Pastern + Fetlock Flashcards
What does the PIPJ (pastern) consist of?
- Low motion, high loading joint
- P1/P2 stabilised by collateral ligaments
- Supported by distal sesamoidean ligaments
- SDFT branches on palmar/plantar scutum
What does the fetlock consist of? (MCPJ/MTPJ)
- P1/ Mc III, PSB
- High motion joint
- Collateral ligaments + collateral sesamoidean ligaments
- Suspensory ligaments
How can you investigate pastern/fetlock problems?
- Clinical exam - pain, swelling, heat, instability
- Diagnostic anaesthesia
- Imaging - Radiography, US, MRI, CT
What are conditions of the equine pastern?
- Osteoarthritis
- Osteochondritis
- Soft tissue injuries
- Fractures / subluxation
How does osteoarthritis of the pastern occur?
- Progressive destruction of the articular cartilage + subchondral bone thickening + osteophyte production
Dx + management of pastern OA?
- Dx = clinical findings, diagnostic anaesthesia + Radiography
- Management = rest / light exercise, intra-articular medications, shoeing, NSAIDs
-Arthrodesis
What is treatment of osteochondrosis?
- Guarded prognosis = palliative care
What are soft tissue injuries of the pastern? Tx?
- SDFT brnach injury
- Distal sesamoidean ligament injury
- Tx = rest, NSAIDs
What is treatment of pastern fractures?
- Conservative = short, incomplete fractures
- Surgical = internal fixation
- Euthanasia = comminuted, open, unstable
What causes pastern subluxation? CS? Dx? Tx?
- Causes = traumatic events, fracture / subluxation
- CS = Acute lameness / instability, soft tissue swelling
- Dx = radiography
- Management = stabilise through external co-aptation + pastern arthrodesis
What are conditions of the equine fetlock?
- PSB fractures
- Sesamoiditis
- Osteochondral fragmentation of P1
- Osteochondrosis
- Osteoarthritis
- Subchondral bone disease/POD
- Chronic proliferative synovitis
- Subluxation
How would you describe a fracture that affects 2 joint spaces?
Biarticular
What causes proximal sesamoid bone fractures? Dx? CS?
- Causes = acute trauma
- CS = acute lameness w swelling + pain + joint effusion
- Dx = imaging - radiograph + US (SL injuries)
What is management of PSB fractures?
- Conservative = uniaxial PSB fractures in foals / non-articular
- Surgical = fragment removal / repair
- Euthanasia = biaxial / comminuted
What is sesamoiditis?
- Inflammation of the soft tissue of palmar fetlock
-may be indicator of SL branch injury - Tx = rest, NSAIDs + cold therapy
What is management of fetlock osteoarthritis?
- Mild / early cases = intra-articular medication - hyaluranon / corticosteroids
- Moderate = NSAIDs, i/a corticosteroids
- Severe cases = arthrodesis / euthanasia
What causes chronic proliferative synovitis? Tx?
- Chronic repetitive trauma to dorsal aspect of fetlock due to hyperextension
- Tx = intra-articular medication / surgical resection
How is fetlock subluxation treated?
- Closed reduction + cast
- Arthrodesis if unstable
