The distal phalanx, also known as the coffin bone, is the innermost bone located within the hoof of a horse. It is a critical component of the equine skeletal system, providing structural support and playing a significant role in weight-bearing and locomotion. The distal phalanx is encased within the hoof capsule and interacts with various soft tissue structures, including the laminae, which connect the hoof wall to the bone. Conditions affecting the distal phalanx, such as fractures, infections, or laminitis, can have significant implications for a horse's mobility and overall health. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, biomechanics, pathology, and treatment options related to the distal phalanx in horses.
Leonardi F, Angelone M, Biacca C, Battaglia B, Pecorari L, Conti V, Costa GL, Ramoni R, Grolli S.Keratoma is a nonmalignant horse tumor that grows in the space between the horn of the hoof and the distal phalanx. Keratoma causes lameness in the horse, and surgical excision is the treatment of choice. Four horses underwent removal of a keratoma by complete hoof wall resection. The remaining wound was treated with platelet-rich plasma (PRP) combined with a sterile three-dimensional polylactic acid scaffold. The PRP was applied at 3, 6, 9, 12, 15, and 18Â days postoperatively. The surgical site was cleaned with gauzes and swabs soaked in Ringer's lactate solution before applying PRP and the ...
Stewart HL, Werpy NM, McIlwraith CW, Kawcak CE.To describe the effects of distal limb immobilization and remobilization in the equine metacarpophalangeal joint. Methods: Randomized, prospective experimental study. Methods: Eight healthy, skeletally mature horses. Methods: One forelimb of each horse was immobilized in a fiberglass cast for 8 weeks; this was followed by 12 weeks of a treadmill-based training program after the cast had been removed. Clinical examinations, radiography, computed tomography (CT), nuclear scintigraphy, MRI, and histomorphometry were used to examine the third metacarpal (MC3), proximal phalanx, proximal sesamo...
Seghrouchni M, Elkasraoui H, Piro M, Alyakine H, Bouayad H, Chakir J, Tligui N, Elallali K, Azrib R.Tbourida is a traditional Moroccan equestrian sport in which 15 horses gallop 200 m in a line while riders fire into the sky with muskets. The stop is the finale and representative demands of this equestrian event. Such particular sudden stop after a fast gallop requires a hyperextension of the metacarpophalangeal joint. Indeed, it is well known that Tbourida show predisposes horses to different injuries of the hard and soft tissues of the distal forelimbs. Yet, there is a paucity of research that examined such lesions. The aim of the present study was to investigate for the first time the typ...
Balducci JJ, Barrett MF, Moorman VJ.Subchondral or osseous cyst-like lesions within the distal aspect of the middle phalanx are not commonly reported in equids. These osseous lesions, which can communicate with the distal interphalangeal joint, can result in significant lameness and may not respond well to medical management. This report describes the clinical, diagnostic imaging, and surgical management of a 4-year-old mixed breed gelding where medical management of a chronic subchondral osseous cyst-like lesion of the middle phalanx, which communicated with the distal interphalangeal joint, was unsuccessful. A successful outco...
Mizobe F, Nomura M, Kanai K, Ishikawa Y, Yamada K.Six Thoroughbred racehorses with palmar process fractures of the distal phalanx were evaluated with standing magnetic resonance imaging (sMRI). In all the cases, the fractures were detectable on T1-weighted images and fat-suppressed images. Furthermore, multi-planar reconstruction images were useful for assessing the articular involvement of the fractures. Follow-up sMRI was obtainable in 3 cases, which revealed that the area of high signal intensity on fat-suppressed images decreased over time as symptoms improved. Our findings support the use of sMRI for the detailed evaluation of distal pha...
Walmsley EA, Jackson M, Wells-Smith L, Whitton RC.Subchondral bone injury at the palmar/plantar aspect of the condyles of the third metacarpal/metatarsal bone (MC/MT3) commonly causes lameness and poor performance in racehorses. Injury occurs due to repetitive loading, the magnitude of which may be influenced by the position of the distal phalanx relative to the ground surface, i.e. the solar angle. The association of solar angle and injury at the palmar/plantar condyles of distal MC/MT3 therefore warrants investigation. Objective: Investigate the relationship between solar angle and radiopharmaceutical uptake at the palmar/plantar aspect of ...
Rowan C, Puggioni A, Hoey SE, O'Leary JM, Kearney C, Connolly SE, Skelly C.The requirement to pack the sulcus of the equine foot as an aid to diagnostic interpretation before acquisition of dorsoproximal-palmarodistal oblique projections is debatable. The purpose of this study was to investigate the benefit of packing the sulcus in the assessment of normal anatomy. 23 cadaver limbs were radiographed in a podoblock (https://www.podoblock.com/products-page/podoblock/podoblock/) A non-packed image (NP) and a packed image (P) of the same foot were acquired. The image quality of P was graded against the reference NP by five observers, where -1=P was superior, 0=no differe...
Pezzanite L, Bass L, Kawcak C, Goodrich L, Moorman V.Lameness can be multifactorial and may result from the accumulation of multiple seemingly unrelated causes. The identification of factors associated with lameness could be one method to decrease incidence of lameness and prolong the equine athlete's competitive life. Objective: To determine if there is an association between hoof balance in the sagittal plane and hindlimb lameness. Methods: Case-control study. Methods: Eighty client-owned horses with hindlimb lameness (cases) and 80 horses with no detectable hindlimb lameness (controls) were prospectively enroled following lameness evaluation ...
Peter VG, O'Keeffe TA, Smith LCR, Schweizer-Gorgas D. To investigate the racing performance of Thoroughbred horses with osseous cyst-like lesions (OCLLs) in the distal phalanx causing lameness and treated conservatively. To assess horses' ability to race and perform after radiographic identification of OCLL in the distal phalanx of Thoroughbred horses with lameness at the time of detection and undergoing conservative treatment. Retrospective case control study. The clinical database of one equine clinic was reviewed in a 10-year period for Thoroughbreds showing lameness localized to the foot and a radiographic diagnosis of OCLL in the distal ...
Schiavo S, Cillán-GarcÃa E, Elce Y, Liuti T, Taylor SE.Solar foot penetration is one of the causes of deep digital flexor tendon injuries in horses, however, limited information is available on the prognosis for return to soundness in the absence of synovial sepsis. Objectives of this retrospective observational study were to describe low-field magnetic resonance imaging (MRI) findings and long-term outcome for a group of horses with this combination of clinical problems. Horses were included if low-field standing MRI of the foot was performed following puncture wounds, injury of the deep digital flexor tendon was diagnosed, and sepsis was confirm...
Quiney LE, Ireland JL, Dyson SJ.There is good correlation between increased radiopharmaceutical uptake anywhere in the feet of sports or leisure horses and the presence of foot pain. However, low sensitivity of scintigraphy for identifying lesions contributing to foot pain as determined by magnetic resonance imaging (MRI) has been reported. The aim of this retrospective, cross-sectional, analytical study was to assess the accuracy of scintigraphy for identifying the cause(s) of foot pain, using MRI as the reference standard. Sports and leisure horses that underwent both skeletal scintigraphy and MRI of the front feet between...
MacDonald JL, Richter RA, Wimer CL.Ultrasonography is an established diagnostic test for evaluating horses with foot pain due to suspected podotrochlear apparatus pathology. However, variations from the previously reported normal appearance of the distal sesamoidean impar ligament have not always coincided with lameness. The objective of this prospective, cross-sectional, descriptive study was to characterize variations in the ultrasonographic appearance of the distal sesamoidean impar ligament in sound horses using the transcuneal approach. Transcuneal ultrasonography of the distal sesamoidean impar ligament was performed on s...
Faramarzi B, Salinger A, Kaneps A, Nout-Lomas Y, Greene H, Dong F. The goal of this study was to quantify external and internal anatomical characteristics of the foal foot throughout the first year of age.  Digital radiographs and photographs were taken bimonthly of the forefeet of nine Arabian foals, beginning at about 2 weeks of age until 12 months of age. Sixty-eight linear and angular variables were measured using NIH (National Institutes of Health) software. Statistical analyses were performed using piecewise random coefficient model and -values < 0.05 were considered significant.  Distinct changes in hoof development were identified betwe...
Geiger SM, Reich E, Böttcher P, Grund S, Hagen J.Biplane high-speed fluoroscopy is a new method for gait analysis of the equine distal extremity. This is the first study validating the noninvasive tracking possibilities (Autoscoping and Scientific Rotoscoping) taking equine anatomy into account. Objective: To determine the resolution with which Autoscoping and Scientific Rotoscoping depict motion of the equine phalanges in comparison to the invasive gold standard marker-based registration. Methods: Comparative ex vivo study. Methods: In 5 distal extremities of slaughtered ponies, 3 or 4 tantalum beads with 1 mm diameter were implanted in e...
Vosugh D, Nazem MN, Hooshmand AR.Among the different breeds of horses, Asil horses with a five thousand year history have played an important role in human life. This study was designed as a result of the lack of information about the normal radiographic anatomy of this breed. Methods: Radiography of the distal phalanx and associated soft tissue structures of the front feet of 10 healthy pure Iranian Arabian horses was performed on lateromedial radiographic projection to determine normal radiographic morphometry of this part. There were no problems in their limbs and in their history. Results: Obtained radiograph of each fron...
Pauwels FE, Rogers CW, Wharton H, Flemming H, Wightman PF, Green RW.Hoof balance radiographs are commonly used as the basis for corrective farriery decision-making in horses, however there are limited published data quantifying effects of the stance of the horse or the horizontal radiographic beam angle. In this analytical study, the influence of variation of the horse's stance in the craniocaudal and lateromodial plane on hoof balance measurements as well as the influence of variation of the horizontal radiographic beam angle on dorsopalmar hoof balance measurements was examined. Distal left thoracic limb lateromedial radiographs were acquired using a standar...
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...
Whitlock J, Dixon J, Sherlock C, Tucker R, Bolt DM, Weller R.Since the 1950s, veterinary practitioners have included two separate dorsoproximal-palmarodistal oblique (DPr-PaDiO) radiographs as part of a standard series of the equine foot. One image is obtained to visualise the distal phalanx and the other to visualise the navicular bone. However, rapid development of computed radiography and digital radiography and their post-processing capabilities could mean that this practice is no longer required. The aim of this study was to determine differences in perceived image quality between DPr-PaDiO radiographs that were acquired with a computerised radiogr...
Bindler D, Koch C, Gendron K, Ferguson SJ, Kaposi AD, Papp M, Bodó G.Mechanical evaluation of a novel screw position used for repair in a type III distal phalanx fracture model and assessment of solar canal penetration (SCP). Methods: Experimental study. Methods: Disarticulated equine hooves (n = 24) and 24 isolated distal phalanges. Methods: Hooves/distal phalanges cut in a sagittal plane were repaired with 1 of 2 different cortical screw placements in lag fashion. In group 1 (conventional screw placement), the screw was inserted halfway between the proximal border of the solar canal (SC) and the subchondral bone surface on a line parallel to the dorsal co...
Pollitt CC, Collins SN.The suspensory apparatus of the distal phalanx (SADP) is functionally and clinically important. Objective: To investigate SADP form and function and the microanatomy of its insertion zone. Methods: Descriptive gross and microanatomy. Methods: The feet of 6 normal Standardbred horses were sectioned into blocks along the traditional perpendicular transverse axis and along functional axes of the SADP, decalcified and processed for staining with haematoxylin and eosin, Jones' periodic acid silver methenamine or Masson's trichrome stains. Results: In traditional midline toe transverse plane section...
Engiles JB, Galantino-Homer HL, Boston R, McDonald D, Dishowitz M, Hankenson KD.Although the equine distal phalanx and hoof lamellae are biomechanically and physiologically integrated, bony changes in the distal phalanx are poorly described in laminitis. The aims of this study were (1) to establish a laminitis grading scheme that can be applied to the wide spectrum of lesions seen in naturally occurring cases and (2) to measure and describe changes in the distal phalanx associated with laminitis using micro-computed tomography (micro-CT) and histology. Thirty-six laminitic and normal feet from 15 performance and nonperformance horses were evaluated. A laminitis grading sc...
Underwood C, Collins SN, van Eps AW, Mills PC, Allavena RE, Bailey SR, Medina Torres CE, Meizler A, Pollitt CC.No validated laminitis drug therapy exists, yet pharmaceutical agents with potential for laminitis prevention have been identified. Many of these are impractical for systemic administration but may be effective if administered locally. This study compared intraosseous infusion of the distal phalanx (IOIDP) with systemic intravenous constant rate infusion (CRI) to determine which was more effective for lamellar marimastat delivery. Ultrafiltration probes were placed in both forefeet of five horses to collect lamellar interstitial fluid as lamellar ultrafiltrate (LUF). Marimastat solution (3.5â€...
Pownder SL, Koff MF, Shah PH, Fortier LA, Potter HG.Post operative imaging in subjects with orthopaedic implants is challenging across all modalities. Magnetic resonance imaging (MRI) is preferred to assess human post operative musculoskeletal complications, as soft tissue and bones are evaluated without using ionising radiation. However, with conventional MRI pulse sequences, metal creates susceptibility artefact that distorts anatomy. Assessment of the post operative equine patient is arguably more challenging due to the volume of metal present, and MRI is often not performed in horses with implants. Novel pulse sequences such as multiacquisi...
de Zani D, Polidori C, di Giancamillo M, Zani DD.There are few studies on the correlations between radiographic measurements of the foot and abnormalities of specific structures found with magnetic resonance imaging (MRI). Objective: To document the relationship between radiographic measurements of the equine foot and the presence of lesions in the foot on MRI. We hypothesised that different radiographic measurements would be associated with specific lesions detected by MRI. Methods: Retrospective analysis of radiographs and MRI studies. Methods: Seventy-four feet from 52 lame horses were included. Twenty parameters were measured on radiogra...
Faramarzi B, McMicking H, Halland S, Kaneps A, Dobson H.Recent studies indicate a high prevalence of fractures of the palmar processes (PP) of the distal phalanx in foals. However, information on the prevalence of such fractures in different breeds and the effect of predisposing factors, such as hoof conformation, is limited. Objective: To examine the prevalence of distal phalanx PP fractures in foals and report the relationship of distal limb and hoof conformation with the prevalence of fracture. Methods: Longitudinal study. Methods: Front hooves of 19 Thoroughbred, Quarter Horse and Arabian foals were examined. Digital radiographic and photograph...
Burd MA, Craig JJ, Craig MF.Digital radiographs are often used to subjectively assess the equine digit. Recently, quantitative and objective radiographic measurements have been reported that give new insight into the form and function of the equine digit. We investigated a radio-dense curvilinear profile along the distal phalanx on lateral radiographs we term the Palmar Curve (PC) that we believe provides a measurement of the concavity of the distal phalanx of the horse. A second quantitative measurement, the Palmar Metric (PM) was defined as the percent area under the PC. We correlated the PM and age from 544 radiograph...
Gasiorowski JC, Richardson DW.To describe clinical use of computed tomography (CT) and hoof surface markers to facilitate internal fixation within the confines of the hoof wall. Methods: Retrospective case series. Methods: Horses (n = 16) that had CT-guided internal fixation of the distal phalanx (DP) or distal sesamoid bone (DSB). Methods: Drill bit entry point and direction were planned from CT image series performed on hooves with grids of barium paste dots at proposed entry and projected exit sites. Post-implantation CT images were obtained to check screw position and length as well as fracture reduction. Imaging, ...
Roach JM, Pfau T, Bryars J, Unt V, Channon SB, Weller R.Kinematic evaluation of the distal limb of the horse using standard methods is challenging, mainly due to the hoof capsule restricting visualisation, but the recent development of a high-speed fluoroscopy (HSF) system has allowed in vivo cineradiographic assessment of moving skeletal structures at high speeds. The application of this non-invasive method to the equine distal limb is used to describe 'internal' distal limb kinematics including intra-horse and inter-horse variability, and variability between walk and trot. Distal limb kinematic data were collected at walk and trot from six non-la...
Williams JM, Elce YA, Litsky AS.To (1) compare strain on the dorsal aspect of the proximal phalanx (P1) between 2 types of transfixation pin casts (TPC) and (2) evaluate the change in strain as the pins are removed. Methods: Experimental. Methods: Equine cadaver forelimbs (n = 10 pair). Methods: Each limb of a pair was assigned to 1 of 2 TPC constructs. Construct 1 consisted of a TPC with 2 positive profile, centrally threaded pins placed in the distal aspect of the third metacarpus (MC3) and construct 2 had 4 smooth Steinmann pins placed similarly. A strain gauge was mounted on P1 and axial compression (444.8-5337.9 N) appl...
Murray RC, Dyson SJ, Schramme MC, Branch M, Woods S.Chronic laminitis is a severe disease affecting the equine digit. It was hypothesized that magnetic resonance (MR) imaging would improve visualization of structures within the foot and pathology associated with chronic laminitis. This study aimed to describe the MR imaging findings in chronic laminitis, compare different pulse sequences for visualization of pathology, and to compare MR imaging with standard radiography. Twenty (10 forelimb, 10 hindlimb) cadaver limbs from 10 horses clinically diagnosed with chronic laminitis (group L) and 10 limbs without laminitis (group N) were used. Laterom...
Dyson S, Pool R, Blunden T, Murray R.There is limited knowledge about the interpretation of alterations in the distal sesamoidean impar ligament (DSIL) detected using magnetic resonance imaging (MRI) and their correlation with histopathology. Objective: There would be: 1) a correlation between histopathology and MRI findings; and 2) a relationship between MR abnormalities at the origin and the insertion of the DSIL, between insertion and body; and origin and body. Methods: Fifty limbs from 28 horses were examined using high-field MRI and histopathology. MR abnormalities of the DSIL, its origin on the navicular bone and its insert...
Leonardi F, Angelone M, Biacca C, Battaglia B, Pecorari L, Conti V, Costa GL, Ramoni R, Grolli S.Keratoma is a nonmalignant horse tumor that grows in the space between the horn of the hoof and the distal phalanx. Keratoma causes lameness in the horse, and surgical excision is the treatment of choice. Four horses underwent removal of a keratoma by complete hoof wall resection. The remaining wound was treated with platelet-rich plasma (PRP) combined with a sterile three-dimensional polylactic acid scaffold. The PRP was applied at 3, 6, 9, 12, 15, and 18Â days postoperatively. The surgical site was cleaned with gauzes and swabs soaked in Ringer's lactate solution before applying PRP and the ...
Bowker RM, Van Wulfen KK, Springer SE, Linder KE.To examine macro- and microscopic characteristics of cartilage of the distal phalanx (ungual cartilage [UC]) and digital cushion in the equine foot and to relate them to the foot's function of energy dissipation. Methods: 85 horses and 5 foals of various breeds and ages. Methods: Feet, obtained at necropsy, were perfused with India ink (n = 30), latex (5), or polymer plastic (10). Select feet were examined histologically for tissue architecture and to identify elastic fibers. Immunochemistry to identify substance P peptides in nerves (feet from foals) and gold chloride impregnation of axons (n...
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...
Busoni V, Denoix JM.The purpose of this paper is to describe the technique for ultrasonographic examination of the podotrochlear apparatus in the horse using a transcuneal approach. In this study, ultrasound scans were performed in 3 normal cadaver limbs and 5 sound horses and images were compared to anatomic sections to establish the normal ultrasonographic anatomy of the podotrochlear apparatus. Detailed description of transverse and sagittal reference ultrasonographic images of this region is provided. This new imaging technique allows the assessment of the distal sesamoid bone flexor surface, the distal porti...
Cardona GA, Uribe A, Ortved K.The economic relevance, populational importance and expansion of the Colombian Paso Horse to other latitudes calls for a growth in studies based on this type of horse. Lack of written reports about the relationship of the distal phalanx (DP) within the hoof in this gaited horse makes it important to establish a baseline to determine hoof health and possible alterations. The purpose of this study was to report, for the first time, the positional parameters of the distal phalanx, and its relationship within the hoof in sound Colombian Paso Horses. A latero-medial radiographic image of each dig...
Hobbs SJ, Richards J, Matuszewski B, Brigden C.To develop and evaluate a marker cluster set for measuring sagittal and extrasagittal movement of joints in the distal portion of the forelimb in ponies. Methods: 4 ponies. Methods: 5 infrared cameras were positioned on a concrete walkway in a frontal-sagittal arc and calibrated. Four segments were defined: hoof, middle phalanx, proximal phalanx, and metacarpus. Rigid clusters with 4 retroreflective markers were placed on each segment. A static trial was recorded with additional anatomic markers on the medial and lateral joint lines. Those anatomic markers were removed, and kinematic data were...
Ruohoniemi M, Kärkkäinen M, Tervahartiala P.Six Finnhorse cadaver forefeet were selected to represent radiographically different types and grades of ossification of the collateral cartilages of the distal phalanx. These cartilages and adjacent tissues were evaluated with computed tomography (CT) and high field magnetic resonance imaging (MRI). In CT the internal structure of the cartilages was consistent, but in MRI some differences were noted. The shape of the collateral cartilages and their ligamentous attachments varied. The border between ossified and non-ossified cartilage appeared distinct, with considerable variation in the exten...
Ritmeester AM, Blevins WE, Ferguson DW, Adams SB.Nuclear scintigraphy was used to assess digital perfusion before and after treatment in 10 horses with clinical and radiographic evidence of chronic laminitis. Horses were evaluated for lameness, degree of distal phalanx rotation, and heel-toe hoof wall growth ratio, and randomly divided into two treatment groups. Group 1 horses received only egg bar-heart bar shoeing; Group 2 underwent egg bar-heart bar shoeing and coronary grooving. Horses were re-evaluated for digital perfusion, lameness, degree of distal phalanx rotation, and hoof wall growth at 6 week intervals over the 18 week follow-up ...
de Preux M, Precht C, Travaglini AT, Propadalo LM, Farra D, Vidondo B, Easley JT, Koch C.To determine the effect of the Vertek aiming device (VAD) on the surgical accuracy of navigated drilling of the distal sesamoid bone (DSB). Methods: Experimental cadaveric study. Methods: A total of 30 paired equine cadaveric limbs from 15 horses. Methods: Each specimen was placed in a purpose-built frame (PBF). Preoperative cone beam computed tomography (CBCT) images were acquired with an imaging unit coupled with a surgical navigation system. In the DSB of each specimen, a 4.5 mm glide hole and a 3.2 mm thread hole were drilled under navigation guidance, to simulate drilling for the repa...
Dyson SJ.It was hypothesised that in solar bone images of the front feet of clinically normal horses, or horses with lameness unrelated to the front feet, there would be less than a 10% difference in the ratio of uptake of radiopharmaceutical in either the region of the navicular bone, or the region of insertion of the deep digital flexor tendon (DDFT), compared to the peripheral regions of the distal phalanx. Nuclear scintigraphic examination of the front feet of 15 Grand Prix show jumping horses, all of which were free from detectable lameness, was performed using dorsal, lateral and solar images. Th...
Keegan KG, Twardock AR, Losonsky JM, Baker GJ.Retrospective radiographic and scintigraphic analyses were performed on 27 fractures of the distal phalanx in 25 horses. Location of 99mtechnetium methylene diphosphonate (99mTc-MDP) uptake was compared with fracture line location as seen on radiography. Intensity (intense, moderate, mild) and pattern (focal, diffuse) of 99mTc-MDP uptake was recorded and compared with duration of fracture. Nine horses were monitored during convalescence by obtaining additional scintigraphic views 3 to 68 months after injury. Palmar scintigraphic views had evidence of focal areas of increased 99mTc-MDP uptake t...
Johnson KA, Smith FW.Lag screw fixation using single 4.5 mm cortical bone screws is a recommended technique for repair of mid-sagittal plane fractures of the distal phalanx in adult horses. However, implant infection and technical difficulties in obtaining adequate interfragmentary compression have made this surgical procedure somewhat controversial. We hypothesized that use of larger diameter screws would result in increased axial compression and improved stability of this fracture. Paired distal phalanges from the forelimbs of 10 adult horses were collected at necropsy and divided in half in the midsagittal plan...
Eustace RA, Caldwell MN.This paper describes the treatment of 10 horses suffering from acute laminitis using the heart bar shoe and a dorsal hoof wall resection technique. All cases had progressed to prolapse of the tip of the pedal bone covered by solar corium through the horny sole; in one case the exposed tip of the distal phalanx became visible. Nine cases of distal phalangeal rotation and one case of distal displacement of the distal phalanx (sinking) are described. Two animals were destroyed because of the degree of lameness, one remains slightly lame at the trot and the remaining seven have returned to their p...
Taylor DD, Hood DM, Potter GD, Hogan HA, Honnas CM.To evaluate patterns of digital cushion (DC) displacement that occur in response to vertical loading of the distal portion of the forelimb in horses. Sample Population-Forelimbs from 10 horses with normal feet. Methods: Patterns of DC displacement induced by in vitro vertical limb loading were determined. Load-induced displacement of the DC was defined as the magnitude and direction of displacement of 6 radio-dense, percutaneously implanted markers in specific regions of the DC. The effects of solar support and nonsupport on displacement of the DC were compared. Results: Regional displacement ...
Peter VG, O'Keeffe TA, Smith LCR, Schweizer-Gorgas D. To investigate the racing performance of Thoroughbred horses with osseous cyst-like lesions (OCLLs) in the distal phalanx causing lameness and treated conservatively. To assess horses' ability to race and perform after radiographic identification of OCLL in the distal phalanx of Thoroughbred horses with lameness at the time of detection and undergoing conservative treatment. Retrospective case control study. The clinical database of one equine clinic was reviewed in a 10-year period for Thoroughbreds showing lameness localized to the foot and a radiographic diagnosis of OCLL in the distal ...
Dyson S, Brown V, Collins S, Murray R.Associations between degree of ossification of the cartilages of the foot and injuries to other structures of the foot have been suggested, but have not been investigated by large scale studies. Objective: To describe the frequency of grade >3 ossification of the cartilages of the foot (possibly significant ossification, PSO), mediolateral symmetry of ossification and left-right symmetry between feet; and to investigate associations between PSO and injury of either the collateral ligaments (CLs) of the distal interphalangeal (DIP) joint or the distal phalanx. Objective: Possibly significant os...
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...
Burd MA, Craig JJ, Craig MF.Digital radiographs are often used to subjectively assess the equine digit. Recently, quantitative and objective radiographic measurements have been reported that give new insight into the form and function of the equine digit. We investigated a radio-dense curvilinear profile along the distal phalanx on lateral radiographs we term the Palmar Curve (PC) that we believe provides a measurement of the concavity of the distal phalanx of the horse. A second quantitative measurement, the Palmar Metric (PM) was defined as the percent area under the PC. We correlated the PM and age from 544 radiograph...
Berry CR, O'Brien TR, Pool RR.Squamous cell carcinoma of the hoof wall, with resultant invasion of the right hind distal phalanx, was identified in a 15-year-old Thoroughbred stallion. The clinical features included a chronic grade 2/5 right hind limb lameness and a sessile dorsal hoof wall mass that was not sensitive to palpation. Radiography revealed a well-circumscribed circular lucency within the distal phalanx, beneath the clinically noticed hoof wall mass. These features were considered to be characteristic of a hoof wall keratoma. Surgical intervention was done 10 months later. The histologic diagnosis at the time o...
Trotter GW, McIlwraith CW, Norrdin RW, Turner AS.Degenerative joint disease of the proximal interphalangeal joint was diagnosed in 9 joint of 6 horses. All of the horses were 3 years old or younger and the affected joints were in the hindlimbs. Radiographic evidence of osteochondrosis involving the distal end of the proximal phalanx was apparent in 5 joints. Lameness and local soft tissue swelling were prominent in all cases. In 1 horse euthanatized tissues because of lameness, histologic examination of joint tissues revealed osteochondrosis as well as severe osteoarthritis. Surgical arthrodesis of the affected joint was performed on 2 horse...
Grenager NS.Endocrinopathic laminitis (EL) primarily occurs because of insulin dysregulation (ID) mediated through downstream effects of insulin on IGF-1R in lamellar tissues. There is likely contributing vascular and metabolic dysfunction within the lamellae, but EL is relatively non-inflammatory. EL is associated with lamellar stretching, proliferation, and failure, ultimately causing failure of the suspensory apparatus of the distal phalanx. Proper education regarding mitigating risk factors makes this a largely preventable cause of laminitis. Annual hoof evaluation plus screening geriatric horses for ...
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...
Nagy A, Dyson SJ, Murray RM.Increased radiopharmaceutical uptake (IRU) in the palmar processes of the distal phalanx is recognised but its clinical significance has not been established. Objective: To investigate the relationship between radiographic, scintigraphic and MRI findings in the palmar processes of the distal phalanx. Objective: Increased radiopharmaceutical uptake in the palmar processes of the distal phalanx is associated with MRI abnormalities; IRU and MRI abnormalities are over-represented in lame limbs. Methods: Clinical data, radiographic, scintigraphic and MRI findings of 258 horses with unilateral or bi...
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),...
Chateau H, Degueurce C, Denoix JM.To develop a method that allows quantification of the 3 anatomic rotations in the digital joints of moving horses and measure these rotations when horses are walking in a straight line on a hard track. Methods: 4 healthy French Trotter horses. Methods: Triads of ultrasonic kinematic markers were surgically linked to the 4 distal segments of the digits of the left forelimb of each horse. Three-dimensional (3-D) coordinates of these markers were recorded in horses walking in a straight line. The three angles of rotation of each digital joint were calculated by use of a joint coordinate system as...
Smith DR, Leach DH, Bell RJ.Anatomical anomalies in the hind feet of a seven month old Appaloosa foal were identified and investigated through the use of gross anatomical dissection, radiography and angiography. Abnormalities were restricted to the distal aspect of both hind legs, the right hind leg being more severely affected. Anatomically the right foot resembled that of an equine fetus of approximately 120 days gestational age. Disruption of vascular perfusion to hoof structures was evident in both hind legs and was related to areas of abnormal bone conformation as well as to areas of abnormal ossification and calcif...
Ruohoniemi M, Laukkanen H, Ojala M, Kangasniemi A, Tulamo RM.The ossification of the collateral cartilages of the distal phalanx was evaluated in dorsopalmar radiographs of the front feet of 202 Finnhorses (101 females and 101 males, aged six months to 20 years) with reference to the sex, age, body measurements and type of horse. Ossification was more common and more extensive in females than in males from about two years of age. In females, the lateral cartilages were significantly more ossified than the medial cartilages; in males, ossification was more symmetrical in the cartilages of each foot. The amount of ossification increased rapidly during the...
Butcher MT, Bertram JE, Benzuidenhout AJ.The distal forelimb of the horse has a complex array of ligaments that play a critical role in determining function of the digit and are often associated with the initiation of foot pathologies. The collateral ligaments of the distal sesamoid bone (CLDS) play an important role in digit stabilization near the end of foot contact and there is also limited evidence to suggest that the CLDS stabilize the proximal interphalangeal joint (PIPJ) during weight bearing. By virtue of their anatomical attachments where the ligaments pass dorsal to the axis of rotation of the PIPJ, it is reasonable to assu...
