Exam 2: Bone Spavin and P1 Fractures Flashcards
The layterm for DJD of the distal intertarsal (DIT) and
tarsometatarsal (TMT) joints.
It is a common cause of hindlimb lameness in the horse
Bone Spavin
The hock joint is made up of 4 joint spaces.
Name them from proximal to distal:
Proximal to distal:
Tibiotarsal
PIT
DIT
TMT
The _______ aspect of the joint
is the most common place to see Bone Spavin
medial
Poor conformation predisposed to
______________
Osteoarthritis
What are two examples of poor conformation that
can predispose for osteoarthritis in the equine?
Sickle hocked
Cow hocked
The conformation where the back leg joints of a horse
are set with too much angle,
resulting in the hock also being excessively angled.
This can result in uneven hoof wear,
and eventually osteoarthritis
SICKLE-hocked
The conformation in an equine where the
back ‘knee’ is set inward,
resulting in a splayed look in the back legs.
This can result in the uneven wearing of hooves,
and eventually osteoarthritis
COW-hocked
Out of the 4 joints that make up the hock,
which 2 joints always communicate?
Tibiotarsal and PIT
(the most proximal joints)
What do you expect to see on rads
of an animal with bone spavin?
Osteophyte formation
What bone is the arrow pointing to?
Central tarsal bone
What grade is this bone spavin?
Grade 1
small osteophyte distolateral central tarsal bone
What bone is this arrow pointing to?
What grade is this bone spavin?
MT3 (3rd metatarsal bone)
Grade 2
Small osteophyte proximal dorsolateral MT3
What bone is this arrow pointing to?
What grade is this bone spavin?
Central Tarsal Bone
Grade 3
medium osteophyte distomedial central tarsal bone
What bone is this arrow pointing to?
What grade is this bone spavin?
MT3 bone
Grade 4
large osteophyte proximal dorsolateral MT3 bone
What are the causes of bone spavin?
Chronic repetitive compression
Torsion
Shear strains
What type of horses are bone spavins
most common in?
WESTERN performance horses
This test is a specific for hock lameness,
if the horse FLEXES and ABDUCTS the leg.
Digital pressure should also be applied
to the area of the cunean bursa in search of sensitivity.
Church Hill Hock Test
Describe how to perform a spavin test
- The horse is trotted to determine the degree of lameness
- The lame proximal hind leg is flexed for 90 seconds
- The horse is trotted again to see if lameness has worsened
If the horse’s lameness is worsened = Positive Spavin Test
What is going on in this image?
Spavin Test
Proximal hind limb flexion
How is bone spavin diagnosed?
Lameness evaluation: Church Hill Test, Spavin Test
Advanced imaging: Nuclear Scintigraphy, MRI, CT
What type of advanced imaging would be
best to use to detect a
cortical bone disease or stress fracture?
Nuclear scintigraphy
What type of advanced imaging would be
best to use to detail
soft and hard tissues in joints,
and is as good as arthroscopy for detecting
subchondral lesions?
MRI
What choices for conservative medical management
are available in the treatment of bone spavin?
IA injections- corticosteroids, chondroprotex, auto anti-inflamms
Phenylbutazone
Exercise adaptation
Corrective shoeing
What are your surgical options for treatment
of bone spavin (osteoarthritis)?
Cunean Tenectomy
Ankylosis (of TMT and DIT)
Transarticular Drilling
Laser-Facilitated Ankylosis
Ethyl Alcohol Facilitate Ankylosis
Monoiodoacetate
What is the success rate for cunean tenectomy
in the treatment of bone spavin in horses?
83%
Transarticular Drilling is a method in which to treat bone spavin.
3 divergent drill tracts at 30 degree angles are created
medially, distal to the cunean tendon.
Post-Op= Phenylbutazone
The average time required for the horse to
return to soundness after this procedure is
__________ months
7.5 months
Using an Nd:YAG or Diode laser,
Laser Facilitated Ankylosis
destroys cartilage by
superheating and vaporizing __________
synovial fluid
Laser Facilitated Ankylosis
promotes _______ ankylosis,
and there is significantly less fusion of
the __________ joints as compared to other methods
Laser Facilitated Ankylosis
promotes partial ankylosis,
and there is significantly less fusion of
the distal tarsal joints as compared to other methods
In regards to Ethyl Alcohol Facilitated Ankylosis:
Lameness resolved in _____% of horses with bone spavin
within _______ months
In regards to Ethyl Alcohol Facilitated Ankylosis:
Lameness resolved in 86% of horses with bone spavin
within 3 months
How does Ethyl Alcohol Facilitated Ankylosis work?
IA injection of 3 mL of 70% Ethyl Alcohol
into the affected joint
kills off nerve endings and cartilage.
Post-px, 2g of Phenylbutazone
Can return to work as soon as 3 days. (can take up to 3m)
Which of the following is NOT and option for treatment
of bone spavin in the horse?:
Cunean Tenectomy
Transarticular Drilling
Laser facilitated ankylosis
Ethyl alcohol facilitated ankylosis
Monoiodoacetate
Monoiodoacetate
- high mortality, severe pain post-op, severe complications*
- d/t PIT joint communication*
Where is the most common location to see
a fracture of the first phalanx (P1)?
In the FORELIMB
______% of all fractures of the first phalanx (P1)
occur in the forelimb
75%
How are fractures of the first phalanx (P1)
treated in horses?
Lag screws and a cast
When drilling for a P1 fracture,
the most proximal screw must be within
5mm of the ___________!
sagittal groove!
When drilling for a P1 fracture,
the most proximal screw must be within
5mm of the sagittal groove.
Additional lag screws are placed at
______mm intervals
20 mm intervals
What salvage procedure is used in
worst case scenarios for a P1 fracture,
like comminuted fractures?
Fetlock Arthrodesis
Strict stall rest in a _______ is necessary
post-op for P1 fractures,
because prognosis depends on
resultant fetlock and pastern DJD
10 x 12 box
This type of P1 fracture has a poor prognosis for returning to
athleticism
Comminuted P1 fractures
