The distal interphalangeal joint, also known as the coffin joint, is a critical anatomical structure located in the lower limb of horses. This joint is formed by the articulation of the distal phalanx, the middle phalanx, and the distal sesamoid bone, commonly referred to as the navicular bone. It plays a significant role in the biomechanics of equine locomotion, facilitating movement and weight-bearing. The health and functionality of the distal interphalangeal joint are essential for maintaining a horse's performance and overall well-being. Conditions affecting this joint, such as osteoarthritis and laminitis, can lead to lameness and reduced mobility. This page compiles peer-reviewed research studies and scholarly articles that investigate the anatomy, pathology, and treatment options related to the distal interphalangeal joint in horses.
Stanek C.A retrospective study (1984-1994) was made of 10 cases of septic arthritis of the distal interphalangeal joint in horses aged 7 months to 17 years. In 6 cases a hind limb was affected, in 4 cases a front limb. The arthritis was caused either by a puncture wound in the sole area (8 cases), by a perforating wound in the coronary region (1) or iatrogenic (1). All horses exhibited a severe lameness at the walk. Radiography showed no typical lesions in fresh cases, whilst later an increasing subluxation of the joint was observed followed by periosteal reactions. Therapy included partial resection o...
Fuller CJ, Barr AR, Dieppe PA, Sharif M.An epitope of keratan sulphate (KS) and total glycosaminoglycans (GAG) were measured in synovial fluid samples from joints of 53 horses immediately following humane destruction. Internal examination of the joints post mortem ensured that there was no gross evidence of osteoarthritis or other joint disease. Joints sampled were distal interphalangeal (DIP), proximal interphalangeal (PIP), metacarpophalangeal (MCP), metatarsophalangeal (MTP), tarsometatarsal (TMT), tarsocrural (TC), femoropatellar (FP) and antebrachiocarpal (ABC) joints. The age of each horse was assessed by examination of the te...
Lumsden JM, Caron JP, Steffe JF, Briggs JL, Arnoczky SP.To compare the apparent viscosity of normal synovial fluid of the mid-carpal, tibiotarsal, and interphalangeal joints of horses. Methods: Viscosity evaluation over a range of shear rates was used to characterize the apparent viscosity of synovial fluids from the 3 joints. Methods: 60 clinically normal adult horses. Methods: Viscosity data for synovial fluid samples were obtained over a shear rate range of 10 to 250/s and apparent viscosity was calculated at 50, 100, 150, 200, and 250/s. Effect of shear rate on apparent viscosity was determined, using a two-way ANOVA, with significant differenc...
Keegan KG, Wilson DA, Kreeger JM, Ellersieck MR, Kuo KC, Li Z.To evaluate the distribution of mepivacaine hydrochloride after distal interphalangeal (DIP) joint injection in horses. Methods: Prospective, uncontrolled study. Methods: 10 adult horses. Methods: 30 minutes before euthanasia, 8 ml of 2% mepivacaine hydrochloride was injected into the dorsal pouch of a forelimb DIP joint. Synovial tissue from the DIP joint and podotrochlear (navicular) bursa and bone tissue from the medullary cavity of the distal sesamoid (navicular) bone were taken from both forelimbs immediately after death. All synovial and bone specimens were analyzed for tissue concentrat...
White NA.Transection of the accessory ligament of the deep digital flexor muscle (distal check ligament desmotomy) was completed in 44 horses using an ultrasound-guided technique. The technique used real-time ultrasound with a 7.5 MHz transducer to observe the dissection and isolation of the check ligament through a 1 to 1.5 cm incision and to check for complete transection of the check ligament. The technique was effective in correcting flexural deformity of the distal interphalangeal joint and the metacarpophalangeal joint in all but three horses. Check ligament desmotomy at a young age (median, 6 mo...
Breit S, König HE.20 extremities of horses were used to investigate the synovial membrane of the distal interphalangeal joint and the navicular bursa. From each extremity five specimens were taken from the distal interphalangeal joint capsule, two further from the navicular bursa. Synovial villi were found near the articular cartilage as well as everywhere where the joint capsule did not form a tight periostal cover or was not connected with ligaments or tendons. Some lay between the articular surfaces of the phalanx media and phalanx distalis. Besides synovial villi and synovial folds "trabecular-like" cords o...
Bowker RM, Rockershouser SJ, Linder K, Vex KB, Sonea IM, Caron JP.The innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments (ligamenta sesamoidea collateralia) (CSL) or proximal suspensory ligament and the ligamentum sesamoideum distale impar or the distal sesamoidean impar ligament (DS-impar ligament) was examined using combined anatomical techniques of silver impregnation and immunocytochemistry. Silver impregnation studies revealed an abundance of nerve fibres present in both the CSL and DS-impar ligament with the latter having relatively more nerve fibres. These silver-impregnated nerves coursed parallel to and were asso...
Madison JB, Garber JL, Rice B, Stumf AJ, Zimmer AE, Ott EA.Thirty-five newborn foals were assigned to 1 of 3 groups and treated with 0.9% NaCl solution (saline; group 1; n = 12), oxytetracycline (44 mg/kg of body weight; group 2; n = 12), or 2-pyrrolidone (oxytetracycline vehicle; group 3; n = 11) in saline solution during the first 36 hours after birth. Serum biochemical analyses were performed on samples obtained from group-1 and group-2 foals before treatment and 24 and 96 hours after treatment. Lateral to medial radiographic views of the forelimbs were obtained before treatment and 24 and 96 hours after treatment in all foals. Metacarpophalangeal ...
Bowker RM, Rockershouser SJ, Vex KB, Sonea IM, Caron JP, Kotyk R.To determine whether the distal interphalangeal (DIP) joint directly or indirectly communicates with the navicular bursa (bursa podotrochlearis) and to identify sensory nerves in these synovial structures that might be desensitized by intra-articular injections of anesthetics, Evans blue dye in physiologic saline solution, Luxol fast blue dye with mepivicaine, or commercial latex was injected into the DIP joint (5 ml) or the navicular bursa (3 ml) of 152 digits obtained from horses or ponies at necropsy. The digits were frozen, cut with a band saw, and examined for distribution of dye or latex...
Wright IM.The clinical features are reported from 118 horses (mean age 9.2 years) which were diagnosed as suffering from navicular disease using predetermined criteria. The animals were used for a variety of purposes and had been lame for periods between 1 and 72 months. The majority of cases (84.7%) had been treated using various techniques before evaluation. The severity of lameness was related to the duration of clinical signs: 78% of horses were bilaterally affected but there was no left:right limb predominance. Broken foot/pastern axes were recorded in 75% of horses while 45% also exhibited mediola...
McClure SR, Hooper RN, Watkins JP.A 13-month-old Quarter Horse colt sustained a puncture wound to the frog region of the foot, which penetrated the navicular bursa and distal interphalangeal joint, 7 days prior to examination. A street-nail procedure was performed to debride the tract and provide drainage of the navicular bursa and distal interphalangeal joint. An indwelling lavage system was placed through the dorsal aspect of the joint and antimicrobials were infused intermittently to supply a high local concentration of drug and to frequently lavage the distal interphalangeal joint and navicular bursa.
Dyson SJ, Kidd L.Analgesia of the distal interphalangeal (DIP) joint and of the navicular bursa was performed independently in the lame or lamer forelimb of 59 horses, in which lameness was significantly improved by perineural analgesia of either the palmar digital or palmar (abaxial sesamoid) nerves. In 3 horses no improvement was detected. Lameness was improved by analgesia of the DIP joint but there was no response to analgesia of the navicular bursa in 3 horses. In 12 horses, lameness was improved by analgesia of the navicular bursa but intra-articular analgesia resulted in no change. Forty-one horses resp...
Schneider RK, Bramlage LR, Hardy J.The distal interphalangeal joint was successfully arthrodesed in two horses using three parallel 5.5-mm cortical screws and an autogenous cancellous bone graft. The screws were directed from the palmar proximal border of the second phalanx dorso-distally across the joint space and into the third phalanx. The technique was first developed on a normal horse. The second horse, a clinical case, ruptured its deep digital flexor tendon with complete luxation of the distal interphalangeal joint. Bony fusion of the distal interphalangeal joint occurred in both horses, but both also had residual lamene...
Jansen MO, van Buiten A, van den Bogert AJ, Schamhardt HC.The in vivo strains of the musculus interosseus medius (suspensory ligament) and its rami extensorii (extensor branches) in the forelimb of the horse were determined from angular changes of the metacarpophalangeal and the distal interphalangeal joints. For this purpose, regression models were fitted to strains and joint angle combinations measured in in vitro limb loading experiments. The in vivo strains were computed from the kinematics of 8 horses at the walk, the trot and the canter. It was found that the extensor branches were strained about 1.0% at hoof impact, which indicates that they p...
Jansen MO, van Raaij JA, van den Bogert AJ, Schamhardt HC, Hartman W.The function of several intrinsic muscles of the fore-and hind limbs of 5 ponies walking normally was evaluated via surface electromyography. Electromyographic signals were band-pass filtered, rectified, linear enveloped, and standardized to the stride duration. Mean data from the muscles of the left and right limbs that were obtained from at least 30 strides in 2 recording sessions were recorded as electromyographic signals-time curves. The timing of muscle activity was determined from these graphs. On the basis of the major peaks in the electromyographic signal, muscle functions were identif...
Vacek JR, Welch RD, Honnas CM.An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between t...
Honnas CM, Welch RD, Ford TS, Vacek JR, Watkins JP.The medical records of 12 horses with septic arthritis of a distal interphalangeal joint were reviewed to determine clinical features and response to treatment. Sepsis was caused by trauma or an injection that resulted in an open or contaminated distal interphalangeal joint. All horses were severely lame. Treatment included broad-spectrum parenterally administered antimicrobial drugs (ten horses), percutaneous through-and-through joint lavage (eight horses), indwelling drains (three horses), immobilization of the limb in a cast (three horses), intraarticular injection of sodium hyaluronate (on...
Honnas CM, Schumacher J, Kuesis BS.A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an att...
Jann H, Henry G, Berry A, Cash L.Twenty cadaver limbs of adult horses were examined by arthrographic examination of the distal interphalangeal joint. The joint capsule and space is described. Comparison is made with existing descriptions.
Dyson SJ.This paper describes the clinical and radiographic features, and response to treatment, of 45 horses which showed lameness that was improved by intra-articular anaesthesia of the distal interphalangeal (DIP) joint. Although many horses had poor conformation of the foot of the lame limb, the majority showed no localising clinical signs suggestive of involvement of the DIP joint. Lameness was usually unilateral. No horse with bilateral lameness responded to treatment. Palmar digital nerve blocks frequently improved or alleviated lameness, although in some horses palmar (abaxial sesamoid) nerve b...
Riley CB, Yovich JV, Huxtable CR.A fusion defect of the proximal and middle phalanges of both hindlimbs, osteochondrosis dissecans of the distal interphalangeal joints of the forelimbs, and subluxation of all 4 distal interphalangeal joints occurred in a Standardbred filly. Lameness was the first abnormality noted and was observed at one week of age in the left forelimb and progressed until all 4 limbs were affected by 5 weeks of age. On radiographs of both forelimbs, the distal interphalangeal joints were subluxated with irregularity and lucency of subchondral bone. On radiographs of the distal hindlimbs, there was a subluxa...
McIlwraith CW, Goodman NL.The various conditions of the interphalangeal joint are presented; these include degenerative joint disease and osteochondral chip fractures of the proximal interphalangeal joint, fractures of the middle phalanx affecting proximal and/or distal interphalangeal joints, subluxation and osteochondrosis of the proximal interphalangeal joint, and arthrosis of the distal interphalangeal joint.
Turner TA.Navicular syndrome can be treated in a variety of ways. This is related to the fact that it has a variety of causes. Prognostically, most horses will improve with treatment. One can expect about 50 per cent of the horses to become useably sound for 1 year, no matter what treatment is used. The disease is progressive, and affected horses eventually will need to be retired because of lameness. The author's therapeutic approach is to utilize shoeing as the primary therapy. Shoeing is performed to correct structural problems and to ensure that shoeing is physiologically sound. Nonsteroidal anti-in...
Reeves MJ, Yovich JV, Turner AS.The etiology, clinical presentation, radiographic findings, diagnostic criteria, differential diagnoses, treatment, and prognosis are reviewed for several clinically important conditions of the equine foot. These include pedal osteitis, sheared heels, distal sesamoid bone (navicular) fractures, subchondral bone cyst of the distal phalanx, distal interphalangeal joint subluxation, congenital phalangeal hypoplasia, bipartite and tripartite distal sesamoid bones, keratoma, ossification of the cartilages of the distal phalanx (sidebones), necrosis of the cartilages of the distal phalanx (quittor),...
Yovich JV, Stashak TS, DeBowes RM, Ducharme NG.Fractures of the distal phalanx of the forelimb were diagnosed in 5 colts and 3 fillies ranging in age from 2 weeks to 5 1/2 months at the time of fracture. Three fractures entered the distal interphalangeal joint and 6 fractures (one foal had bilateral fractures) were nonarticular. All foals with articular fractures became sound with conservative treatment. Four of 5 foals with nonarticular fractures became sound with conservative treatment and 1 foal developed separation of the hoof at the coronary band after application of acrylic around the hoof. On the basis of our observations in these f...
Wagner PC, Grant BD, Kaneps AJ, Watrous BJ.After desmotomy of the accessory ligament of the deep digital flexor tendon (distal check ligament) had been performed in 40 horses with flexural deformity of the distal interphalangeal joint (contracture of the deep digital flexor tendon), the horses' records were evaluated retrospectively. Information concerning soundness, return to intended purpose, and cosmetic appearance of the limb and hoof was obtained. The condition had been diagnosed and treated in 26 horses before they were one year old (group A, acute) and in 14 horses greater than one year of age (group B, chronic). Nine months to ...
Mackey VS, Pool RR.Fracture of the lateral wing of the third phalanx with secondary infection of the distal interphalangeal joint occurred in a neurectomized mare. Puncture of the sole may have been the inciting cause, emphasizing the need for careful daily foot care in neurectomized horses.
Bernard-Strother S, Mansmann RA, Beckstead C.A 6-month-old Quarter Horse colt, with severe left foreleg lameness of 6 weeks' duration, had swelling of the distal interphalangeal joint and a smaller-than-normal left front foot. Radiographs revealed a nondisplaced, midsagittal, intraarticular fracture of P3, which was treated with an eggbar shoe with 2 quarter clips, and stall rest for 10 weeks. The colt was sound after 10 weeks.
Martin GS, McIlwraith CW, Turner AS, Nixon AJ, Stashak TS.A retrospective study was made of 21 horses in which proximal interphalangeal arthrodesis had been performed. The right hindlimb was the most often affected (52%). Acute trauma was the most common reason for performing the surgery (62%). Follow-up data were obtained from the owners regarding return to serviceability . When available, follow-up radiographs and clinical examinations were reviewed. Of the 20 horses on which follow-up information was available, 16 were serviceable . Of the horses in which a hindlimb was arthrodesed , 86% were serviceable , whereas 67% of the horses affected in the...
Lanovaz JL, Clayton HM, Watson LG.This study was designed to test the impact characteristics of the equine digit in vitro with the objective of providing a better understanding of the role of the digital structures in the attenuation of impact shock. Uni-axial accelerometers were mounted on cadaver digits on the distolateral hoof wall, the proximolateral hoof wall, the dorsal surface of the second phalanx, and the mid-lateral first phalanx. The hoof-mounted accelerometers were aligned with the hoof tubules while the bone-mounted accelerometers were oriented along the longitudinal axis of the bone. Each digit was mounted in a t...
Cota LO, Malacarne BD, Dias LA, Neto ACP, Kneipp MLA, Cavalcante MA, Cunha MSLD, Paz CFR, Carvalho AM, Faleiros RR, Xavier ABDS.The analgesic specificity of navicular bursa (NB) anesthetic infiltration is still questionable. The study aimed to determine the mechanical nociceptive threshold of non-specific analgesia in the dorsal lamellar stratum, as well as in the sole, coronary band, and heel bulbs of the hoof, after navicular bursa anesthetic infiltration. Six healthy horses with no clinical or radiographic changes of the digits and no communication between the NB and the distal interphalangeal joint, were used. After random selection, the NB of one of the forelimbs was infiltrated with 2% lidocaine and the contralat...
Stanek C.A retrospective study (1984-1994) was made of 10 cases of septic arthritis of the distal interphalangeal joint in horses aged 7 months to 17 years. In 6 cases a hind limb was affected, in 4 cases a front limb. The arthritis was caused either by a puncture wound in the sole area (8 cases), by a perforating wound in the coronary region (1) or iatrogenic (1). All horses exhibited a severe lameness at the walk. Radiography showed no typical lesions in fresh cases, whilst later an increasing subluxation of the joint was observed followed by periosteal reactions. Therapy included partial resection o...
Góss GC, Mozzaquatro FD, Vanhove R, Camargo LP, Döwich Pradella G, Leite CT, Gomes EM, Carneiro ALM, Heckler GF, Duarte CA.The physiological measurements of collateral ligaments of distal interphalangeal joint (CL-DIPJ) differ in the literature. The factors that influence these differences are not well described. The aims of this study are to compare CL-DIPJ sizes in equines with different withers height, as well as to correlate body weight and hoof size to the size of these ligaments. In total, 52 horses were used in the study. They were divided into two groups according to wither height: Group 1 (G1) - 21 animals with up to 147 cm - and group 2 (G2) - 21 animals with greater than 148 cm. CL-DIPJ was ultrasonog...
Pearce SG, Boure LP, Bolger A, Thomason JJ, Dobson H.To determine the conformational changes in the distal forelimb of horses following heel elevation of 15 degrees and greater. An experimental study with repeated, within-horse measurements. Methods: Five clinically normal, mixed-breed horses were used to determine distal forelimb conformation following heel elevation from 0 to 45 degrees in 15 degree increments. Data were also compared to conformation of the limb in a Kimzey splint. Conformation was determined using lateral to medial radiographic projections. Conformation parameters assessed included measurement of apparent lengths of digital f...
Willemen MA, Jacobs MW, Schamhardt HC.An in vitro model was developed and validated in vivo to quantify the attenuation of impact vibrations, transmitted through the lower equine forelimb and to assess the effects of horseshoeing on this attenuation. The transsected forelimbs of 13 horses were equipped with custom-made hollow bone screws in the 4 distal bones, on each of which a tri-axial accelerometer could be mounted. The limbs were then preloaded while the impact was simulated by dropping a weight on the steel plate on which the hoof was resting. At the hoof wall, the distal, middle and proximal phalanx and at the metacarpal bo...
Adler DMT, Jørgensen E, Cornett C.To determine the synovial fluid (SF) concentrations of lidocaine and mepivacaine after intra-articular injection with clinically relevant doses to the distal interphalangeal (DIP), metacarpophalangeal (MCP), middle carpal (MC), and tarsocrural (TC) joint at two different time points after injection in order to be able to compare concentrations with previously established concentrations associated with cytotoxicity and antimicrobial activity. Unassigned: In the first of two experiments, 20 joints (5 MC, 5 MCP, 10 DIP joints) of five horses under general anesthesia were injected with clinically ...
White NA.Transection of the accessory ligament of the deep digital flexor muscle (distal check ligament desmotomy) was completed in 44 horses using an ultrasound-guided technique. The technique used real-time ultrasound with a 7.5 MHz transducer to observe the dissection and isolation of the check ligament through a 1 to 1.5 cm incision and to check for complete transection of the check ligament. The technique was effective in correcting flexural deformity of the distal interphalangeal joint and the metacarpophalangeal joint in all but three horses. Check ligament desmotomy at a young age (median, 6 mo...
Ruohoniemi M, Ryhänen V, Tulamo RM.Radiographic findings in the navicular bone and distal interphalangeal joint as well as the ossification status of the collateral cartilages of the distal phalanx were evaluated in 100 Finnhorse cadaver forefeet. The most common shapes of the proximal articular margin of the navicular bone were convex and straight. Remodeling of the navicular bone was common, especially on the lateral extremity. No bony fragments were identified at the distal flexor margin even though this area appeared irregular in several feet. Several large, rounded or lollipop-shaped synovial invaginations were identified ...
Crowe OM, Hepburn RJ, Kold SE, Smith RK.To report long-term outcome after arthroscopic removal of fragmentation of the extensor process of the distal phalanx in horses. Methods: Case series. Methods: Adult horses (n=13). Methods: Medical records (2003-2004) of horses that had arthroscopic debridement of fragmentation of the extensor process of the distal phalanx were reviewed. Inclusion criteria included: lameness localized to the foot, fragmentation of the extensor process of the distal phalanx debrided arthroscopically, and a follow-up period of > or = 4 years. Results: Of the 13 horses, lameness was resolved in 11 (85%) initia...
Walmsley EA, Anderson GA, Adkins AR.Determine the long-term outcome for Thoroughbreds undergoing desmotomy of the accessory ligament of the deep digital flexor tendon (DAL-DDFT) for type 1 flexural deformity of the distal interphalangeal joint (DIPJ). Methods: Retrospective matched cohort study Methods: Medical records were retrieved over a 17-year period for Thoroughbreds that underwent DAL-DDFT for type 1 flexural deformity. Long-term outcome was determined by analysis of race records and comparison with maternal siblings. Comparisons between cases and controls included 2-year-old, 3-year-old and total career performance data....
Viitanen MJ, Wilson AM, McGuigan HR, Rogers KD, May SA.Increased joint pressure has been implicated in the progression of osteoarthritis. Objective: That intra-articular pressure in the distal interphalangeal joint (DIP) is significantly higher in legs loaded with heel up (HU), low heel (TU), lateral side up (LU) and medial side up (MU) imbalance compared to the balanced position. Methods: Twelve elbow down limbs were compressed in a hydraulic loading jig and DIP pressure measured. Results: Elevating the heels by 5 degrees significantly increased DIP pressure. After 5 ml of contrast was injected into the joint, heel elevation caused a greater incr...
Crevier-Denoix N, Roosen C, Dardillat C, Pourcelot P, Jerbi H, Sanaa M, Denoix JM.Five sound mature horses, age 8-14 years, with toe angles 45.5-55.0 degrees were placed on a specially designed platform with only the left forelimb weightbearing, which allowed the successive production of 7 different conditions of foot orientation: neutral position (N), 5, 10, 15 degrees heel (H5, H10, H15) and toe (T5, T10, T15) elevation, performed according to 2 different sequences. For each condition, 2 lateromedial radiographs were taken to evaluate the metacarpophalangeal joint (MPJ) and both interphalangeal joint (PIPJ and DIPJ) angles, respectively. In addition, two-dimensional (2-D)...
Koch DW, Barrett MF, Jackman BR, MacDonald D, Goodrich LR.Aims: To compare the outcome, in terms of lameness score or return to athletic function, of horses with acute vs. chronic digital lameness that underwent magnetic resonance imaging (MRI) of the distal limb and to compare the proportion of horses that received intra-articular therapy of the distal interphalangeal (DIP) joint and pattern of diagnostic analgesia in these groups. Methods: This is a retrospective study of horses (n = 95) with acute (≤12 weeks; n = 46) or chronic (>12 weeks; n = 49) digital lameness that underwent MRI of the distal limb from 2009-2016, at two equine re...
Kay AT, Durgam S, Stewart M, Joslyn S, Schaeffer DJ, Horn G, Kesler R, Chew P.To compare reduction of type III distal phalangeal fractures using 4.5 and 5.5 mm cortical screws placed in lag fashion and an intact hoof capsule model. Methods: Cadaveric experimental study. Methods: Hooves from 12 adult horses (n=24). Methods: Sagittal fractures were created in pairs of distal phalanges after distal interphalangeal joint disarticulation and were reduced with either 4.5 or 5.5 mm cortical screws placed in lag fashion. Contralateral phalanges served as non-reduced controls. Fracture reduction following screw placement was assessed by comparing pre-reduction and post-reduction...
Honnas CM, Schumacher J, Kuesis BS.A 6-month-old 300-kg Quarter Horse filly was treated for septic arthritis of the distal interphalangeal joint and septic navicular bursitis that developed as a result of a deep puncture to the foot. Initial treatment consisted of establishing ventral drainage for the navicular bursa, lavage of the distal interphalangeal joint, and administration of broad-spectrum antimicrobial drugs and non-steroidal anti-inflammatory drugs. Because of continuing sepsis in the distal interphalangeal joint, subsequent treatment included packing the defect in the bottom of the foot with cancellous bone in an att...
Gutierrez-Nibeyro SD, White NA, Werpy NM, Tyrrell L, Allen KA, Sullins KE, Mitchell RD.We report the use of a low-field magnetic resonance (MR) imaging system for the detection of desmopathy of the collateral ligament of the distal interphalangeal joint and the long-term outcome. Twenty horses were studied and their medical records and MR images were reviewed retrospectively. Long-term follow-up information was obtained by telephonic questionnaires of owners, trainers, or referring veterinarians. Desmopathy of the medial collateral ligament (80%) and enthesopathy of the affected collateral ligament (80%) were common MR imaging features. Treatment consisted of stall rest followed...
MacLellan KN, MacDonald DG, Crawford WH.A 4-month-old colt with stage I flexural deformity of the distal interphalangeal joint was diagnosed as having a type IV nondisplaced fracture of the extensor process of the 3rd phalanx. An inferior check ligament desmotomy and internal fixation of the fracture were performed. Favorable long-term results for internal fixation of extensor process fractures are presented.
Dyson S, Murray R.Nuclear scintigraphy is commonly used as a diagnostic aid for foot pain, but there is limited information about different patterns of radiopharmaceutical uptake (RU) and their correlation with the results of other imaging modalities. Objective: To describe patterns of RU in horses with foot pain. Methods: Scintigraphic images of the feet of 264 horses with front foot pain were analysed subjectively and using region of interest analysis. Magnetic resonance images of all feet were analysed prospectively; the navicular bones were reassessed retrospectively and assigned a grade. A Spearman rank co...
McClure SR, Hooper RN, Watkins JP.A 13-month-old Quarter Horse colt sustained a puncture wound to the frog region of the foot, which penetrated the navicular bursa and distal interphalangeal joint, 7 days prior to examination. A street-nail procedure was performed to debride the tract and provide drainage of the navicular bursa and distal interphalangeal joint. An indwelling lavage system was placed through the dorsal aspect of the joint and antimicrobials were infused intermittently to supply a high local concentration of drug and to frequently lavage the distal interphalangeal joint and navicular bursa.
Lescun TB, Morisset SM, Fugaro MN, Blevins WE.A 3-month-old Quarter Horse colt sustained a penetrating injury over the coronary band on the right forelimb resulting in an articular bone sequestrum and septic arthritis of the distal interphalangeal joint. Despite aggressive treatment for septic arthritis, severe osteoarthritis and ongoing sepsis resulted in persistent lameness. Facilitated ankylosis of the distal interphalangeal joint was performed using a combination of open surgical debridement, placement of an autogenous cancellous bone graft and stabilisation within a transfixation cast. Bony ankylosis of the joint was observed radiogr...
Gandini M.To compare 3 dorsal techniques for arthrocentesis of the distal interphalangeal joint in horses with regard to ease of performing the technique and to determine the role of operator experience in ease of performing these techniques. Methods: Observational study. Sample Population-Forelimbs from 17 equine cadavers and 12 horses (16 joints) undergoing arthrocentesis for therapeutic or diagnostic purposes. Methods: In both forelimbs from 7 of the equine cadavers, 3 arthrocentesis techniques (dorsal perpendicular, dorsolateral, and dorsal inclined) were performed in random order by a single experi...
Hague BA, Honnas CM, Simpson RB, Peloso JG.This study evaluates skin bacterial flora before and after aseptic preparation of clipped and nonclipped arthrocentesis sites in horses. Methods: The hair over one midcarpal joint and one distal interphalangeal joint on each horse was clipped. The contralateral joint served as the nonclipped comparison. Methods: Twelve adult horses. Methods: A prescrub sample for microbial culture was taken from the dorsal surface of all four joints for each horse. Each site was aseptically prepared with povidone iodine and 70% alcohol, followed by postscrub sampling for microbial culture. Colony forming units...
Trope GD, Whitton RC.A 12-year-old show-jumping mare was presented for investigation of a chronic hindlimb lameness of 16 weeks duration. Perineural anaesthesia and ultrasonography localised the lesion to the medial collateral ligament of the distal interphalangeal joint of the left hindlimb. Treatment consisted of a heavily padded distal limb cast for 6 weeks, strict box rest and a strictly regulated hand walking program. Serial ultrasonographic examinations were performed throughout the rehabilitation period. Collateral ligament desmitis of the distal interphalangeal joint is a commonly diagnosed condition of th...
Smith R, Parsons J, Dixon J.Desmopathy of the collateral ligaments of the distal interphalangeal joint is a common cause of equine foot lameness and carries a poor prognosis with conservative management. Intralesional injections may improve healing, although accuracy of radiographically guided injections is significantly less than when guided by MRI, which requires special needles. Longitudinal ultrasound-guided injection of the distal collateral ligament has not been evaluated objectively. In this prospective, anatomic study, seven equine cadaver limbs (14 collateral ligaments) were injected with methylene blue dye and ...
Boyce M, Malone ED, Anderson LB, Park S, Godden SM, Jenner F, Trumble TN.To determine whether triamcinolone acetonide diffuses from the distal interphalangeal joint (DIPJ) to the navicular bursa, diffusion is direct or systemic, and addition of sodium hyaluronan has an effect on diffusion in horses. Methods: 11 adult horses without forelimb lameness. Methods: 1 randomly chosen forelimb DIPJ of each horse received an injection of 10 mg of triamcinolone acetonide plus 20 mg of sodium hyaluronan (group 1), and the contralateral forelimb DIPJ received an injection of 10 mg of triamcinolone acetonide plus 2 mL of lactated Ringer's solution (group 2). Synovial fluid samp...
Caudron I, Grulke S, Farnir F, Aupaix R, Serteyn D.This study is part of a work to develop a radiographic method that defines objectively the individual conformation of an equine digit and its appropriate trimming. The authors used isolated distal limbs fastened on a rotation support with variable inclinations to study the influence of induced asymmetric bearings on various angles measured from specific radiographs. The digit responded to asymmetric bearings by 1. deformation of the hoof; 2. rotation of the phalanges; and 3. joint asymmetry or local articular space narrowing. The two last situations occurred mainly in the distal interphalangea...
Viitanen M, Bird J, Smith R, Tulamo RM, May SA.The study hypothesis was that navicular disease is a process analogous to degenerative joint disease, which leads to changes in navicular fibrocartilage and in deep digital flexor tendon (DDFT) matrix composition and that the process extends to the adjacent distal interphalangeal joint. The objectives were to compare the biochemical composition of the navicular articular and palmar cartilages from 18 horses with navicular disease with 49 horses with no history of front limb lameness, and to compare navicular fibrocartilage with medial meniscus of the stifle and collateral cartilage of the hoof...
Viitanen M, Bird J, Makela O, Schramme M, Smith R, Tulamo RM, May S.The purpose of this study was to investigate biochemical changes in synovial fluid in navicular disease, and to establish if synovial fluid from the distal interphalangeal joint (DIP) could be used diagnostically to assess alterations in the synovial fluid of the navicular bursa. Cartilage oligomeric matrix protein (COMP), total glycosaminoglycans (GAG), hyaluronan (HA), metalloproteinases 2 and -9 (MMP-2 and MMP-9) and total protein (TP) levels were determined in synovial fluids obtained from 18 navicular bursae and 35 DIP -joints from animals suffering from navicular disease, and the same sy...
Compagnie E, Ter Braake F, de Heer N, Back W.Report long-term clinical and radiological follow-up in horses after removal of large extensor process fragments occupying >25% of the joint surface of the distal interphalangeal joint (DIJ). Methods: Retrospective case series. Methods: Friesian horses (n=18) that underwent arthroscopic removal of a large extensor process fragment. Methods: Arthroscopic examination of the DIJ was performed in dorsal recumbency with the affected foot in extension using routine portals. Visualization of the fragment was improved using motorized synovial resectors. A dissection plane between the common digital ex...
