Exam 2: Bone Spavin and P1 Fractures Flashcards by Preeti Gulve

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

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The hock joint is made up of 4 joint spaces.

Name them from proximal to distal:

^{Proximal to distal:}

Tibiotarsal

PIT

DIT

TMT

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The _______ aspect of the joint

is the most common place to see Bone Spavin

medial

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Poor conformation predisposed to

______________

Osteoarthritis

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What are two examples of poor conformation that

can predispose for osteoarthritis in the equine?

Sickle hocked

Cow hocked

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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

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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

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Out of the 4 joints that make up the hock,

which 2 joints always communicate?

Tibiotarsal and PIT

(the most proximal joints)

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What do you expect to see on rads

of an animal with bone spavin?

Osteophyte formation

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What bone is the arrow pointing to?

Central tarsal bone

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What grade is this bone spavin?

Grade 1

small osteophyte distolateral central tarsal bone

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What bone is this arrow pointing to?

What grade is this bone spavin?

MT3 (3rd metatarsal bone)

Grade 2

Small osteophyte proximal dorsolateral MT3

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What bone is this arrow pointing to?

What grade is this bone spavin?

Central Tarsal Bone

Grade 3

medium osteophyte distomedial central tarsal bone

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What bone is this arrow pointing to?

What grade is this bone spavin?

MT3 bone

Grade 4

large osteophyte proximal dorsolateral MT3 bone

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What are the causes of bone spavin?

Chronic repetitive compression

Torsion

Shear strains

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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

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Exam 2: Bone Spavin and P1 Fractures Flashcards

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