Splint Exotosis and Dorsal Metacarpal III Disease

Question 1

treatment for dorsal metacarpal III disease

Answer 1

conservative: rest + NSAIDs + monitor with rads

osteostixis +/- screw

1. insert staples pre op using rad guidance to help mark approach
2. make 6-8 osteostixis holes 10 mm apart into marrow/medullary cavity to access stem cells
3. drill parallel to fracture and place unicortical positional screw (22 mm)

Question 2

signalment for dorsal metacarpal III disease

Answer 2

YOUNG RACEHORSES training fast long distance

Question 3

dorsal metacarpal III disease is also known as…

Answer 3

bucked shins/ periositis/dorsal cortical fracture of MCIII/ stress fracture of MCIII

Question 4

causes of splint exotosis

Answer 4

aka proliferative periostitis

• direct trauma (young clumsy horses kicking themselves)
• ligamentous inflammation

Question 5

signalment for splint exotosis

Answer 5

YOUNG horses

usually affects MCII

Question 6

what to beware of when doing surgery to treat splint exotosis on the tarsus

Answer 6

Dorsal Metatarsal n. and a. runs between MTIV and MTIII

Question 7

possible sequelae to splint exotosis

Answer 7

suspensory desmitis

Question 8

what to remember post op following surgery for splint exotosis

Answer 8

requires EXCELLENT bandage to ensure cosmetic

Question 9

splint exotosis most commonly affects which bone?

Answer 9

MCII

Question 10

appearance of dorsal metacarpal III disease

Answer 10

fissure extending 60% through dorsal cortex at 30 degree angle proximally then disappearing

may curve back to cortex forming a saucer fracture

Question 11

what type of screw is used to repair dorsal metacarpal III disease?

Answer 11

unicortical positional screw (22 mm) placed perpendicular to fracture

Question 12

splint exotosis is also known as…

Answer 12

proliferative periositis

Question 13

prognosis for dorsal metacarpal III disease

Answer 13

good for return to racing BUT end up losing time and money when treating

best prognosis following surgery is screw is removed in 60 days

Question 14

treatment for splint exotosis

Answer 14

conservative: rest, nsaids, local DMSO or steroids

if causing suspensory desmitis -> surgery: linear incision with en bloc removal. requires EXCELLENT bandage post op to ensure cosmetic

Question 15

prevention of dorsal metacarpal III disease

Answer 15

prioritize short distance breezing over long distance galloping when training young racehorses