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Objective— To report long-term outcome after arthroscopic removal of fragmentation of the extensor process of the distal phalanx in horses.
Study Design— Case series.
Animals— Adult horses (n=13).
Methods— Medical records (2003–2004) of horses that had arthroscopic debridement of fragmentation of the extensor process of the distal phalanx were reviewed. Inclusion criteria included: lameness localized to the foot, fragmentation of the extensor process of the distal phalanx debrided arthroscopically, and a follow-up period of ≥4 years.
Results— Of the 13 horses, lameness was resolved in 11 (85%) initially but distal interphalangeal joint pain recurred in 2 (15%) within 1 year of surgery. Three (23%) other horses were retired because of lameness at other sites during the follow-up period resulting in 46% (6/13) being not lame and in full work after 4 years. Substantial changes were identified at surgery in the contralateral joint of 7 horses, even when fragments were only present unilaterally.
Conclusions— Arthroscopic debridement of fragmentation of the extensor process of the forelimb distal phalanx has a good short-term prognosis for resolution of lameness and return to work but a more guarded prognosis for long-term soundness.
Clinical Relevance— These results allow for more accurate prognostication preoperatively and may support early debridement of fragmentation of the extensor process of the distal phalanx.  相似文献   
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Objectives— To report the technique, observations on fracture configurations and results of treatment by fixation lag screw following the fracture plane determined by an approach to the third metacarpal/metatarsal bone (MC3/MT3) that begins laterally over the metacarpo(metatarso)phalangeal joint and extends dorsally over the diaphysis of the bone.
Study Design— Case series.
Animals— Thoroughbred horses (n=18) with propagating fractures of the medial condyle of MC3/MT3.
Methods— Retrospective analysis of case records of horses with fractures of the medial condyle of MC3/MT3 that propagated sagittaly or in a spiral configuration into the diaphysis, repaired surgically under general anesthesia by screw fixation in lag fashion through a lateral approach with periosteal reflection.
Results— Fractures were readily identified at surgery, enabling screw fixation in lag fashion following the fracture plane. Fracture configurations varied and could be classified as sagittal and spiral fractures with fractures within each group generally following a similar course. All horses recovered relatively uneventfully from general anesthesia and surgery, and all fractures healed well. Thirteen horses returned to training; 5 subsequently raced.
Conclusions— Repair of propagating sagittal and spiral fractures of the medial condyle of MC3/MT3 with diaphyseal involvement, through a lateral approach with periosteal reflection permits stable fixation with minimal complications. In this series there were no catastrophic failures.
Clinical relevance— Fractures of the medial condyle of MC3/MT3 that propagate either sagittaly or in a spiral configuration into the diaphysis can be successfully repaired with screw fixation in lag fashion using a lateral approach with periosteal reflection.  相似文献   
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Objective— To describe a lateral approach for screw fixation in lag fashion of simple spiral medial condylar fractures of the third metacarpus/metatarsus (MC3/MT3).
Study Design— Case series.
Animals— Thoroughbred racehorses (n=9).
Methods— Nondisplaced medial MC3/MT3 condylar fractures (3 thoracic, 6 pelvic limbs), with mean length 126 mm (range, 91–151 mm) were repaired by internal fixation, under general anesthesia, using multiple 4.5 mm cortical screws inserted in lag fashion from the lateral aspect of the limb, using radiographic or fluoroscopic guidance. Horses were recovered from anesthesia in half-limb casts; 7 unassisted and 2 using a rope-recovery system. Horses had 2 months box rest, 1 month in-hand walking, and follow-up radiographic examination at 3 months.
Results— Horses recovered uneventfully from anesthesia. Five horses raced; 1 returned to training, was persistently lame, and was retired to stud; 2 were retired directly to stud; and 1 horse was lost to follow-up.
Conclusions— MC3/MT3 medial condylar fractures were successfully repaired by screws inserted n lag fashion form the lateral aspect.
Clinical Relevance— Use of a lateral approach to medial condylar MC3/MT3 fractures allows screw insertion perpendicular to the fracture plane without interference with palmar/plantar soft tissue structures or from the splint bones. Although repair was performed under general anesthesia, the technique should be adaptable to application in standing horses.  相似文献   
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Chronic laminitis is a severe disease affecting the equine digit. It was hypothesized that magnetic resonance (MR) imaging would improve visualization of structures within the foot and pathology associated with chronic laminitis. This study aimed to describe the MR imaging findings in chronic laminitis, compare different pulse sequences for visualization of pathology, and to compare MR imaging with standard radiography. Twenty (10 forelimb, 10 hindlimb) cadaver limbs from 10 horses clinically diagnosed with chronic laminitis (group L) and 10 limbs without laminitis (group N) were used. Lateromedial radiographs and sagittal and transverse MR images of the foot were obtained. Radiographs and MR images were evaluated for anatomic definition and evidence of pathology. Dorsal hoof wall thickness and angle of rotation and displacement distance of the distal phalanx were measured. Comparisons were made between group L and N, forelimb and hindlimb within each horse, and MR imaging and radiography. Features consistently noted with MR images in group L, but not detected using radiography, included laminar disruption, circumscribed areas of laminar gas, laminar fluid, and bone medullary fluid. Other findings seen only on MR images included increased size and number of vascular channels, alterations in the corium coronae, and distal interphalangeal joint distension. Magnetic resonance imaging allowed better definition of laminar gas lines and P3 surface irregularity observed on radiographs. Based on measurements, group L had a greater angle of rotation, distal displacement, and dorsal hoof wall thickness than group N; forelimb hoof wall thickness was greater than hindlimb; and distal displacement and hoof wall thickness measurements were smaller using MR imaging than radiography, but had a similar pattern. It is concluded that there are features of chronic laminitis consistently observed using MR imaging and that these may be additional to features observed radiographically.  相似文献   
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Bone-phase scintigraphy is sensitive to the dynamic process of bone modeling and remodeling, which may be adaptive or pathologic. Our knowledge of normal patterns of radiopharmaceutical uptake (RU) is limited, making interpretation of images problematic. It is therefore important to characterize normal patterns of RU at specific sites and relate these to age and exercise, to ensure valid interpretation of images in clinical cases with subtle lesions. This study aimed to characterize patterns of uptake of radiopharmaceutical in the distal tarsal region in clinically normal horses, and to investigate the effects of age and work discipline. Retrospective evaluation of nuclear scintigraphic images of the distal tarsal region of 30 clinically sound, high-level showjumpers and lower-level riding horses was performed. All images were acquired dynamically as a series of 35 two-second frames, which were then motion corrected and summated. The images were assessed using vertical and horizontal profile analysis across the distal tarsal region, and regions of interest comparisons between the distal tarsal region and tibia within each horse. There was a repeatable pattern of RU across the distal tarsal region in both horizontal and vertical directions. There was significantly greater RU on the dorsal compared with plantar aspect, and lateral compared with medial aspect of the distal tarsal region. RU in the right distal tarsal region was significantly greater than in the left. Elite showjumpers had significantly higher RU ratio compared with the lower-level riding horses, but no significant alterations in the pattern of RU were detected.  相似文献   
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