful return to racing. Twenty-five Thoroughbreds were suitable for later study and 13 of these (52%) raced on 5 or more occasions. Fifteen Standardbreds were suitable for later study and 10 of these (66%) raced on 5 or more occasions. Within the racing industry it is generally thought that about 20 to 30% of horses with superficial digital flexor tendonitis can return to racing after a prolonged rest. The results of this study suggest that bilateral superior check ligament desmotomy may improve the prognosis for a horse returning to racing after injury to the superficial digital flexor tendon.  相似文献   

18.
The usefulness of inferior check ligament desmotomy as a treatment for acquired tendon contracture in horses was evaluated in 13 cases of deep digital flexor (DDF) contracture and in 3 cases of combined superficial digital flexor (SDF) and DDF contracture. In 8 of 9 cases of DDF contracture in which the dorsal surface of the hoof had not passed beyond being vertical to the ground, the surgical procedure was successful in returning the limb to a normal position and function. Compared with DDF tenotomy, inferior check ligament desmotomy was a superior treatment technique because of decreased postoperative pain, better postoperative appearance, and improved return to function. In 4 cases of DDF contracture in which the dorsal SDF contracture was also involved, inferior check ligament desmotomy was generally insufficient to allow return of the limb to normal alignment and function.  相似文献   

19.
Between January 1985 and May 1989, 53 Thoroughbred horses (mean age 3.2 years) were surgically treated for dorsal cortical fractures of the third metacarpal bone (MC III). All horses were treated with cortical drilling through the fracture line (osteostixis). Diagnosis of the fractures was confirmed by xeroradiography. Lifetime racing records were obtained for all horses. Forty-seven horses returned to racing after surgery (89%). The mean time between surgery and the first race was 6.8 months. Horses had a mean of 10.9 starts before surgery and 16.1 starts after surgery. The mean earnings per start before surgery was $6,459 and after surgery was $5,685. Of the 47 horses that raced after surgery, 70% raced at the same class or improved. Complications related to surgery were seen in 10 horses. Two horses had a second fracture of MC III at the same site, and were again treated by osteostixis, after which both horses returned to competition. Fractured drill bits were left in the MC III of 4 horses. One of these horses had catastrophic failure of MC III. Two horses developed subcutaneous infections and 2 horses had catastrophic failure of MC III in the surgically treated limb. Osteostixis appears to be an effective treatment for returning horses affected with dorsal cortical fractures to racing.  相似文献   

20.
Reasons for performing study: Few studies have evaluated the athletic prognosis of foals affected by gastrocnemius disruption. Objective: To examine the diagnosis and management of gastrocnemius disruption in Thoroughbred (TB) foals, determine short‐term survival rate and assess future racing performance. The hypothesis was that Thoroughbred foals with gastrocnemius disruption are able to perform as racehorses comparably to their age matched maternal siblings. Methods: The medical records of foals diagnosed with gastrocnemius muscle disruption were reviewed. Information on training and racing was acquired from published works and race records. Paired t tests were utilised to compare performance variables of affected racehorses to their maternal siblings in starts, earnings and earnings/start for their 2‐ and 3‐year‐old racing seasons. Fisher's exact tests were employed to determine the association between sex, limb affected, age on admission, degree of caudal reciprocal apparatus dysfunction, concurrent disease, antibiotic therapy, complications, abscess formation and likelihood of entering training or starting a race. Results: Sample size was too small to detect significant differences in performance variables between affected horses and controls. Of 28 foals, 17 (61%) presented with concomitant illness; foals without concurrent disease were more likely to achieve race training or start a race (P = 0.04); 23 (82%) were short‐term survivors defined as survival to discharge. Of these 23 survivors, 7 were aged <2 years at the time of the study. Eighty‐one percent (13/16) of the survivors that were of racing age were in training or had started a race. Conclusions: In this population, 82% of TB foals affected with gastrocnemius disruption were able to achieve training or start a race. Foals presenting for gastrocnemius disruption have a high prevalence of concurrent disease processes. Potential relevance: The assessment of athletic prognosis and treatment complications provides useful information to clinicians treating gastrocnemius muscle disruption in foals and making recommendations to clientele.  相似文献   

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