Topic:Distal Phalanx
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.
Comparison of intraosseous and intravenous infusion of technetium Tc 99m pertechnate in the distal portion of forelimbs in standing horses by use of scintigraphic imaging. To describe and compare the distribution of technetium Tc 99m (99mTc) pertechnate following intraosseous or i.v. injection (with or without use of a tourniquet) in the distal portion of the forelimb in standing horses. Methods: 4 horses. Methods: Each horse received 4 forelimb treatments in random sequence: intraosseous infusion with tourniquet application (IOT), intraosseous infusion without tourniquet application, i.v infusion with tourniquet application (IVT), and i.v. infusion without tourniquet application. Dynamic nuclear scintigraphic imaging of the third metacarpal bone, proximal and m...
Evaluation of displacement of the digital cushion in response to vertical loading in equine forelimbs. 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 ...
Comparison of computer-assisted surgery with conventional technique for the treatment of axial distal phalanx fractures in horses: an in vitro study. To compare the precision obtained with computer-assisted screw insertion for treatment of mid-sagittal articular fractures of the distal phalanx (P3) with results achieved with a conventional technique. Methods: In vitro experimental study. Methods: Thirty-two cadaveric equine limbs. Methods: Four groups of 8 limbs were studied. Either 1 or 2 screws were inserted perpendicular to an imaginary axial fracture of P3 using computer-assisted surgery (CAS) or conventional technique. Screw insertion time, predetermined screw length, inserted screw length, fit of the screw, and errors in placement wer...
Deep digital flexor tendon force and digital mechanics in normal ponies and ponies with rotation of the distal phalanx as a sequel to laminitis. Previous studies have implicated tension in the deep digital flexor tendon (DDFT) in the rotation of the distal phalanx (DP) after the breakdown of the dorsal laminae caused by laminitis. Howeveer, once the DP has rotated, the DDFT should become shorter, reducing the force it exerts on the DP. Objective: To compare DDFT force and ground reaction forces (GRFs) in normal ponies and ponies with rotation of the DP as a sequel to laminitis. Methods: Six normal ponies (Group 1) and 6 sound ponies with 6-13 degrees of rotation of the DP in relation to the dorsal hoof wall (Group 2) were assessed at t...
Injury of the collateral ligaments of the distal interphalangeal joint diagnosed by magnetic resonance. We describe the clinical, imaging, and necropsy findings of two horses with severe injury of the collateral ligaments of the distal interphalangeal (DIP) joint diagnosed using magnetic resonance (MR) imaging. In MR images it was possible to examine the collateral ligaments of the DIP joint from the origin at the middle phalanx to the insertion on the distal phalanx. Both horses in this report had abnormal high signal intensity within the collateral ligaments of the DIP joint, and one horse had abnormal high signal intensity within the bone of the distal phalanx on short tau inversion recovery ...
Bipartite distal phalanx and navicular bone in an Andalusian stallion. We describe the clinical findings and radiographic abnormalities of a horse with a bipartite distal phalanx and a bipartite navicular bone of the right forelimb. Associated findings including suspected keratoma and degenerative joint disease of the distal interphalangeal joint are described and possible etiologies are discussed.
Three-dimensional kinematics of the equine distal forelimb: effects of a sharp turn at the walk. Sharp turns are suspected to increase expression of several distal forelimb lamenesses even at the walk but the biomechanical consequences of such a movement remain unknown. Objective: To quantify the effects of a sharp turn at the walk on the 3-dimensional movements of the distal segments of the forelimb. Methods: Kinematics of the distal segments were measured in 4 healthy horses invasively with an ultrasonic system. Three-dimensional rotations of the digital joints were calculated by use of a joint coordinate system. Data obtained for a turn at the walk were compared to those obtained in a ...
Ultrasonography of the solar aspect of the distal phalanx in the horse. Ultrasonographic examinations were performed on the solar aspect of the distal phalanx of 10 feet of five normal live horses (Group 1), 22 feet of seven normal cadavers (Group 2), and nine feet of five horses with pathology of the dorsal solar aspect of the distal phalanx (Group 3). Lateromedial radiographs of the distal phalanx were made in all groups, and in Group 2, digits were sagitally sectioned after imaging. The ultrasonographic and radiographic appearance of the sagittal solar aspect of the distal phalanx was described. Measurements of the distance between the sole and the distal tip o...
Relationship of foot conformation and force applied to the navicular bone of sound horses at the trot. Collapsed heels conformation has been implicated as causing radical biomechanical alterations, predisposing horses to navicular disease. However, the correlation between hoof conformation and the forces exerted on the navicular bone has not been documented. Objective: The angle of the distal phalanx in relation to the ground is correlated to the degree of heel collapse and foot conformation is correlated to the compressive force exerted by the deep digital flexor tendon on the navicular bone. Methods: Thirty-one shod Irish Draught-cross type horses in routine work and farriery care were trotte...
Arthroscopic debridement of subchondral bone cysts in the distal phalanx of 11 horses (1994-2000). Historically, there has been a consensus that conservative management of subchondral cystic lesions of the distal phalanx carries a poor prognosis. Surgical management has been advocated; however, there are no reports documenting its routine use and successful surgical treatment. Objective: To describe arthroscopically-guided curettage of distal phalangeal subchondral cystic lesions (SCLs) and report the qualitative and quantitative results in 11 affected horses age 16-33 months. Methods: Medical records of horses with previously treated lameness resulting from SCLs of the third phalanx were r...
Evaluation of three-dimensional kinematics of the distal portion of the forelimb in horses walking in a straight line. 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...
Magnetic resonance imaging of the equine digit with chronic laminitis. 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...
Form and function of the equine digit. The list of possible diagnoses derived from matching anatomic structures or tissues to pathologic processes is inevitably broad in nature. Understanding and observation of distal limb function, conformation, and balance is the basis of identifying where the greatest abnormal stresses within the distal limb are likely to occur. This is key to focusing the diagnostic process and, in some instances, to treating the horse when a definitive diagnosis cannot be achieved.
Axial compression generated by cortical and cancellous lag screws in the equine distal phalanx. 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...
Force- and moment-generating capacities of muscles in the distal forelimb of the horse. A detailed musculoskeletal model of the distal equine forelimb was developed to study the influence of musculoskeletal geometry (i.e. muscle paths) and muscle physiology (i.e. force-length properties) on the force- and moment-generating capacities of muscles crossing the carpal and metacarpophalangeal joints. The distal forelimb skeleton was represented as a five degree-of-freedom kinematic linkage comprised of eight bones (humerus, radius and ulna combined, proximal carpus, distal carpus, metacarpus, proximal phalanx, intermediate phalanx and distal phalanx) and seven joints (elbow, radiocarp...
Retrospective evaluation of equine prepurchase examinations performed 1991-2000. Prepurchase examinations of horses are used increasingly as a means of evaluating future soundness. Data is lacking in the literature of the radiographic findings and results of the lameness examination of comprehensive prepurchase examinations. Objective: To summarise the clinical and radiographic findings of prepurchase examinations and determine if radiographic findings correlated with the lameness examination and sale outcome. Methods: Records of 510 cases were reviewed, radiographs evaluated and grades assigned the navicular bone, distal phalanx, and tarsus. Follow-up information on the h...
Unilateral white line disease and laminitis in a quarter horse mare. A 5-year-old quarter horse mare presented with unilateral, severe, chronic forelimb lameness. Radiographs revealed extensive hoof wall separation and capsular rotation of the distal phalanx. Treatment included dorsal hoof wall resection, phenylbutazone, a bar shoe, and stall rest. Whether white line disease or laminitis was the primary lesion remains unclear.
Magnetic resonance imaging of the equine foot: 15 horses. Foot pain is a common cause of equine lameness and there have been significant limitations of the methods available for the diagnosis of the causes of foot pain (radiography, nuclear scintigraphy and ultrasonography). Until recently, magnetic resonance imaging (MRI) in the horse has been limited to examination of cadaver limbs. Objective: Our purpose was to 1) describe MRI of the foot in live horses, 2) describe MRI findings in horses with foot pain in which a definitive diagnosis could not be established by alternative means and 3) correlate MRI findings with other methods of clinical investi...
[The effect of a treatment protocol on the prognosis of equine laminitis]. All horses and ponies with laminitis treated at the Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, between 1995 and 1998 were analysed retrospectively (n = 152). Based on the results of this study and on the world-wide knowledge on laminitis a standardised treatment protocol was adopted in 1999. Fifty-eight patients have been treated for laminitis between 1999 and 2001 following the treatment protocol. Compared to our hospital-population (orthopaedic patients), mares and ponies are at higher risk developing laminitis, but the prognosis does not differ betwee...
Collateral cartilage ossification of the distal phalanx in the Brazilian Jumper horse. Collateral cartilage ossification of the distal phalanx in the Brazilian Jumper horse is a common finding. The objective of this study was to evaluate the prevalence and the degree of ossification of the collateral cartilages of the distal phalanx in Brazilian Jumper horses. In an analysis of 652 collateral cartilages from the front feet of 163 horses, 93% of these cartilages had collateral cartilage ossification (P < 0.005), and 7% of these cartilages did not have any type of ossification. In ossified cartilages, 86.4% had ossification beginning from the base, and 6.6% had a separate cente...
Subjective and quantitative scintigraphic assessment of the equine foot and its relationship with foot pain. 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...
Fusion of the distal sesamoid and distal phalanx in a yearling colt. This paper describes a rare malformation of the distal portion of the left foredigit of a 15-month-old half-bred colt which was severely lame. Radiological, pathological and tomographic studies revealed hypoplasia of the metacarpophalangeal skeleton, absence of the distal sesamoid and deformation of the distal phalanx. Morphological analysis of the lesion and computerised measurement of the width of the articular surface of the distal phalanx suggested an early fusion between the distal sesamoid and distal phalanx.
Evaluation of tachykinins and their receptors to determine sensory innervation in the dorsal hoof wall and insertion of the distal sesamoidean impar ligament and deep digital flexor tendon on the distal phalanx in healthy feet of horses. To localize substance P (SP) and neurokinin A (NKA) and their receptors in the insertion of the distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), and dorsal hoof wall of healthy feet of horses. Methods: 18 healthy feet from horses. Methods: Samples from the dorsal hoof wall and insertion of the DSIL and DDFT of 10 feet were processed for immunocytochemical analysis, using rabbit polyclonal antisera raised against SP and NKA. Tissue sections from 8 feet were incubated with 125-labeled SP to localize tachykinin receptors and their specificity and with control solutions...
Ultrasonography of the podotrochlear apparatus in the horse using a transcuneal approach: technique and reference images. 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...
Effect of contact stress in bones of the distal interphalangeal joint on microscopic changes in articular cartilage and ligaments. To examine articular cartilage of the distal interphalangeal (DIP) joint and distal sesamoidean impar ligament (DSIL) as well as the deep digital flexor tendon (DDFT) for adaptive responses to contact stress. Methods: Specimens from 21 horses. Methods: Pressure-sensitive film was inserted between articular surfaces of the DIP joint. The digit was subjected to a load. Finite element models (FEM) were developed from the data. The navicular bone, distal phalanx, and distal attachments of the DSIL and DDFT were examined histologically. Results: Analysis of pressure-sensitive film revealed signific...
Morphology of the laminar junction in relation to the shape of the hoof capsule and distal phalanx in adult horses (Equus caballus). The purpose was to investigate whether differences in equine hoof shape, which are inferred to alter foot function, are accompanied by differences in morphology of the laminar junction. Ten fore feet from adult horses were segregated into normal and low-angle groups, depending on the dorsal angle of the hoof wall. Twenty measurements of external hoof shape and four of the enclosed distal phalanx were tested for differences between groups, and for intragroup correlations. Three measurements of laminar morphology (spacing, orientation and degree of bend) were recorded for samples of up to 50 pri...
Removal of large fragments of the extensor process of the distal phalanx via arthrotomy in horses: 14 cases (1992-1998). To evaluate the outcome of horses with large fragments of the extensor process of the distal phalanx that were removed by use of arthrotomy. Methods: Retrospective study. Methods: 14 horses with large fragments of the extensor process of the distal phalanx. Methods: Medical records for horses with large fragments of the extensor process that were removed by use of arthrotomy were reviewed. Data retrieved from medical records included signalment, use of horse, affected limb, lameness history, lameness examination findings, radiographic findings, surgical technique, and outcome. Follow-up evalua...
In vitro transmission and attenuation of impact vibrations in the distal forelimb. 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...
Nonsurgical management of type II fractures of the distal phalanx in 48 standardbred horses. To evaluate nonsurgical management of type II fractures of the distal phalanx in Standardbred horses. Methods: Retrospective study of 48 affected horses. Results: Most fractures occurred on the lateral palmar process of the left forelimb or the medial palmar process of the right forelimb; 81% of horses were considered sound enough to return to training and 63% raced. Of those returning to racing, 41% competed in > 10 races, 37% in 2 to 10 races and 22% in only 1 race. There was no difference in performance before and after fracture. Twenty-four of 25 horses had a bar shoe fitted for > 50...
The digital pathologies of chronic laminitis. This review indicates that the patient-to-patient uniqueness commonly seen in chronic laminitis represents the variable presence of the digital pathologies. Although some degree of mechanical failure is always present, the secondary metabolic and growth dysplasias, vascular pathologies, and sepsis may or may not be evident. The presence and severity of these pathologies appear to have a more significant impact on the prognosis of individual cases than does the displacement of the distal phalanx. It should be reiterated that it is often the combined presence of these individual pathologies that...