PubMed Health⌕ Search

Biomedical subjects

L R Bramlage

Publications and source records attributed to L R Bramlage.

At least 19 recordsLinked to original sources
PubMed2007

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age < 2 years: 151 cases (1989--2002).

REASONS FOR PERFORMING STUDY: Studies on arthroscopic removal of apical proximal sesamoid fracture fragments in Thoroughbred (TB) horses age > or = 2 years have reported a high success rate. However, there are no reports documenting the racing prognosis of TB horses that undergo such surgery as weanlings or yearlings. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in immature TB horses, age < 2 years and determine probability and quality of racing performance after arthroscopic removal of such fractures in 151 TB weanlings and yearlings. METHODS: The medical records of TB horses age < 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. Follow-up information was obtained from race records. Student's t tests were used to compare performance variables of operated racehorses to that of their maternal siblings. RESULTS: Ninety-two percent (139/151) of fractures occurred in the hindlimbs and 8% (11/151) in the forelimbs (fracture of both fore- and hindlimb, n = 1). Horses with forelimb fractures had a greatly reduced probability of racing (55%) compared to those with hindlimb fractures (86%). Overall, 84% of the horses raced post operatively and had performance records similar to that of their maternal siblings, 78% (787/1006) of which raced. CONCLUSIONS: Arthroscopic removal of apical proximal sesamoid fracture fragments in TB weanlings and yearlings carries an excellent prognosis for racing in horses with hindlimb fractures and a reduced prognosis in those with forelimb fractures. Medial fractures of the forelimb carry the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis increases knowledge on apical sesamoid bone fractures and potential for arthroscopic restoration of the ability to race; and enables the value of yearlings for subsequent sale to be established.

Age Factors↗
PubMed2006

Oral hyaluronan gel reduces post operative tarsocrural effusion in the yearling Thoroughbred.

REASONS FOR PERFORMING STUDY: Hyaluronan (HA) has been used to treat joint disease via intra-articular, i.v. and oral administration. The efficacy of intra-articular and i.v. use has been evaluated but the oral route has yet to be examined. OBJECTIVES: To determine the effect of oral hyaluronan gel on joint effusion following arthroscopic surgery for osteochondritis dissecans (OCD) of the tarsocrural joint of yearling Thoroughbreds. METHODS: Forty-eight yearlings diagnosed with unilateral or bilateral osteochondritis dessicans (OCD) of the tarsus were arbitrarily chosen prior to arthroscopic surgery. The yearlings were included only if they had mild or no synovial effusion pre-surgery. Twenty-four of the yearlings (27 joints) were treated with 100 mg of HA orally for 30 days post operatively and 24 (30 joints) with a placebo orally for 30 days. At 30 days post operation, a blinded examiner scored the effusion of the dorsomedial tarsocrural joint individually using a scale of 0 to 5 (0 = no effusion, 1 = barely palpable effusion, 2 = palpable effusion [without plantar effusion], 3 = golf ball sized effusion with plantar effusion, 4 = tennis ball sized effusion with plantar effusion, 5 = > tennis ball sized effusion with plantar effusion). Half grades were allowed and OCD lesion sizes and locations were compared. RESULTS: A total of 57 joints were examined, of which 33 had OCD of the distal intermediate ridge of the tibia, 19 OCD of the distal lateral trochlear ridge of the talus and 5 OCD of the medial malleolus. The mean 30 day effusion score of the HA treated group (27 joints) was 0.67 while the mean of the 30 day placebo group (30 joints) was 2.05 (P < or = 0.0001). Similar results were noted when comparing treated vs. placebo for each lesion location as well as for lesion sizes. CONCLUSIONS AND POTENTIAL RELEVANCE: Oral preparations of hyaluronan are being used to treat joint disease in horse. Anecdotal reports supporting the efficacy of these preparations already exist. This study provides objective evidence that oral HA reduces joint effusion post operatively following the arthroscopic removal of an OCD lesion in the tarsocrural joint.

Adjuvants, Immunologic↗
PubMed2006

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002).

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.

Age Factors↗
PubMed2004

Arthroscopic debridement of subchondral bone cysts in the distal phalanx of 11 horses (1994-2000).

REASONS FOR PERFORMING STUDY: Historically, there has been a consensus that conservative management of subchondral cystic lesions of the distal phalanx carries a poor prognosis. Surgical management has been advocated; however, there are no reports documenting its routine use and successful surgical treatment. OBJECTIVES: To describe arthroscopically-guided curettage of distal phalangeal subchondral cystic lesions (SCLs) and report the qualitative and quantitative results in 11 affected horses age 16-33 months. METHODS: Medical records of horses with previously treated lameness resulting from SCLs of the third phalanx were reviewed. Arthroscopic debridement of the SCLs was described. Follow-up information was obtained from race records and telephone contact with owners and trainers. The sign-rank test was used to compare performance of operated racehorses to that of unoperated siblings. RESULTS: Ten of the 11 horses (91%) in the study returned to athletic soundness after surgical treatment and had performance records similar to their siblings. CONCLUSIONS: Data show that arthroscopic debridement of distal phalangeal SCLs is a viable treatment for affected horses age 16-33 months and can result in a successful return to intended athletic performance. No horses younger than 16 months or older than 33 months were treated and results in horses younger or older than this group may vary in success. POTENTIAL RELEVANCE: The description of treatment and approach used for arthroscopic curettage will increase awareness of this option and increase treatment options for this condition.

Age Factors↗
PubMed2003

Dystocia in a referral hospital setting: approach and results.

REASONS FOR PERFORMING STUDY: Dystocia in the mare is an emergency in which duration has a profound effect on survival of the foal. Specific examination of the effects of dystocia duration on foal survival provides information to enable horse care personnel and veterinarians to manage these cases more effectively and maximise the chances of obtaining a live foal. HYPOTHESIS: Dystocia duration would have a negative impact on foal survival while method of dystocia resolution would not have an effect on foal survival. Additionally, we were interested in determining the effects of dystocia on subsequent fertility. METHODS AND RESULTS: In the years 1986-1999, 247 dystocias were admitted. Of these, 91 % resulted in survival and discharge of the mare, 42% in delivery of a live foal, and 29% of foals survived to discharge. Period from hospital arrival to delivery for foals alive at discharge (23.0 +/- 14.1 mins) was not significantly different than for foals not surviving (24.8 +/- 10.6 mins) (P > 0.05); and from chorioallantoic rupture to delivery for foals alive at discharge (71.7 +/- 343 mins) was significantly less than for foals not surviving (853 +/- 37.4 mins) (P < 0.05). Average predystocia live foaling rates for all mares with available records was 84%. Overall post dystocia live foaling rates over the entire period of this study were 67%. Of mares bred in the year of the dystocia, 59% had a live foal in the year following. CONCLUSIONS: Based on these results, dystocia duration has a significant effect on foal survival and resolution methods should be chosen to minimise this time, as the difference between mean dystocia duration for foals that lived and those that did not in this study was 13.6 mins. Post dystocia foaling rates reported here are higher than previously reported for both same-season and overall breedings, indicating same-season breeding may be rewarding for select dystocia cases. POTENTIAL RELEVANCE: Dystocia resolution methods that minimise delivery time may maximise foal survival. Post dystoicia breeding may be rewarding in select cases.

Animals↗
PubMed2003

Correlation of racing performance with radiographic changes in the proximal sesamoid bones of 487 Thoroughbred yearlings.

REASONS FOR PERFORMING STUDY: Proximal sesamoiditis has been a common and confusing radiographic diagnosis in Thoroughbred yearling surveys. This study categorised the radiographic appearance of yearling proximal sesamoid bones and determined their effect on the number of races started and earning potential for racing at ages 2 and 3 years. HYPOTHESIS: Yearlings with moderate to severe proximal sesamoiditis have decreased performance at age 2 and 3 years. METHODS: Survey radiographs of 487 Thoroughbred yearlings were reviewed. Proximal sesamoid bones were examined and findings placed into 7 categories, 5 of which measured size, shape, and number of vascular canals, and 2 examined the radiographic shape of the sesamoid abaxial surface. Records of horses age 2 and 3 years were reviewed to obtain the number of races completed and money won in those races. RESULTS: Vascular canals with parallel sides < 2 mm in width in any number were normal. Yearlings with 1 or 2 abnormally conformed vascular canals (nonparallel sides and > 2 mm in width) had a decrease in number of race starts at age 2 years when compared to normal horses. This same change in the fore- or hindlimbs was associated with decreases in starts and earnings at age 2 years. If uniformly present in both fore- and hindlimbs there was no difference from normal horses. Yearlings with > 2 irregular vascular canals had a decrease in number of race starts and earnings at age 2 and 3 years. Changes in proximal sesamoid bone contour did not affect performance. CONCLUSIONS: Horses with enlarged vascular canals, within their sesamoids as yearlings, start fewer races and earn less prize money than horses with normal vascular canals. POTENTIAL RELEVANCE: One or two enlarged canals affected horses as 2-year-olds. Three or more enlarged vascular canals affected horses at ages 2 and 3 years, which should be taken into account when examining radiographs for potential purchase of young horses.

Age Factors↗
PubMed2003

Radiographic changes in Thoroughbred yearlings. Part 1: Prevalence at the time of the yearling sales.

REASONS FOR PERFORMING STUDY: Radiography in presale examinations of TB yearlings has become standard practice in recent years. OBJECTIVES: To describe the prevalence and distribution of radiographic changes in the fetlocks, carpi, tarsi, stifles and fore feet of Thoroughbred yearlings in central Kentucky when these joints were examined as part of routine pre- and post sale evaluations. METHODS: Horses subjected to radiographs included the fore (n = 1127) and hind (n = 1102) fetlocks, carpi (n = 1130), tarsi (n = 1101), stifles (n = 660) and fore feet (n = 300). Radiographic changes were categorised by location and type of change present (e.g. lucency, fragment) for each series. RESULTS: In the fore fetlocks 1.6% had fragmentation of the proximal dorsal first phalanx and 0.5% fragmentation of the proximal palmar aspect. In the hind fetlocks 5.9% had fragmentation at the plantar aspect and 3.3% fragmentation dorsally. Lucencies, fragments or loose bodies were detected at the dorsal aspect of the distal third metacarpus in 2.8% and, at the same location on the third metatarsus, 3.2%. Most yearlings (98%) had vascular channels in the proximal sesamoid bones and irregular vascular channels (> 2 mm wide or with nonparallel sides) were more common (79%) than regular vascular channels (56%). The intermediate ridge of the distal tibia was the most common location for fragmentation in the tarsus (4.4%). CONCLUSIONS: While some radiographic changes, e.g. vascular channels in proximal sesamoid bones, are very common in Thoroughbred yearlings, others, e.g. fragmentation or subchondral lucency within joints are quite rare usually affecting less than 5% of the population. POTENTIAL RELEVANCE: Veterinarians should expect to find radiographic changes in Thoroughbreds presented for examination prior to the yearling sales. The rarity of some changes thought to affect soundness or racing performance will make further invesigation of these conditions in horses without clinical signs more difficult.

Animals↗
PubMed2003

Radiographic changes in Thoroughbred yearlings. Part 2: Associations with racing performance.

REASONS FOR PERFORMING STUDY: Although the radiographic examination of yearlings has become commonplace at some large Thoroughbred sales, there are few data to support the decisions facing veterinarians who are asked to evaluate future racing potential. OBJECTIVES: To identify radiographic changes in the fetlocks, proximal sesamoid bones, carpi, tarsi, stifles and fore feet of Thoroughbred yearlings associated with future racing performance during ages 2 and 3 years. METHODS: Radiographs from routine pre- and post sale examinations of 1162 yearlings were used to identify individual radiographic changes in sale yearlings. Starting a race, the percent of starts placed, money earned and earnings per start were used to assess racing performanceand examined for associations with the radiographic changes observed. RESULTS: Overall 946 (81%) yearlings started at least one race during ages 2 or 3 years. Fourteen of 24 (58%) yearlings with moderate or extreme palmar supracondylar lysis of the third metacarpus, 8 of 14 (57%) of those with enthesophyte formation on the proximal sesamoid bones and 19 of 30 (63%) of those with dorsal medial intercarpal joint disease started a race. The odds of starting a race when age 2 or 3 years were 3 times lower for yearlings with these changes (P < 0.01) compared with yearlings that did not have these changes. Twenty-five of 36 (69%) yearlings with proximal dorsal fragmentation of the first phalanx in the hind fetlock started a race and these yearlings were also less likely (OR = 0.51, P = 0.07) to start a race. Yearlings with enthesophyte formation on hind proximal sesamoid bones placed in a smaller percentage of starts (16%, P = 0.01) earned less money (987 US dollars, P = 0.02) and had lower earnings per start (252 US dollars, P = 0.03) compared to starters without this change. CONCLUSIONS: Although many of the changes observed on radiographs of sale yearlings do not appear to influence future racing performance, some are associated with reduced performance. POTENTIAL RELEVANCE: The results of this study are best applied in parallel with the clinical impressions of veterinarians experienced in examining radiographs of sale yearlings. Some findings support those established in the literature as incidental findings and others suggest new areas for concern not previously reported as a problem in Thoroughbred sale yearlings.

Animals↗
PubMed2001

Proximal interphalangeal arthrodesis in 22 horses.

The purpose of this study was to evaluate a new method of internal fixation technique for pastern arthrodesis. Pastern arthrodeses are performed commonly in horses with chronic osteoarthritis of the pastern joint or, in cases of acute traumatic injury to the pastern, in which the weightbearing bony column must be restored. Chronic osteoarthritis of the pastern is a frequent cause of lameness in the equine athlete and is evidenced by chronic lameness localised to the pastern joint, and supported radiographically by periosteal proliferation and loss of joint space. Nonsurgical and surgical treatments have both been described in the literature. Complications following pastern arthrodesis have been reported on several occasions and appear to focus on excessive periarticular exostoses and increased time in a cast due to prolonged time to bony fusion. The hospital records of horses presenting for pastern arthrodesis to the Rood and Riddle Equine Hospital in Lexington, Kentucky, were reviewed and 22 met criteria for inclusion in the study. Horses with chronic osteoarthritis of the proximal interphalangeal joint or horses with an acute traumatic injury to the pastern undergoing pastern arthrodesis with one of the following techniques were included in the study. Horses with severe comminution of the middle phalanx were excluded. Three 5.5 mm cortical bone screws placed in lag fashion alone or in combination with a 4 or 3 hole dynamic compression plate affixed with 4.5 mm cortical bone screws were compared. A lower limb fibreglass cast was applied in all cases. Period in cast, time to return to intended use, complications encountered and outcome were evaluated. Seven of the 8 hindlimbs treated with the combination technique became sound. Three out of 6 of the front limbs treated with the combination technique became sound. Four of the 5 horses with hindlimbs, and one of the 2 with front limbs, treated with screws only returned to their intended use. The type of internal fixation did not appear to influence the overall number of horses returning to the intended level of performance. The period spent in cast and the time to return to soundness were decreased in horses operated on using the combination technique. We concluded that, in the immediate postoperative period, the combination of the parallel screw technique with a dorsally-applied dynamic compression plate provides the most stable and secure fixation, minimising motion, expediting bone remodelling and therefore favouring rapid fusion of that joint.

Animals↗
PubMed2000

Qualitative and quantitative documentation of the racing performance of 461 Thoroughbred racehorses after arthroscopic removal of dorsoproximal first phalanx osteochondral fractures (1986-1995).

The purpose of this study was to examine the longevity of postoperative careers and quality of performance of 461 Thoroughbred racehorses after arthroscopic removal of dorsoproximal first phalanx (P1) osteochondral fractures. Six hundred and 59 dorsoproximal P1 chip fractures were removed arthroscopically from 574 joints in 461 horses presented for lameness or decreased performance attributed to the chip fractures. Radiological and arthroscopic examination revealed an average of 1.43 fragment sites/horse, 1.15 fragment sites/joint and 1.25 affected joints/horse. Eighty-nine percent of the horses (411/461) raced after surgery and 82% (377/461) did so at the same or higher class. Fifty horses did not race after surgery. Sixty-eight percent of the horses raced in a Stake or Allowance race postoperatively. Data, previously undocumented, establishes that the quantity and quality of performance is not diminished after arthroscopic treatment of dorsoproximal P1 fragmentation. Surgical removal of chip fractures is a means of preserving the economic value of an injured Thoroughbred, allowing a rapid and successful return to racing at the previous level of racing performance.

Animals↗
PubMed2000

Uroperitoneum in the hospitalised equine neonate: retrospective study of 31 cases, 1988-1997.

Historical, physical and diagnostic data were reviewed retrospectively in 31 equine neonates with uroperitoneum. Gender predilection was not observed, and classic electrolyte abnormalities were seen in less than 50% of the cases. Aetiologies for uroperitoneum have been well described, but this review found that septicaemia/severe illness played a crucial role the outcome of uroperitoneum. Approximately half the individuals with uroperitoneum had positive sepsis scores. Foals receiving fluid therapy were more likely to be septic and to have normal electrolyte concentrations. Ultrasonographic findings, serum creatinine and serum:peritoneal creatinine ratios were not affected by previous fluid therapy and were invaluable aids in the diagnosis of uroperitoneum, even with multisystemic disease such as sepsis.

Abdomen↗
PubMed1999

Fractures of the rostral portion of the mandible and maxilla in horses: 89 cases (1979-1997).

OBJECTIVE: To compare fracture locations, repair methods, complications, and outcomes of horses with fractures of the rostral portions of the mandible and maxilla. DESIGN: Retrospective study. ANIMALS: 89 horses with fractures of the rostral portions of the mandible and maxilla. PROCEDURE: Medical records and radiographs were reviewed. Fractures were categorized by fracture location and stability. Postoperative complications and long-term outcome were determined by clinical examination and telephone interviews with horse owners. RESULTS: 4 fracture types were recognized. Fractures involving just the alveolar plate (33%) and those involving the alveolar plate and the body of the bone (32%) were most common and were often repaired by interdental wiring. Unilateral fractures of the mandible (11%) were managed without surgery if stable. Unstable fractures were repaired with wires, a U-shaped bar (U-bar), or a bone plate. Bilateral fractures (24%) were often repaired with orthopedic wires in foals or with a U-bar, acrylic splint, wires, or bone plate in adult horses. In 2 horses, bilateral fractures were managed conservatively. Short-term complications developed in 24 of 89 (27%) horses. Soft tissue infections and wire loosening or failure were the most common short-term and long-term complications. Wire replacement was not required in any horses after release from hospital. Persistent draining tracts were most often associated with bone sequestration. Long-term functional and cosmetic outcomes were favorable for all fracture types and repair methods. CLINICAL IMPLICATIONS: Although complications in horses with fractures of the mandible and maxilla are common, long-term prognoses for functional and cosmetic outcome are favorable.

Animals↗
PubMed1999

Characterisation of the type and location of fractures of the third metacarpal/metatarsal condyles in 135 horses in central Kentucky (1986-1994).

The objective of this retrospective study was to provide a detailed description of the characteristics of condylar fractures represented in a population of 135 horses who sustained 145 fractures. Records and radiographic studies were examined. Fifty-nine percent of the horses were male and the majority Thoroughbreds. The distribution of fractures was 37% incomplete-nondisplaced, 30% complete-nondisplaced and 32% complete-displaced. The right front was more likely to sustain a complete-displaced fracture, whereas the left front was more likely to sustain an incomplete-nondisplaced fracture. Forelimbs (81%) and lateral condyles (85%) were more likely to be involved. Contrary to previous studies, the right forelimb was slightly more often involved than the left. Fractures tended to involve the middle portion of the condyle (59%). The mean length of all fractures was 75+/-3.8 mm. Axial fractures and medial condyle fractures tended to be longer. Fifteen percent of the fractures had definitive articular comminution. Ninety-five percent of fractures with articular comminution were associated with complete fractures. When fractures entered the middle area of the condyle, 23% had articular comminution. Eight of the fractures spiralled, all involved forelimbs. Concurrent lesions included proximal phalanx chip fractures, sesamoid fractures, sesamoiditis, proximal phalanx fractures, 'splint' bone periostitis and ligamentous injuries. The complete description of the fractures in this group of horses allows us better to define the condylar fracture, compare these fractures to previous studies and establish new data for use in defining prognosis.

Animals↗
PubMed1999

Results of treatment of 145 fractures of the third metacarpal/metatarsal condyles in 135 horses (1986-1994).

The objectives of this study were to correlate condylar fracture characteristics and type of treatment with subsequent capacity for athletic ability, and to determine the characteristics of healing that affect prognosis after fracture fixation. Medical records, post operative radiographic studies and race records were examined for 135 horses sustaining 145 fractures. Sixty-five percent of horses overall started in a race post injury (SPI) in a mean time of 9.7 months with a mean of 13.7 races post injury. Having raced pre-injury did not confer an advantage to starting post injury, though nonstarters pre-injury tended to take longer to return. For horses starting pre- and post injury, 66% improved or maintained their race class level after injury, whereas 64.2% decreased their race earnings post injury. Eighty-five percent of the fractures received internal fixation, of which 70% were complete fractures. Eighty-seven percent of horses with incomplete-nondisplaced fractures treated conservatively raced post injury. The percent SPI for incomplete-nondisplaced, complete-nondisplaced and complete-displaced fractures treated with internal fixation were 74%, 58%, and 60%, respectively. Males (72%) raced post injury more frequently than fillies (53%), and may represent a truer probability of SPI. Spiral fractures tended to take longer until their first start (mean 13.3 months). Fifty-two percent of horses with articular fragments were able to race post injury. Horses were more likely to start if 2-4 month radiographic healing revealed no evidence of the fracture except the presence of lag screws. Based on this series of cases, the majority of horses, with proper treatment, were able to return to racing regardless of fracture characteristic. Prognosis appeared to be affected by the severity of the injury to the joint, the presence of articular comminution and the quality of surgical repair.

Animals↗
PubMed1999

Results of screw fixation combined with cortical drilling for treatment of dorsal cortical stress fractures of the third metacarpal bone in 56 Thoroughbred racehorses.

The purpose of this study was to evaluate screw fixation with cortical drilling as a surgical treatment for dorsal cortical stress fractures of MCIII in the Thoroughbred racehorse. Details of age, sex, limb affected, fracture assessment, and post operative recommendations were obtained from medical records and radiographs. Fracture healing was assessed radiographically at the time of screw removal. Performance evaluation was determined from race records obtained from The Jockey Club Information System, Lexington, Kentucky. Fifty-six Thoroughbred racehorses were treated surgically for stress fracture of MCIII with screw fixation and cortical drilling. Stress fractures occurred primarily in the left front limb of the male 3-year-olds, in the dorsolateral cortex of the middle third of MCIII. Ninety-seven percent of the fractures travelled in a dorsodistal to palmaroproximal direction. Median period to screw removal was 2.0 months. Evaluation at time of screw removal revealed 98% of single stress fractures of the left front limb were healed radiographically. Median period to resume training was 2.75 months (single stress fractures); median period to race was 7.62 months. There was no statistically significant difference in earnings/start before and after surgical intervention. Of the 63 fractures treated, two recurred. There were no catastrophic failures, and no incisional infections.

Animals↗
PubMed1997

Use of antibiotic-impregnated polymethyl methacrylate in horses with open or infected fractures or joints: 19 cases (1987-1995).

OBJECTIVE: To evaluate the clinical efficacy of antibiotic-impregnated polymethyl methacrylate (PMMA) in horses with open or infected fractures or joints in which internal fixation or external coaptation devices were used. DESIGN: Retrospective case series. ANIMALS: 19 horses in which antibiotic-impregnated PMMA was used as part of the treatment regimen. PROCEDURES: Medical records of each horse were reviewed, and owners and trainers were contacted to provide additional information. RESULTS: Musculoskeletal problems in these horses included 10 fractures of long bones, 2 comminuted phalangeal fractures, 5 joint injuries, and 2 chronically septic joints in which ankylosis was stimulated. Nine horses had open fractures, 8 had closed wounds and developed infection after internal fixation of fractures, and 2 had chronically septic joints. Bony union was achieved in 15 of 19 horses. Twelve horses were discharged from the hospital and survived long term. Gentamicin sulfate, tobramycin sulfate, amikacin sulfate, and cefazolin sodium were used in PMMA. CLINICAL IMPLICATIONS: Use of antibiotic-impregnated PMMA provided high local concentrations of antibiotics and should be considered in the treatment of horses with open fractures and acute and chronic bone and joint infections.

Amikacin↗
PubMed1997

Surgical treatment of subchondral cystic lesions of the third metacarpal bone: results in 15 horses (1986-1994).

Subchondral cystic lesions (SCLs) in the condyle of the third metacarpal bone (MCIII) were surgically treated in 15 horses. The median age at presentation was 18 months (range 10 months-12 years) with 10 of 15 horses less than age 2 years. The SCLs were confined to the front limbs in all cases with 2 horses having bilateral lesions. Lesions were isolated to the medial condyle(s) of MCIII in 13 of 15 horses; a cystic lesion occurred in the lateral condyle in one horse and in the sagittal ridge in one horse. One horse with bilateral lesions had an additional cystic lesion located in the right medial femoral condyle. Fourteen of 15 horses had a history of moderate lameness attributable to the metacarpophalangeal joint; the lesion was an incidental finding in one horse. Duration of lameness ranged from 4 weeks to 8 months and was either acute in onset, or occurred intermittently and was associated with exercise. Fetlock flexion significantly exacerbated the lameness in all cases. Synovial effusion was absent in 8 (53%) cases. Cystic lesions were curetted arthroscopically in 12 horses, and through a dorsal pouch arthrotomy in 3 horses. Concurrent osteostixis of the cystic cavity was performed in 7 horses. Two horses were treated arthroscopically for osteochondral fragmentation of the proximodorsal aspect of the proximal phalanx one year following surgical curettage of the SCL. Twelve of 15 horses (80%) were sound for intended use following surgical treatment. Two horses did not regain soundness and follow-up information was unavailable for one horse. Total period of follow-up was 1-6 years. Follow-up radiographic examinations were available for 9 horses. Mild periarticular osteophyte formation and enthesiophyte formation at the dorsal joint capsular attachments was present in 5 of the 9 horses. Bony ingrowth of the cystic lesion was detectable in 8 horses and enlargement of the cystic cavity was observed in one horse. Based on the information gained from this study, it would appear that surgical treatment of SCLs in the distal metacarpus can result in a favourable outcome for athletic use.

Animals↗