Bone Spavin and P1 Fractures Flashcards
DJD of the distal tarsal and TMT joints is known as a what?
Bone spavin
What is the most common location for a bone spavin?
Why?
- Medial aspect of joint
- Where most of the force is
What might be seen with a bone spavin?
May see significant osteophyte formation.
Bone spavins are a common cause of what?
Hindlimb lameness
What are 6 methods that can be used when trying to diagnose a bone spavin?
- PE
- Lameness evaluation
- Diagnostic analgesia
- Radiographs
- Nuclear scintigraphy
- MRI
When a horse is “standing under behind,” this is known as what?
Sickle-hocked
Poor conformation can predispose a horse to what?
Osteoarthritis
What are the 4 joints of the tarsus?
- Tibiotarsal joint
- Proximal intertarsal joint
- Distal intertarsal joint
- Tarsometatarsal joint
How are bone spavins graded?
1 - 4
A very small osteophyte is considered what grade?
Grade 1 bone spavin
A small osteophyte is considered what grade?
Grade 2 bone spavin
A medium osteophyte is considered what grade?
Grade 3 bone spavin
A large osteophyte is considered what grade?
Grade 4 bone spavin
What are bone spavins often caused by?
Chronic repetitive compression, torsion and shear strains
A proximal limb flexion test is also sometimes called what?
“Spavin” test
How long do you hold the leg for with a proximal limb flexion test?
60-90 seconds
What is an example of a diagnostic tool that is sensitive but non-specific?
Nuclear scintigraphy
What is an example of a diagnostic tool that is helpful in detailing cortical bone disease and stress fractures?
Nuclear scintigraphy
What is an example of a diagnostic tool that is sensitive and specific?
MRI
What is an example of a diagnostic tool that can be used to exam soft and hard tissue in joints?
MRI
Bone spavins are common in what discipline of horses?
Western performance horses
Results of medical management for bone spavins can be disappointing and lameness can persist in what percentage of affected horses?
25 - 50%
What are 3 examples of possible medical management for bone spavins?
- Intra-articular injections of corticosteroids and chondro-protectives
- Phenylbutazone
- Light exercise
What is an example of a mechanical form of arthrodesis that can be used for bone spavins?
Drill out joint with a drill bit to remove cartilage.
What are 2 examples of chemical forms of arthrodesis that can be used for bone spavins?
What is one that is no longer used?
- 70% ethanol, Nd:YAG or Diode laser arthrodesis
- Sodium monoiodoacetate (MIA)
What is an approach for trans-articular drilling for bone spavin treatment?
Medial approach distal to the cunean tendon.
How many drill tracts are usually drilled?
What angles are the tracts to each other?
- 3 drill tracts
- 30 degrees from each other at diverging angles
How many weeks should a horse be bandaged for post-operatively after treatment for a bone spavin?
2 weeks
How many weeks should a horse be hand-walked for post-operatively after treatment for a bone spavin?
2 weeks
Light riding can begin when post-operatively after treatment for a bone spavin?
3-4 weeks
Most horses see improvement how many monthss post-operatively after treatment for a bone spavin?
4-5 months
What percentage of horses return to soundness after surgical arthrodesis (drilling)?
59-85%
What is a treatment that destroys cartilage by superheating it and vaporizing the synovial fluid?
Laser facilitated ankylosis
What is a surgical treatment where the horse experiences less pain and discomfort post-operatively compared to other techniques?
Laser facilitated ankylosis
What is an example of a treatment technique that promotes partial ankyloses?
Laser facilitated ankylosis
Laser facilitated ankylosis results in significantly less fusion of what joints compared to other techniques?
Distal tarsal joints
Lameness resolved in what percentage of bone spavin cases treated with ethyl alcohol facilitated ankylosis in one study?
How long did it take for the lameness to disappear?
- 86%
- 3 months
How much ethyl alcohol is injected for ankylosis?
What percentage is the alcohol?
- 3 mL
- 70%
When can a horse usually return back to work after ethyl alcohol facilitated ankylosis?
Immediately
Can ethyl alcohol facilitated ankylosis be done with standing sedation?
Yes
What is a major complication seen with MIA injections?
Severe post-op pain
What percentage of horses treated with MIA have a successful outcome?
40-90%
Horses treated with MIA injections usually have bone fusion by what time?
12 months
Cunean tenectomy decreases what?
Decreases rotational forces
Performing a cunean tenectomy is controversial when what is present?
Controversial for early OA
Cunean tenectomy can reduce pain with what condition?
Chronic OA with bone proliferation
Torsion with axial weight bearing can cause what?
Fracture of the first phalanx
P1 fractures are common in horses used for what?
Speed events
Why are nerve blocks a bad idea when a fracture is suspected?
A partial fracture can turn into a full break if horse walks on it.
75% of fractures of the proximal phalanx are located where?
Forelimb
Where should the most proximal screw be placed when drilling for a P1 fracture?
Within 5 mm of the sagittal groove.
Additional screws should be placed at what interval for P1 fracture repair?
20-22 mm intervals
A distal limb cast can be used after the lag screws have been added for how long?
2-6 weeks
Prognosis of P1 fracture repair is partially dependent on what?
Fetlock and pastern DJD
What kind of prognosis does a comminuted fracture of P1 have?
Poor prognosis for returning to athletic activities.
What is a procedure for a P1 fracture that is not frequently done and is considered a Salvage procedure?
Fetlock arthrodesis
What is a possible complication that can be seen with P1 fracture repair?
Contralateral limb laminitis
