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Biomedical subjects

R M Embertson

Publications and source records attributed to R M Embertson.

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↗
PubMed2007

The effect of uterine torsion on mare and foal survival: a retrospective study, 1985--2005.

REASONS FOR PERFORMING STUDY: Anecdotal speculation suggests that prognosis for survival of mares and foals following correction of uterine torsion has improved over the past 30 years. OBJECTIVES: To determine statistically the outcome of uterine torsion according to duration of clinical signs, stage of gestation, parity, physical examination findings, method of correction, prognosis for survival and reproductive health of the mare, and prospects for the foal within the neonatal period. METHODS: This retrospective study combined cases from 4 equine referral hospitals. RESULTS: The stage of gestation at which uterine torsion occurred was a risk factor for survival of mare and foal. Overall mare survival was 53/63 (84%); when uterine torsion occurred at < 320 days gestation, 36/37 (97%) of mares survived compared to 17/26 (65%) survival rate when uterine torsion occurred at > or = 320 days gestation. Overall foal survival was 54% (29/54). When uterine torsion occurred at < 320 days gestation, 21/29 (72%) foals survived compared to 8/25 (32%) when uterine torsion occurred at > or = 320 days gestation. Thirty mares were discharged from the hospital carrying a viable fetus following uterine torsion correction and 25/30 (83%) of these mares delivered live foals that survived beyond the neonatal period. CONCLUSIONS: Prognosis for survival for mares and foals following uterine torsion is good and improves if torsion occurs < 320 days compared to > or = 320 days gestation. CLINICAL RELEVANCE: Gestational timing of uterine torsion should be considered when advising clients about the prognosis for survival of the mare and foal. The prognosis for a mare delivering a live foal is good if the mare is discharged from the hospital following uterine torsion correction with a viable fetus.

Animals↗
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↗
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↗
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

Colic surgery in 206 juvenile thoroughbreds: survival and racing results.

The purpose of our study was to determine the types of lesions that cause colic in juvenile Thoroughbreds, factors associated with these lesions and the subsequent survival and athletic performance of the juveniles. The age of juvenile Thoroughbreds requiring surgical exploration for abdominal pain has an influence on the type of lesion causing colic. The short-term survival rate (discharge from the hospital) after colic surgery for foals was 85% and was strongly influenced by the lesion causing colic. Thirteen percent of juveniles recovered from the first surgery experienced another severe colic episode requiring additional surgery or euthanasia. Eight percent of foals recovered from the first celiotomy developed adhesions. Adhesion formation was related to the initial lesion causing colic and the foals' age at the first surgery. Foals being suckled (15 days to 6 months) were at greatest risk for adhesions and more frequently required multiple surgeries. Juvenile Thoroughbreds that had a celiotomy were significantly less able to race (63%) than their unaffected siblings (82%), and age at the initial surgery was associated with the percentage of horses that raced. However, affected foals able to race won as much money, raced as often, and made as many starts as their siblings. Colic and surgical treatment have a negative impact on athletic performance, but the majority of foals discharged from the hospital after colic surgery will perform athletically as adults.

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

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↗
PubMed1995

Racing performance after hemicircumferential periosteal transection for angular limb deformities in thoroughbreds: 199 cases (1987-1989).

Racing records of 199 Thoroughbred foals with angular limb deformities surgically treated by hemicircumferential periosteal transection and elevation (HCPT) from 1987 through 1989 (principals) were compared with records of their 1,017 siblings (controls) for starting status; 2-, 3-, and 4-year-old starts; earnings and earnings per start; and starts percentile ranking number (SPR). Principals had a slightly lower percentage of horses starting a race (45 vs 55%), fewer 2-year-old starts (1.06 vs 1.72), and lower SPR (33.49 vs 49.18), compared with those of controls (P < 0.05). Starting status was significantly (P < 0.05) affected by surgery and the horse's sex, but not by anatomic site treated. Fillies were 1.74 times less likely to start than were colts, regardless of surgery, whereas principal fillies were 2.63 times less likely to start than were control colts. Difference was not detected between principals and controls in 3- or 4-year-old starts; 2-, 3-, or 4-year-old earnings, or earnings per start. Horses treated with distal metacarpal/metatarsal HCPT had fewer 2-year-old starts (1.09 vs 2.19), but did not have a significantly different SPR or lower starting percentage, compared with values for controls. Horses treated with distal radial HCPT had lower starting percentage (48 vs 55%), fewer 2-year-old starts (1.22 vs 1.70), and lower SPR (32.53 vs 53.32), compared with those of controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1995

Unilateral choanal atresia in a foal.

A 4-month-old Thoroughbred foal was examined because of a history of exercise intolerance and lack of airflow from the right nostril since birth. Endoscopy of the airways revealed complete membranous obstruction of the right nasal passage at the level of the nasopharynx and marked narrowing of the caudal aspect of the right ventral meatus. Unilateral choanal atresia was diagnosed. Laser ablation of the obstructing tissues was attempted through a videoendoscope. Scar tissue occluded the right nasal passage at follow-up examination 7 weeks later. Intranasal resection, using laparoscopic instruments, was then performed, and a nasal stent was maintained for 2 weeks after surgery. At 1 year of age, the foal was reported to have decreased airflow from the right nares and excessive respiratory noise during exercise. Atresia of the choanae in horses usually is bilateral and, therefore, life-threatening and detectable at birth. Unilateral choanal atresia may not be suspected until later, but should be considered in horses with decreased or no airflow from 1 naris.

Airway Obstruction↗
PubMed1995

Diagnosis and management of incomplete fracture of the distal palmar aspect of the third metacarpal bone in five horses.

Incomplete fracture of the distal palmar aspect of the third metacarpal bone was diagnosed in 5 horses. Mild to moderate lameness and positive response to flexion of the metacarpophalangeal joint were evident in all horses. Fractures were not detectable in 4 horses when the routine 30 degrees proximodorsal-palmarodistal radiographic view was used. Visualization of the fractures in these 4 horses required imaging of the palmar condylar surface by use of a dorsopalmar view of the flexed joint or a 125 degrees dorsoproximal-dorsodistal view. The dorsopalmar view of the flexed joint was used in a fifth horse to evaluate fracture healing when the fracture was no longer evident on routine radiographic views. Scintigraphy was used to locate the fracture sites in 2 horses. Treatment in all horses involved rest with gradual return to exercise, and all horses returned to their previous levels of racing. Scintigraphy and imaging of the palmar condylar surface of the third metacarpal bone allow for a more complete evaluation when other diagnostic images are within normal limits.

Animals↗
PubMed1994

Postoperative racing performance in standardbreds and thoroughbreds with osteochondrosis of the tarsocrural joint: 109 cases (1984-1990).

Medical records for 64 Thoroughbred and 45 Standardbred horses with osteochondrosis dissecans (OCD) of the tarsocrural joint that were treated by means of arthroscopic removal of the fragments before 2 years of age and before beginning racing were reviewed. Lesion site was recorded for all horses. The other foals from the dams of these surgically treated horses (siblings) were identified from mare progeny records. Racing data, including number of starts and money won during the 2- and 3-year-old racing years were obtained from the Jockey Club and the United States Trotting Association for affected horses and their siblings. Statistical analysis was performed to test the hypothesis that there was no difference between the racing performance of horses with OCD of the tarsocrural joint that were surgically treated by means of arthroscopic removal of the fragments prior to racing and that of their siblings. One hundred and seventy-four lesions were recorded in 109 horses. The distribution of lesions was similar to that previously reported. For the Standardbreds, 22% of those that had surgery raced as 2 year olds and 43% raced as 3 year olds, compared with 42 and 50% of the siblings that raced as 2 year olds and 3 year olds, respectively. For the Thoroughbreds, 43% of those that had surgery raced as 2 year olds and 78% raced as 3 year olds, compared with 48% and 73% of the siblings that raced as 2 year olds and 3 year olds, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1994

Congenital abnormalities of tendons and ligaments.

Congenital deformities of tendons and ligaments are not uncommon in foals. The vast majority of hyperextension deformities are treated successfully with exercise management and extended heel shoes. Successful treatment of contractural deformities depend on the site and severity of the deformity and on the appropriate use of medical, physical, and, possibly, surgical therapy.

Animals↗