Injury to the Metacarpal/tarsal Bones

Question 1

what is an intermittent, vague, or insiduous onset lameness usually associated with?

Answer 1

proximal suspensory desmitis or stress reaction

Question 2

when should surgery be performed for a stress reaction and stress fracture of proximal palmar MC3?

Answer 2

for cases of avulsion or concurrent suspensory desmitis

Question 3

what is the limiting factor of a stress reaction and stress fracture of proximal palmar MC3?

Answer 3

degree of concurrent suspensory desmitis and size of avulsion

Question 4

do splint bones provide support and stabilization?

Answer 4

yes

Question 5

where are most fractures of the small metacarpal/tarsal bones?

Answer 5

distal 1/3

Question 6

what is medical management of distal fractures of the small metacarpal/tarsal bones?

Answer 6

rest
bandaging
anti-inflammatories
cold therapy

Question 7

what is a mid-to-proximal fracture of metacarpal/tarsal 2 and 4 frequently associated with?

Answer 7

open wound

Question 8

what are the surgical options for mid-to-proximal fracture of MC/MT 2 and 4?

Answer 8

complete excision of splint bone
excision of affected segment of splint bone
internal fixation

Question 9

what does prognosis of mid-to-proximal fractures of MC/MT-2and4 depend on?

Answer 9

degree of concurrent suspensory ligament injury
stability of the fracture
callus formation
degree of OA at the level of CMC or TMT joints

Question 10

when are clinical signs seen with splints?

Answer 10

at the start of hard training

Question 11

where is overloading and stress in a stress reaction/fracture of proximal palmar metacarpal III?

Answer 11

on or near the origin of the suspensory ligament

Question 12

what is conservative treatment of a stress reaction/fracture of proximal palmar metacarpal III?

Answer 12

2-6 months of rest and controlled exercise
local and systemic anti-inflammatories
platelet rich plasma and stem cell therapy
ESWT
tildren

Question 13

what is the role of splint bones?

Answer 13

important role in providing support and stabilization

Question 14

what is there a high incidence of with distal fractures of the small metacarpal/metatarsal bones?

Answer 14

concurrent suspensory desmitis

Question 15

what are the surgical options for distal fractures of the small metacarpal/tarsal bones?

Answer 15

excision of distal aspect of the fracture
excision just proximal to callus

Question 16

what is the prognosis of distal fractures of the small metacarpal/tarsal bones?

Answer 16

usually very good, condition of suspensory ligament is limiting factor

Question 17

why should you avoid excising metatarsal IV in a mid to proximal fracture of metatarsal IV as much as possible?

Answer 17

potential for chronic degenerative changes at the level of the tarsal-metatarsal joint

Question 18

what are splints?

Answer 18

interosseous desmitis/proliferative periostitis of the small metacarpal/metatarsal bones

Question 19

why would you perform surgery for splints?

Answer 19

cosmetic and therapeutic reasons