Fetlock Injury Flashcards
which joint has the largest range of motion of any of the limb joints?
fetlock joint
how much does fatigue increase the maximum extension angle?
4-11 degrees which is 7-15% of normal
how common are osteochondral/chip fractures of dorsal P1?
most common “chip fracture” in any joint of racing thoroughbreds
are dorsal frontal fractures of P1 more common in the metacarpal or metatarsal joint?
metatarsal joint
what is the prognosis of a dorsal frontal fracture of P1?
typically good
dictated by degree of concurrent osteoarthritis
what are the clinical signs of a non-comminuted mid-sagittal fracture of P1?
acute onset of moderate to severe lameness
marked joint effusion
pain upon firm palpation dorsal P1
how long should a horse be rested for a non-comminuted mid-sagittal fracture of P1?
4 months
what are fractures of the proximal sesamoid bones typically due to?
overloading
how can non-articular, minimally displaced fractures of the proximal sesamoid bones often be treated?
rest for 4-6 months
what is the history with condylar fractures?
acute onset of severe lameness during or shortly after a race or high speed training
what is the prognosis of displaced condylar fractures?
guarded to poor
what are the clinical signs of an osteochondral/chip fracture of dorsal P1?
joint effusion
lameness variable up to moderate
positive to lower limb flexion
what is the medical treatment option for an osteochondral/chip fracture of dorsal P1?
intraarticular therapy
what is the prognosis of osteochondral/chip fracture of dorsal P1?
very good to excellent
depends on degree of pre-existing articular damage
how are dorsal frontal fracture of P1 classified?
incomplete or complete: displaced or not
do standardbred trotters or pacers get dorsal frontal fractures of P1 more?
trotters
what are the clinical signs with a dorsal frontal fracture of P1?
more lame than with chip fracture of P1
joint effusion
what is the medical treatment for a dorsal frontal fracture of P1?
rest
intraarticular hyaluronan therapy, no corticosteroids during healing process
what is the prognosis of a dorsal frontal fracture of P1 if the fracture is displaced and left in to heal in that position?
guarded to poor because of degree of osteoarthritis that will develop
what are the types of non-comminuted mid-sagittal fractures of P1?
short incomplete: <30 mm
long incomplete
complete
what is contraindicated in diganosis of a non-comminuted mid-sagittal fracture of P1?
diagnostic anesthesia
what is the surgical treatment for a non-comminuted mid-sagittal fracture of P1?
interfragmentary compression using cortical screws in lag fashion
post-operative convalescent period of 4-6 months
what is the prognosis of a non-comminuted mid-sagittal fracture of P1?
very good if short fracture without concurrent pathology/osteoarthritis
guarded for complete, depends on degree of osteoarthritis
what is the onset like of clinical signs with a proximal sesamoid bone fracture?
acute onset of relatively severe lameness
what is often the limiting factor in terms of prognosis for fractures of the proximal sesamoid bones?
concurrent suspensory desmitis
what are mid-body fractures of the proximal sesamoid bones like?
very serious, career limiting
guarded prognosis for high performance activities
convalescence up to 10-12 months
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
3 mm in width
what should be done about articular fracture of the proximal sesamoid bones?
removal via arthroscopy or arthrotomy
what are axial/sagittal fractures of thee proximal sesamoid bones almost always associated with?
lateral condylar fracture of metacarpal/tarsal III
if so: very poor prognosis for soundness
what are the types of condylar fractures?
incomplete lateral condylar fracture
complete non-displaced lateral condylar fracture
complete displaced lateral condylar fracture
medial condylar fracture
which condylar fractures can be managed conservatively?
short incomplete lateral condylar fractures
what is the prognosis of complete lateral condylar fractures?
non-displaced: good to guarded
displaced: guarded to poor
what is the prognosis of medial condylar fractures?
25-40% fail catastrophically
healed: 68% return to racing