Metacarpus + metatarsus Flashcards
What runs down the dorsal aspect of the Mt/Mc III?
- Digital extensor tendon
Whats on the plantar/palmar aspect from most superficial?
- SDFT
- DDFT
- Accessory ligament of the DDFT
- Suspensory ligament
How can you investigate problems of the metacarpus/metatarsus?
- Clinical Exam
- Diagnostic Anaesthesia - High 4/6
- Radiography
- Ultrasonography
What are bone conditions of the metacarpus + metatarsus?
- Fractures of the third Mt/Mc
- Dorsal metacarpal bone disease
- Fractures of the 2nd/4th Mc/Mt (splint)
- Exostosis of the 2nd/4th Mc/Mt (splint)
What are soft tissue conditions of the Metacarpus?
- SDFT/DDFT tendinitis
- ALDDFT desmitis - poor prognosis
- SL desmitis
- DFTS tenosynovitis
- Wounds
What does fractures of the third Mc/Mt include? Causes? What fractures can’t be treated?
- Includes = Condylar, diaphyseal, transverse + proximal articular #
- Causes = single overload injury / external trauma (kick)
- Condylar fractures fail due to repetative strain cycles
What are CS of # of Mc/Mt III?
– Lame (moderate/severe, acute), signalment
– Swelling/crepitus/pain on palpation/flexion
– +/- joint effusion
– Displacement (diaphyseal)
– Open/closed
How would you manage # of the Mc/Mt III?
- First aid – Zone 2 external co-aptation
- Conservative – Non-displaced, closed, transverse and some proximal articular fractures
- Surgical – Condylar fractures, diaphyseal fractures
- Euthanasia – Displaced, open, comminuted
How would you stabilise a leg fracture prior to transport for surgery?
- Robert jones bandage + splint
What is dorsal metacarpal disease? Dx? Tx?
- AKA Sore shins / bucked shin complex = young racehorses
- Excessive loading = painful periosteitis
- Imaging = radiography = hairline fractures
- Tx = alter training regime, screw placement if bad
What are causes of # of the 2nd/4th Mc/Mt? Dx? Tx?
- Often lateral splint bone
- Causes = Trauma (kick), distal fractures due to abnormal stress from fetlock hyperextension
- Dx = Radiography
- Tx = conservative = rest, NSAIDs, Remove loose fragments, wound debridement
- Surgical tx = partial ostectomy + internal fixation
What causes exostosis of the 2nd/4th Mc/Mt? CS? Dx? Tx?
- Causes = trauma resulting in periosteal bleed, then bone formation
- CS = acute = pain, heat, swelling
-chronic = bony swelling - Dx = Clinical exam + radiography
- Tx = conservative = rest, cold therapy, NSAIDs
- Only surgical tx if recurrent / severe
How is SDFT tendonitis diagnosed?
- Clinical exam = swelling / pain / loss of normal borders / fetlock sinking
- Ultrasound = anechoic lesion in the SDFT
What is Tx of SDFT tendonitis?
- Acute = NSAIDs + cold hosing, supporting dressing + box rest
- Reparative / proliferative phase =
-promote angiogenesis = tendon splitting, stem cells, PRP
-minimise formation of excessive scar tissue = PRP, stem cells
-early exercise - Chronic modelling = controlled exercise
What is seen with suspensory ligament desmitis? Dx?
- CS = acute = swelling, heat, pain
-chronic = lameness, poor performance - Dx = palpation, local anaesthesia, ultrasound (ligament enlargement w poor fibre pattern)
What is Tx of desmitis of the SL?
- Conservative = cold hosing, NSAIDs, ECSWT, 3-6month rest + rehab, monitor with US
- Surgery = for chronic desmitis
What can cause conditions of the digital flexor tendon sheath + annular ligament?
PAL Syndrome?
– DFTS tenosynovitis
– SDFT tear = Manica flexoria (part of SDFT)
– DDFT tear
– PAL desmitis
– Combination
– (sepsis)
What is seen with PAL syndrome? (palmar/plantar annular ligament) Dx?
- CS =
-DFTS effusion
-Notching of limb - PAL constriction
-Lameness
-Pain on flexion
-+ve response to DFTS analgesia - Dx = Ultrasound, contrast tenogram
What is Tx of PAL syndrome?
- Conservative = cold hosing, rest, controlled exercise
-NSAIDs / corticosteroids - Surgical = tenoscopy - assess tendons + remove damaged portions
