Fetlock Injury

Question 1

which joint has the largest range of motion of any of the limb joints?

Answer 1

fetlock joint

Question 2

how much does fatigue increase the maximum extension angle?

Answer 2

4-11 degrees which is 7-15% of normal

Question 3

how common are osteochondral/chip fractures of dorsal P1?

Answer 3

most common “chip fracture” in any joint of racing thoroughbreds

Question 4

are dorsal frontal fractures of P1 more common in the metacarpal or metatarsal joint?

Answer 4

metatarsal joint

Question 5

what is the prognosis of a dorsal frontal fracture of P1?

Answer 5

typically good
dictated by degree of concurrent osteoarthritis

Question 6

what are the clinical signs of a non-comminuted mid-sagittal fracture of P1?

Answer 6

acute onset of moderate to severe lameness
marked joint effusion
pain upon firm palpation dorsal P1

Question 7

how long should a horse be rested for a non-comminuted mid-sagittal fracture of P1?

Answer 7

4 months

Question 8

what are fractures of the proximal sesamoid bones typically due to?

Answer 8

overloading

Question 9

how can non-articular, minimally displaced fractures of the proximal sesamoid bones often be treated?

Answer 9

rest for 4-6 months

Question 10

what is the history with condylar fractures?

Answer 10

acute onset of severe lameness during or shortly after a race or high speed training

Question 11

what is the prognosis of displaced condylar fractures?

Answer 11

guarded to poor

Question 12

what are the clinical signs of an osteochondral/chip fracture of dorsal P1?

Answer 12

joint effusion
lameness variable up to moderate
positive to lower limb flexion

Question 13

what is the medical treatment option for an osteochondral/chip fracture of dorsal P1?

Answer 13

intraarticular therapy

Question 14

what is the prognosis of osteochondral/chip fracture of dorsal P1?

Answer 14

very good to excellent
depends on degree of pre-existing articular damage

Question 15

how are dorsal frontal fracture of P1 classified?

Answer 15

incomplete or complete: displaced or not

Question 16

do standardbred trotters or pacers get dorsal frontal fractures of P1 more?

Answer 16

trotters

Question 17

what are the clinical signs with a dorsal frontal fracture of P1?

Answer 17

more lame than with chip fracture of P1
joint effusion

Question 18

what is the medical treatment for a dorsal frontal fracture of P1?

Answer 18

rest
intraarticular hyaluronan therapy, no corticosteroids during healing process

Question 19

what is the prognosis of a dorsal frontal fracture of P1 if the fracture is displaced and left in to heal in that position?

Answer 19

guarded to poor because of degree of osteoarthritis that will develop

Question 20

what are the types of non-comminuted mid-sagittal fractures of P1?

Answer 20

short incomplete: <30 mm
long incomplete
complete

Question 21

what is contraindicated in diganosis of a non-comminuted mid-sagittal fracture of P1?

Answer 21

diagnostic anesthesia

Question 22

what is the surgical treatment for a non-comminuted mid-sagittal fracture of P1?

Answer 22

interfragmentary compression using cortical screws in lag fashion
post-operative convalescent period of 4-6 months

Question 23

what is the prognosis of a non-comminuted mid-sagittal fracture of P1?

Answer 23

very good if short fracture without concurrent pathology/osteoarthritis
guarded for complete, depends on degree of osteoarthritis

Question 24

what is the onset like of clinical signs with a proximal sesamoid bone fracture?

Answer 24

acute onset of relatively severe lameness

Question 25

what is often the limiting factor in terms of prognosis for fractures of the proximal sesamoid bones?

Answer 25

concurrent suspensory desmitis

Question 26

what are mid-body fractures of the proximal sesamoid bones like?

Answer 26

very serious, career limiting guarded prognosis for high performance activities convalescence up to 10-12 months

Question 27

fragments >__________________ or that extends to the palmar/plantar aspect of the bone carry a much less favorable prognosis in fracture of the proximal sesamoid bones

Answer 27

3 mm in width

Question 28

what should be done about articular fracture of the proximal sesamoid bones?

Answer 28

removal via arthroscopy or arthrotomy

Question 29

what are axial/sagittal fractures of thee proximal sesamoid bones almost always associated with?

Answer 29

lateral condylar fracture of metacarpal/tarsal III if so: very poor prognosis for soundness

Question 30

what are the types of condylar fractures?

Answer 30

incomplete lateral condylar fracture complete non-displaced lateral condylar fracture complete displaced lateral condylar fracture medial condylar fracture

Question 31

which condylar fractures can be managed conservatively?

Answer 31

short incomplete lateral condylar fractures

Question 32

what is the prognosis of complete lateral condylar fractures?

Answer 32

non-displaced: good to guarded displaced: guarded to poor

Question 33

what is the prognosis of medial condylar fractures?

Answer 33

25-40% fail catastrophically healed: 68% return to racing