Bone Spavin and P1 Fractures

Question 1

DJD of the distal tarsal and TMT joints is known as a what?

Answer 1

Bone spavin

Question 2

What is the most common location for a bone spavin?

Why?

Answer 2

• Medial aspect of joint

- Where most of the force is

Question 3

What might be seen with a bone spavin?

Answer 3

May see significant osteophyte formation.

Question 4

Bone spavins are a common cause of what?

Answer 4

Hindlimb lameness

Question 5

What are 6 methods that can be used when trying to diagnose a bone spavin?

Answer 5

• PE
• Lameness evaluation
• Diagnostic analgesia
• Radiographs
• Nuclear scintigraphy
• MRI

Question 6

When a horse is “standing under behind,” this is known as what?

Answer 6

Sickle-hocked

Question 7

Poor conformation can predispose a horse to what?

Answer 7

Osteoarthritis

Question 8

What are the 4 joints of the tarsus?

Answer 8

• Tibiotarsal joint
• Proximal intertarsal joint
• Distal intertarsal joint
• Tarsometatarsal joint

Question 9

How are bone spavins graded?

Answer 9

1 - 4

Question 10

A very small osteophyte is considered what grade?

Answer 10

Grade 1 bone spavin

Question 11

A small osteophyte is considered what grade?

Answer 11

Grade 2 bone spavin

Question 12

A medium osteophyte is considered what grade?

Answer 12

Grade 3 bone spavin

Question 13

A large osteophyte is considered what grade?

Answer 13

Grade 4 bone spavin

Question 14

What are bone spavins often caused by?

Answer 14

Chronic repetitive compression, torsion and shear strains

Question 15

A proximal limb flexion test is also sometimes called what?

Answer 15

“Spavin” test

Question 16

How long do you hold the leg for with a proximal limb flexion test?

Answer 16

60-90 seconds

Question 17

What is an example of a diagnostic tool that is sensitive but non-specific?

Answer 17

Nuclear scintigraphy

Question 18

What is an example of a diagnostic tool that is helpful in detailing cortical bone disease and stress fractures?

Answer 18

Nuclear scintigraphy

Question 19

What is an example of a diagnostic tool that is sensitive and specific?

Answer 19

MRI

Question 20

What is an example of a diagnostic tool that can be used to exam soft and hard tissue in joints?

Answer 20

MRI

Question 21

Bone spavins are common in what discipline of horses?

Answer 21

Western performance horses

Question 22

Results of medical management for bone spavins can be disappointing and lameness can persist in what percentage of affected horses?

Answer 22

25 - 50%

Question 23

What are 3 examples of possible medical management for bone spavins?

Answer 23

• Intra-articular injections of corticosteroids and chondro-protectives
• Phenylbutazone
• Light exercise

Question 24

What is an example of a mechanical form of arthrodesis that can be used for bone spavins?

Answer 24

Drill out joint with a drill bit to remove cartilage.

Question 25

What are 2 examples of chemical forms of arthrodesis that can be used for bone spavins? What is one that is no longer used?

Answer 25

- 70% ethanol, Nd:YAG or Diode laser arthrodesis | - Sodium monoiodoacetate (MIA)

Question 26

What is an approach for trans-articular drilling for bone spavin treatment?

Answer 26

Medial approach distal to the cunean tendon.

Question 27

How many drill tracts are usually drilled? | What angles are the tracts to each other?

Answer 27

- 3 drill tracts | - 30 degrees from each other at diverging angles

Question 28

How many weeks should a horse be bandaged for post-operatively after treatment for a bone spavin?

Answer 28

2 weeks

Question 29

How many weeks should a horse be hand-walked for post-operatively after treatment for a bone spavin?

Answer 29

2 weeks

Question 30

Light riding can begin when post-operatively after treatment for a bone spavin?

Answer 30

3-4 weeks

Question 31

Most horses see improvement how many monthss post-operatively after treatment for a bone spavin?

Answer 31

4-5 months

Question 32

What percentage of horses return to soundness after surgical arthrodesis (drilling)?

Answer 32

59-85%

Question 33

What is a treatment that destroys cartilage by superheating it and vaporizing the synovial fluid?

Answer 33

Laser facilitated ankylosis

Question 34

What is a surgical treatment where the horse experiences less pain and discomfort post-operatively compared to other techniques?

Answer 34

Laser facilitated ankylosis

Question 35

What is an example of a treatment technique that promotes partial ankyloses?

Answer 35

Laser facilitated ankylosis

Question 36

Laser facilitated ankylosis results in significantly less fusion of what joints compared to other techniques?

Answer 36

Distal tarsal joints

Question 37

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?

Answer 37

- 86% | - 3 months

Question 38

How much ethyl alcohol is injected for ankylosis? | What percentage is the alcohol?

Answer 38

- 3 mL | - 70%

Question 39

When can a horse usually return back to work after ethyl alcohol facilitated ankylosis?

Answer 39

Immediately

Question 40

Can ethyl alcohol facilitated ankylosis be done with standing sedation?

Answer 40

Yes

Question 41

What is a major complication seen with MIA injections?

Answer 41

Severe post-op pain

Question 42

What percentage of horses treated with MIA have a successful outcome?

Answer 42

40-90%

Question 43

Horses treated with MIA injections usually have bone fusion by what time?

Answer 43

12 months

Question 44

Cunean tenectomy decreases what?

Answer 44

Decreases rotational forces

Question 45

Performing a cunean tenectomy is controversial when what is present?

Answer 45

Controversial for early OA

Question 46

Cunean tenectomy can reduce pain with what condition?

Answer 46

Chronic OA with bone proliferation

Question 47

Torsion with axial weight bearing can cause what?

Answer 47

Fracture of the first phalanx

Question 48

P1 fractures are common in horses used for what?

Answer 48

Speed events

Question 49

Why are nerve blocks a bad idea when a fracture is suspected?

Answer 49

A partial fracture can turn into a full break if horse walks on it.

Question 50

75% of fractures of the proximal phalanx are located where?

Answer 50

Forelimb

Question 51

Where should the most proximal screw be placed when drilling for a P1 fracture?

Answer 51

Within 5 mm of the sagittal groove.

Question 52

Additional screws should be placed at what interval for P1 fracture repair?

Answer 52

20-22 mm intervals

Question 53

A distal limb cast can be used after the lag screws have been added for how long?

Answer 53

2-6 weeks

Question 54

Prognosis of P1 fracture repair is partially dependent on what?

Answer 54

Fetlock and pastern DJD

Question 55

What kind of prognosis does a comminuted fracture of P1 have?

Answer 55

Poor prognosis for returning to athletic activities.

Question 56

What is a procedure for a P1 fracture that is not frequently done and is considered a Salvage procedure?

Answer 56

Fetlock arthrodesis

Question 57

What is a possible complication that can be seen with P1 fracture repair?

Answer 57

Contralateral limb laminitis