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Y4 EQ - Orthopaedics > Foot penetrations and conditions of the hoof wall > Flashcards

Foot penetrations and conditions of the hoof wall Flashcards

1
Q

List the visible structures on the bottom of a horses hoof

A
  • Hoof wall
  • White line
  • Sole
  • Frog apex
  • Bars
  • Central sulcus
  • Collateral sulcus
  • Heel bulb
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2
Q

Hoof cracks usually run in which direction?

A

Proximo-distal

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3
Q

What are transverse hoof cracks associated with?

A

Coronary band injury

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4
Q

What are the consequences of hoof cracks

A

Instability -> shear forces -> further separation -> infection and pain

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5
Q

How should you assess hoof cracks before treatment?

A
  • Characterise depth, direction,
  • Determine sensitive/insensitive parts (do not nerve block)
  • Incomplete often just need trimming/shoeing
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6
Q

How are hoof cracks treated?

A
  1. Farriery
    - Debride/dremmel all necrotic tissue
    - Filler to stabilise (plate; wire)
    - Trim foot/unload crack/bar shoe/quarter clips
  2. Identify underlying cause (and treat)
  3. Antibiotics (local/systemic) - Flush via catheter/tubing
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7
Q

What is white line disease?

A

Progressive, crumbling, poor quality hoof wall with separation at the white line
- Non-pigmented portion of the stratum medium and the laminar horn

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8
Q

Which factors can act as risk factors for white line disease?

A

Warm, wet weather
Biotin/methionine/zinc/selenium deficiency
Bacterial infection common

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9
Q

What are the clinical signs of white line disease?

A

+/- lameness
Separation of hoof wall esp at toes/quarters
Grey/black crumbly horn

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10
Q

How is white line disease treated?

A
  • Remove abnormal horn
  • Support remaining horn: Bar shoe+clips, Hoof acrylic
  • Prevent progression: Environmental factors, Topical povidone/iodine, Feed supplementation
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11
Q

Wire lacerations/foot trapped (e.g. gate/fence)/overreach injuries most commonly cause injuries to which part of the hoof?

A

Coronary band and hoof wall

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12
Q

Why must you assess if there is damage to the coronary band?

A

Damage to the coronary band can affect how the hoof wall grows

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13
Q

List the clinical signs of damage to the coronary band and hoof wall

A
  • Avulsion/disruption to the hoof wall +/- coronary band
  • Lameness: Moderate/severe
  • Haemorrhage++
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14
Q

Which other structures may be involved when there is damage to the coronary band and hoof wall?

A

Synovial structure = DIP/PIP/Navicular bursa/DFTS
Tendons/ligaments (DDFT/SDFT/extensor tendons/collateral ligaments)

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15
Q

How are injuries to the coronary band and hoof wall treated?

A
  • Primary or secondary intention healing
  • Preserve coronary band if you can
  • Antibiotics
  • NSAIDs
  • Bandaging
  • Cast
  • Flush
  • Shoes
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16
Q

Why is it important to flush synovial structures?

A

Treat sepsis early and aggressively

17
Q

How should puncture wounds of the foot be assessed and managed?

A
  • Common cause of lameness
  • Most are managed conservatively with a good prognosis
  • All foot penetrations have the potential to involve deeper structures resulting in life threatening complications
  • Need to know what kind of object is involved
18
Q

What is nail bind?

A

Nail close to sensitive structures
Mild lameness
Pain around nail

19
Q

What is shoeing prick?

A

Nail into sensitive structures
Immediately painful/blood
May develop into subsolar abscess if left

20
Q

How do subsolar abscesses occur?

A

Penetration of bacteria results in abscess formation and pressure on sensitive hoof lamina

21
Q

What are the clinical signs of subsolar abscessation?

A
  • Usually acute lameness: SEVERE!
  • Increased digital pulse
  • Increased hoof temperature
  • Sensitive to hoof testers
22
Q

How are subsolar abscesses treated?

A
  1. Key: DRAINAGE
    - Remove shoe/nail (if present)
    - Pare foot: follow tracts and remove all necrotic/underrun horn
  2. Poultice or tub
  3. Bandage - Protect foot/apply poultice
  4. (NSAIDs/antibiotics)
  5. Check tetanus status
23
Q

Which structures could be damaged when there are foot penetrations affecting synovial structures?

A

Navicular bone/bursa
DDFT
Distal sesamoidean impar ligament – joins the bottom of the navicular bone to the back of P3
DIP joint
DFTS

24
Q

How are foot penetrations affecting synovial structures diagnosed?

A
  • Moderate to severe lameness
  • Presence of nail/foreign body in foot, particularly the middle third
  • Puncture wound – can be difficult to find sometimes
  • Distal limb swelling/DIP effusion/DFTS effusion
  • Increased digital pulse to foot
  • Sensitive to hoof-testers over tract
  • Radiography
  • Synoviocentesis
  • MRI
25
Q

How are foot penetrations affecting synovial structures treated?

A
  • Debridement of infected tissue - Removal of necrotic horn/tendon
  • Flushing of affected synovial structures
  • Bandage
  • NSAIDs
26
Q

Describe the prognosis following foot penetration that has damaged synovial structures?

A
  • Infection: fair (56% survival to discharge)
  • Return to athletic function: guarded (due to involvement of DDFT/impar ligament) (36% return to pre-injury function)
27
Q

List some possible underlying causes of chronic foot abscesses

A
  • Immunocompromise e.g Cushing’s
  • Keratoma
  • Sequel to laminitis (poor quality laminae)
  • Bone sequestrum/collateral cartilage infection
  • Infective (pedal) osteitis
28
Q

What is a keratoma?

A

Benign tumour of the hoof/solar horn

29
Q

How does a keratoma present?

A
  • Intermittent lameness/discharge
  • Characteristic circular area of abnormal keratinisation with discharging tract
  • Radiography may show smooth, radiolucent defect in P3
30
Q

How is a keratoma treated?

A

Surgical resection under GA

31
Q

What is quittor?

A

Infection of the collateral cartilages
Trauma/wound
Swelling/chronic discharge from coronary band

32
Q

How is quittor treated?

A

Surgical debridement of infected tissues
Be careful of the DIPJ!

33
Q

What is canker?

A

Chronic condition associated with hypertrophy of the germinal layer of the epithelium of the frog
- May affect frog, bars, heels and sole

34
Q

What agent is linked to cause canker?

A

Fusobacterium/Bacteriodes spp

35
Q

What are the consequences of canker?

A
  • Infection leads to dyskeratosis of the keratin producing cells
  • Results in abnormal hyperkeratotic horn with keratolysis and fronds of unconnected intertubular horn
36
Q

How can early/mild cases of canker be managed and treated?

A
  • Improve environment
  • Debride abnormal areas
  • Apply metronidazole bandages +/- systemic abs
  • Astringents: picric acid (5%) and benzoyl peroxide (10%)
37
Q

How can advanced/severe cases of canker be managed and treated?

A

Aggressive surgical debridement
Bandaging/shoeing

Y4 EQ - Orthopaedics (14 decks)

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