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1.
REASONS FOR PERFORMING STUDY: Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. METHODS: Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. RESULTS: Sixty-four percent of fractures occurred in the hindlimbs and 36% in the forelimbs. Horses with forelimb fractures had a reduced probability of return to racing (67%) compared to those with hindlimb fractures (83%), but the majority (77%) of treated horses recovered to return to race post operatively. Horses with medial forelimb fractures raced at only a 47% rate; those with suspensory desmitis at 63%. Unlike Standardbreds, there was no difference in probability of racing post operatively between horses that had, and had not, raced preoperatively. CONCLUSIONS: Data show that arthroscopic removal of apical proximal sesamoid fracture fragments is successful at restoring ability to race in skeletally mature TB horses without evidence of severe suspensory ligament damage. Prognosis for return to racing is excellent (83%) in horses with hindlimb fractures and good (67%) in those with forelimb fractures. Medial fractures of the forelimb have the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis for differing sites in TB racehorses should increase knowledge of apical proximal sesamoid bone fractures and improve communication from veterinarian to owner, and trainer, on the potential for arthroscopic restoration of the ability to race.  相似文献   

2.
Reason for performing study: Analysis was performed to examine a method for refining the preoperative prognosis for horses that had surgery to remove apical fractures of the proximal sesamoid bones (PSBs). Objectives: To determine if: 1) there was a difference in size or configuration of apical fractures between the different anatomical locations of the PSBs, which have been shown to affect the prognosis; and 2) the size or configuration could predict the prognosis for racehorses with these fractures. Methods: The study included 110 weanlings and yearlings and 56 training racehorses that underwent surgery to remove apical PSB fractures. Radiographs of the fractures were used for measurement of the abaxial and axial proportion and the abaxial to axial ratio, and race records were used to determine average earnings per start (AEPS) and total post operative starts. Analysis of variance and regression statistics were used to compare the fragment sizes between the specific PSBs on each of the limbs and compare size and configuration of the fractures to prognosis. Results: There was a significantly larger abaxial to axial ratio (more transverse fracture) for the forelimb medial sesamoids than for all other sesamoids in untrained racehorses (P = 0.03). There were no other significant differences in size. There was no relationship between fracture size or configuration and AEPS nor total post operative starts. Conclusions: Apical fractures in weanlings and yearlings tend to be more transverse in the forelimb medial PSBs than the other PSBs. Apical fracture size and geometry does not determine prognosis for apical sesamoid fractures. Potential relevance: Horses that undergo surgery to remove larger apical fractures of the PSBs do not have a worse outcome than those horses with smaller fractures.  相似文献   

3.
OBJECTIVE: To determine whether fracture fragment dimensions, suspensory ligament damage, and racing status at the time of injury were associated with outcome in Standardbred horses with apical fracture of the proximal sesamoid bone. DESIGN: Retrospective study. ANIMALS: 43 Standardbred racehorses. PROCEDURE: Medical records, racing records, and radiographs were reviewed, and ultrasonographic findings were scored. Measurements of the fractured portion of the proximal sesamoid bone were made. RESULTS: Seventy-four percent (32/43) of horses were pacers, and 26% (11/43) were trotters. Statistical differences between trotters and pacers regarding ability to start, number of starts, or amount of money earned after injury were not detected. Females earned significantly more money per start after injury than males. Eighty-six percent (37/43) of fractures involved hind limbs and 14% (6/43) involved forelimbs. Horses with forelimb injuries earned less money per start. Severity of suspensory ligament damage did not affect postinjury racing performance. A higher proportion of horses that had raced before injury returned to racing after surgery than horses that had not raced before injury, although a significant difference between these groups was not detected. Eighty-eight percent of horses that raced before injury raced after injury. Fifty-six percent of horses that did not race before injury raced after injury. Fracture fragment dimensions did not affect outcome. CLINICAL IMPLICATIONS: Dimensions of the apical fracture fragment of the proximal sesamoid bone in Standardbred horses and degree of suspensory ligament damage did not affect outcome. Prognosis for return to racing soundness is good in horses that had raced before injury and fair in horses that had not raced before injury.  相似文献   

4.
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   

5.
Fractures of the proximal sesamoid bones (PSBs) range in severity from simple to complex and comminuted and can be articular or nonarticular. The majority of PSB fractures are diagnosed in racehorses, but PSB fractures, especially simple ones, do occur in sport horses undertaking various disciplines. For simple apical, basilar and abaxial articular PSB fractures, surgical removal via arthroscopy carries the best prognosis for return to athletic performance. Removal of apical and abaxial PSB fractures generally result in a favourable prognosis for return to racing but are dependent on the amount of suspensory ligament injury. Removal of basilar PSB fracture fragments results in a less favourable or fair prognosis for return to racing. Mid‐body PSB fractures typically require (lag screw) surgical fixation preferably with arthroscopic guidance and carry a fair to guarded prognosis for return to racing.  相似文献   

6.
OBJECTIVE: To assess individual and combined associations of high-speed exercise and horseshoe characteristics with risk of forelimb proximal sesamoid bone fractures and proximal sesamoid bone midbody fractures in Thoroughbred racehorses. ANIMALS: 269 deceased Thoroughbred racehorses. PROCEDURES: A case-control study design was used to compare 121 horses with a fracture of at least 1 of 4 forelimb proximal sesamoid bones (75 horses had a midbody fracture) and 148 horses without a forelimb proximal sesamoid bone fracture. Univariable and multivariable logistic regression analyses were used to evaluate potential risk factors for association with proximal sesamoid bone fracture. RESULTS: Compared with horses that died without proximal sesamoid bone fractures, horses that died with proximal sesamoid bone fractures were more likely to be sexually intact males, spend more time in active trainingand racing, complete more events, train and race longer since their last layup, have higher exercise intensities during the 12 months prior to death, and have greater cumulative distances for their career. Horses with proximal sesamoid bone midbody fractures were more likely to be sexually intact males, train and race longer since their last layup, and have higher exercise intensities during the 12 months prior to death. CONCLUSIONS AND CLINICAL RELEVANCE: Limitingexercise intensity and the continuous time spent in activity duringa horse's career may decrease the frequency of forelimb proximal sesamoid bone fractures in Thoroughbred horses.  相似文献   

7.
Case records of 25 horses with transverse fractures of the proximal sesamoid bone were reviewed to evaluate the success of treatment. All fractures were repaired by use of lag screw fixation and an autogenous cancellous bone graft because the fracture fragments were considered too large for surgical removal and reconstruction of the suspensory apparatus was necessary. Radiography was performed in all cases, and the fractures were classified into 3 types: (1) proximal midbody fractures, which included all fractures in the proximal aspect of the sesamoid bone that resulted in fragments involving greater than one third but less than one half of the total mass of the sesamoid bone; (2) midbody fractures that divided the bone into 2 equal portions; and (3) distal midbody fractures, which included transverse fractures in the distal aspect of the sesamoid bone that resulted in fragments involving greater than one third but less than one half of the total mass of the sesamoid bone. Of these cases, race records were obtained for 9 Standardbreds and 5 Thoroughbreds. Postoperative performance criteria evaluated were the ability to train and start 1 race, ability to maintain preinjury class of racing, earnings per start, and the number of starts following surgery. In Thoroughbreds, fractures occurred most commonly in the right forelimb; in Standardbreds, the left hind limb was most commonly involved. The midbody fracture was the most common type in both breeds, and the distribution of fracture location within the sesamoid bone was similar for both breeds.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

8.
Five horses with apical and abaxial fractures of the proximal sesamoid bones were treated arthroscopically. Ipsilateral and contralateral triangulation were used to remove abaxial fragments; apical fragments were removed by ipsilateral triangulation. Excellent visibility of the fracture fragments was obtained with each method. Dissection and removal of fragments was accomplished with standard arthroscopic instruments, tendon-splitting knives, and curved scissors. Excellent functional and cosmetic results were achieved in all cases.  相似文献   

9.
The case records of 49 horses with proximal sesamoid bone fracture were studied. The population consisted of 20 Thoroughbreds, 20 Standardbreds, 5 Quarter Horses, 2 Arabians, and 2 grade horses. The fractured bones were classified into 5 categories: apical fractures, basilar fractures, abaxial fractures, middle one-third fractures, and bilateral comminuted-distracted fractures. Apical fractures occurred most frequently in the Standardbred, with the prevalence of medial fracture being equal to that of lateral fracture. Basilar fractures occurred predominantly in the Thoroughbred, with the highest prevalence in the lateral sesamoid bone of the right front fetlock. Bilateral comminuted-distracted fractures also occurred primarily in the right front fetlock. The prognosis following surgical removal of apical fractures appeared to be superior to that for stall rest alone. The prognosis for basilar fractures was poor.  相似文献   

10.
OBJECTIVE: To compare results (ie, return to racing and earnings per race start) of surgical versus nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses. DESIGN: Retrospective study. ANIMALS: 32 racehorses (19 Thoroughbreds, 11 Standardbreds, and 2 Arabians). PROCEDURE: Medical records and radiographs were reviewed to obtain information regarding signalment and treatment. Follow-up information was obtained from race records. Robust regression analysis was performed to evaluate earnings per start in horses that raced at least once before and after injury. RESULTS: 22 (69%) horses raced at least once after treatment of the fracture. All 7 horses treated by means of interfragmentary compression raced after treatment, and horses that underwent interfragmentary compression had significantly higher earnings per start after the injury than did horses treated without surgery. Eight of 9 horses treated by means of arthroscopic debridement of the damaged cartilage and bone raced after treatment, but only 7 of 16 horses treated without surgery (ie, stall rest) were able to return to racing after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that racehorses with sagittal slab fractures of the third carpal bone have a favorable prognosis for return to racing after treatment. Horses treated surgically were more likely to race after treatment than were horses treated without surgery.  相似文献   

11.
OBJECTIVE: To evaluate nonsurgical management of type II fractures of the distal phalanx in Standardbred horses. DESIGN: Retrospective study of 48 affected horses. RESULTS: Most fractures occurred on the lateral palmar process of the left forelimb or the medial palmar process of the right forelimb; 81% of horses were considered sound enough to return to training and 63% raced. Of those returning to racing, 41% competed in > 10 races, 37% in 2 to 10 races and 22% in only 1 race. There was no difference in performance before and after fracture. Twenty-four of 25 horses had a bar shoe fitted for > 50% of the treatment phase. Of those horses returning to training without a bar shoe, 89% refractured at the same site. Sixty percent of horses returning to training with a bar shoe raced successfully. The total convalescent time, the time rested in a box and the time spelled in a paddock were similar for horses returning to racing and those that did not. The age of the horse had no effect on the ability to return to racing. CONCLUSION: The prognosis for type II fractures of the distal phalanx is guarded. It is advisable to fit a bar shoe on the horse during convalescence. Horses returning to training and racing with a bar shoe appear less likely to refracture the distal phalanx. Those horses that return to racing can perform at a level similar to that prior to fracture.  相似文献   

12.
Objective— To describe the characteristics of unilateral mid‐body proximal sesamoid bone (PSB) fractures, to determine factors associated with the outcome of horses after surgical repair, and to describe a technique for arthroscopically assisted screw fixation in lag fashion. Study Design— Retrospective case series. Animals— Horses (n=25) with unilateral mid‐body PSB fracture. Methods— Medical records (1996–2006), radiographs, and arthroscopic videos of horses with surgically repaired unilateral mid‐body PSB fractures were reviewed. Retrieved data included signalment, affected limb and PSB, fracture characteristics, and surgical technique. Outcome was established by radiographic assessment of healing and race records; categorical data were analyzed using Fisher's Exact test. Results— Medial forelimb PSBs were most commonly affected (80%). Surgical technique and degree of reduction were significantly associated with outcome; 44% of horses with screw repair and none of the horses with wire fixation raced (P=.047). Factors that may have influenced this outcome were differences in fracture reduction (improved reduction in 22% wire repairs and 88% screw repairs, P=.002) and use of external coaptation (22% wire repair and 88% lag screw repair, P=.002). None of the horses with unimproved reduction raced after surgery. Conclusions— Only 28% of horses with mid‐body PSB fractures raced after surgery. Compared with wire fixation, screw fixation in lag fashion resulted in good reduction and is seemingly a superior repair technique. Clinical Relevance— For mid‐body PSB fractures, arthroscopically assisted screw fixation in lag fashion and external coaptation for anesthesia recovery and initial support provides the best likelihood of return to athletic use.  相似文献   

13.
REASONS FOR PERFORMING STUDY: Little information exists regarding talus fractures in the horse and there have been no previously published case series of racehorses diagnosed with incomplete sagittal fracture of the talus. OBJECTIVE: To describe the diagnosis, treatment and post injury performance of horses with incomplete sagittal fracture of the talus. METHODS: Medical records of 11 racehorses (8 Standardbreds and 3 Thoroughbreds) admitted between January 1992 and January 1999 were reviewed. Subject details, anamnesis, results of lameness examination, radiographs and nuclear scintigraphic findings were evaluated. Racing performance was assessed by comparing pre- and post injury race records. RESULTS: Nuclear scintigraphic examination, performed in 8 of the 11 horses, revealed focal increased radiopharmaceutical uptake in the proximal aspect of the affected talus. Fractures could best be seen on dorsal 10-20 degrees lateral-plantaromedial oblique radiographs; all had raced pre-injury. All horses were treated conservatively and follow-up information was available for 8 horses, of which 7 raced after injury. Performance in 3 horses was improved, in 1 it was unchanged and in 3 horses performance declined. CONCLUSIONS: Horses with incomplete fracture of the talus have a good prognosis for return to racing after conservative management. POTENTIAL RELEVANCE: Incomplete sagittal fracture of the talus should be considered as a cause of hindlimb lameness in racehorses. Further research is necessary to determine the pathophysiology of these fractures.  相似文献   

14.
In a retrospective study, we examined the case records for 69 horses with noncomminuted fractures of the proximal phalanx, excluding proximal chip fractures. Forty-nine of the horses sustained the fracture while racing or training for racing. Radiographic examination of all affected limbs was performed, and fractures were classified into 6 noncomminuted types: midsagittal fractures, including short incomplete midsagittal fractures, long incomplete midsagittal (LIMS) fractures, and complete midsagittal (CMS) fractures; dorsal frontal fractures; distal joint fractures; plantar process fractures; physeal fractures; and oblique fractures. Four horses were destroyed before treatment. Sixty-five horses were treated and 63 survived to go home. Long-term follow-up evaluation of the horses that were sent home revealed that 4 were euthanatized after discharge because of persistent lameness of the fractured limb. Of the 59 remaining horses, 34 returned to racing, 7 were used as show or pleasure riding animals, 8 were used for breeding, and 10 were lost to follow-up. More Standardbreds with noncomminuted proximal phalangeal fractures returned to racing than did Thoroughbreds. Of 30 Standardbreds that raced or trained before the fracture, 23 (76.7%) returned to racing--8 to their previous level of performance, 11 to a lower level of performance, and 4 to an unknown level of performance. The Standardbreds that returned to racing were horses with physeal fractures (2/2), LIMS fractures (4/4), CMS fractures (11/16), short incomplete midsagittal fractures (4/7), distal joint fractures (1/2), and plantar process fractures (1/2). Of 21 Thoroughbreds that raced or trained before the injury, 11 (52.4%) returned to racing--7 to their previous level of performance and 4 to a lower level of performance.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

15.
OBJECTIVES: To describe the outcome after arthroscopic electrosurgical excision of axial osteochondral (OC) fragments of the proximal plantar aspect of the 1st phalanx (P1) in horses. STUDY DESIGN: Retrospective study. POPULATION: Twenty-three Standardbred racehorses. METHODS: Medical records of Standardbred racehorses that had arthroscopic dissection of axial OC fragments of the proximal plantar aspect of P1 with electrocautery probes were reviewed. Horses were positioned in dorsal recumbency; a 1.5% glycine solution was used to maintain joint distension. The arthroscope portal was in the proximal plantar joint pouch and OC fragments were approached using either an ipsilateral or a contralateral triangulation technique. Dissection of the fibrous attachments was performed using loop and hook electrocautery probes. Follow-up was obtained by telephone questionnaire of owners or trainers and examination of race summary records. RESULTS: Thirty-three axial OC fragments were removed from 28 metatarsophalangeal joints (left, 14; right, 14). No major operative or postoperative complications occurred. Seven of 8 (79%) of horses that raced before surgery raced after surgery. Thirty-six percent (n=4) of horses that had not raced before surgery raced after surgery. CONCLUSION: Intra-articular electrosurgery is a safe, easy alternative to conventional excision of axial OC fragments of the proximal plantar aspect of P1. CLINICAL RELEVANCE: Arthroscopic excision using electrocautery probes is a valid alternate method for removal of axial OC fragments of the proximal plantar aspect of P1. In addition, the dorsal recumbency position facilitates removal of several fragments and multiple joint surgery.  相似文献   

16.
Medical records, radiographs, and sonograms of 63 horses with metacarpophalangeal joint synovial pad proliferation were examined retrospectively. All horses had lameness, joint effusion, or both signs associated with one or both metacarpophalangeal joints. Bony remodeling and concavity of the distodorsal aspect of the third metacarpal bone (Mc3) just proximal to the metacarpal condyles was identified by radiography in 71 joints (93%); 24 joints (32%) had radiographic evidence of a chip fracture located at the proximal dorsal aspect of the proximal phalanx. Fifty-four joints (71%) were examined by ultrasound. The mean ± SD sagittal thickness of the synovial pad was 11.3 ± 2.8 mm. Seventy-nine percent of the horses had single joint involvement with equal distribution between the right and left forelimbs. Sixty-eight joints in 55 horses were treated by arthroscopic surgery. Sixty joints (88%) had debridement of chondral or osteochondral fragmentation from the dorsal surface of Mc3 beneath the synovial pad and 30 joints (44%) had a bone chip fracture removed from the medial or lateral proximal dorsal eminence of the proximal phalanx. Complete or partial excision of both medial and lateral synovial pads was completed in 42 joints. Only the medial synovial pad was excised or trimmed in 21 joints, and 5 joints had only the lateral pad removed. Eight joints in eight horses were treated by stall rest, administration of intra-articular medication and systemic nonsteroidal anti-inflammatory drugs. Follow-up information was obtained for 50 horses treated surgically and for eight horses treated medically. Forty-three (86%) that had surgery returned to racing; 34 (68%) raced at an equivalent or better level than before surgery. Three (38%) of the medically treated horses returned to racing; only one horse raced better than the preinjury level. Horses that returned to racing at a similar or equal level of performance were significantly younger in age than horses returning at a lower level or not racing (P≤.05). Overall, horses with synovial pad proliferation treated by arthroscopic surgery had a good prognosis for return to racing at a level equal or better than before injury.  相似文献   

17.
There is limited information on the treatment of lateral malleolus (LM) fractures in the horse, with no previously published case series for the outcome following arthroscopic removal of such fractures. This report reviews and evaluates findings of a retrospective study of 13 horses admitted to a private equine referral hospital over a 10 year period (1999–2009) that underwent arthroscopic removal of fractures of the LM. Hospital records were reviewed and details including patient history, aetiology of the fracture and limb affected, results of all diagnostic tests and surgical reports were documented. Performance information concerning Thoroughbred horses that went onto race post operatively was collected using an online database. Owners and trainers were contacted regarding the return to performance for non‐Thoroughbred cases or those that did not go onto race post operatively. Of the 13 horses presented, 12 were Thoroughbreds, 9 of which were National Hunt racehorses and 3 were Flat racehorses. The other horse in the study was used for general purpose riding. All cases presented with an acute unilateral fracture. Eleven of the 13 had >6 months post operative follow‐up and all were nonlame. Of the 12 Thoroughbreds, 10 have raced again, a total of 104 times (median 5 times). The median time from surgery to return to racing was 241 days (180–366 days). It is concluded that horses with fractures of the LM have an excellent prognosis for return to full athletic performance following arthroscopic debridement; and that arthroscopic fragment removal is an appropriate treatment method for fractures of the LM.  相似文献   

18.
OBJECTIVE: To determine the distribution for limbs and bones in horses with fractures of the proximal sesamoid bones and relationships with findings on palmarodorsal radiographic images. SAMPLE POPULATION: Proximal sesamoid bones obtained from both forelimbs of cadavers of 328 racing Thoroughbreds. PROCEDURE: Osteophytes; large vascular channels; and fracture location, orientation, configuration, and margin distinctness were categorized by use of high-detail contact palmarodorsal radiographs. Distributions of findings were determined. Relationships between radiographic findings and fracture characteristics were examined by use of chi2 and logistic regression techniques. RESULTS: Fractures were detected in 136 (41.5%) horses. Biaxial fractures were evident in 109 (80%) horses with a fracture. Osteophytes and large vascular channels were evident in 266 (81%) and 325 (99%) horses, respectively. Medial bones typically had complete transverse or split transverse simple fractures, indistinct fracture margins, > 1 vascular channel that was > 1 mm in width, and osteophytes in abaxial wing and basilar middle or basilar abaxial locations. Lateral bones typically had an oblique fracture and distinct fracture margins. Odds of proximal sesamoid bone fracture were approximately 2 to 5 times higher in bones without radiographic evidence of osteophytes or large vascular channels, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Biaxial fractures of proximal sesamoid bones were common in cadavers of racing Thoroughbreds. Differences between medial and lateral bones for characteristics associated with fracture may relate to differences in fracture pathogeneses for these bones. Osteophytes and vascular channels were common findings; however, fractures were less likely to occur in bones with these features.  相似文献   

19.
OBJECTIVE: To determine the outcome of horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone was removed arthroscopically and to determine whether fragment size was associated with outcome. DESIGN: Retrospective study. ANIMALS: 26 horses. PROCEDURE: Dorsopalmar and axial-abaxial lengths of the fracture fragment were measured on the dorsopalmar and mediolateral radiographic views, respectively, and percentage of the base of the sesamoid bone involved was estimated. Fractures were classified as grade 1 (< or = 25% of the base involved) or grade 2 (> 25% but < 100% of the base involved). Outcome was classified as successful if the horse started at least 2 races or unsuccessful if the horse started only 1 race or failed to return to racing. RESULTS: There were 24 racehorses and 2 nonracehorses. Twelve (50%) of the racehorses returned to racing and started at least 2 races. Eight of 14 horses with grade-1 fractures and 4 of 10 horses with grade-2 fractures had a successful outcome. Ten of 16 horses without associated articular disease had successful outcomes, compared with 2 of 8 horses with associated articular disease. However, fragment size and presence of associated articular disease were not significantly associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE: Horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone is removed arthroscopically have a fair prognosis for return to racing.  相似文献   

20.
Equine carpal and fetlock joints have been the most frequent sites for arthroscopic surgical procedures and were the initial locations where techniques were developed. The primary indication for surgical treatment of chip fragments in the equine athlete is normalization of the interior of the joint and prevention of osteoarthritis. Osteochondral chip fragments in the equine carpus are common in racehorses. The overall success rate with arthroscopic removal is 68.1% racing at a level equal to or better to preinjury in 88.6% starting at least one race. Depending on the degree of articular cartilage and bone damage, the prognosis for return to racing at a level equal to or better than preinjury ranges from 71% to 54%. Success rate with proximodorsal first phalanx chip fragments is 83.5% return to their previous use; 73.6% return to racing at the same level of performance. Other fracture fragments operated in the fetlock joint include, plantar or palmar first phalanx fragments, osteochondritis dissecans fragments from the sagittal ridge and distal dorsal metacarpus as well as apical, abaxial and basal sesamoid fragments. The success rates with these various arthroscopic surgeries are also presented.  相似文献   

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