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.
Trimming and shoeing the chronically affected horse. Several of the technical approaches applied to the foot overlap with regard to intent. Frog or solar support, for example, may be provided either to stabilize the distal phalanx within the hoof capsule or in an effort to unload regional pain arising from the solar surface of the foot. It is likewise obvious that some techniques such as lowering the heels to achieve phalangeal realignment and raising the heels to relieve deep digital flexor tendon tension are contradictory. In these instances, it is not that one technique is always correct but that differences exist among horses. Currently, it ...
Treatment of acute laminitis. Supportive therapy. Over the last decade, both the farriery and veterinary professions have greatly increased their collective experience and understanding of the treatment of acute laminitis. Many horses that would have not been considered candidates for treatment 10 to 15 years ago are now saved, and some progress to successful careers as athletes. Unfortunately, the difficulties over prediction of the course of the disease persist, which continues to complicate treatment decisions. By its nature, supportive therapy is designed to make the horse more comfortable and limit further laminar injury by countering ad...
Detection of a radiographically occult fracture of the lateral palmar process of the distal phalanx in a horse using computed tomography. A horse with a suspected injury of the distal phalanx was examined using radiography at day two and 19 after the onset of the lameness, with no definite diagnosis. Using computed tomography an incomplete fracture of the lateral wing of the distal phalanx was diagnosed at day 25. Based on computed tomography it was determined that the fracture probably did not enter the joint or involve the palmar cortex throughout its length which were of prognostic importance. The day following the CT examination a new oblique radiographic projection was made. In this radiography which was based on, and never...
In vitro attenuation of impact shock in equine digits. 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...
Digital perfusion, evaluated scintigraphically, and hoof wall growth in horses with chronic laminitis treated with egg bar-heart bar shoeing and coronary grooving. 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 ...
Septic osteitis of the distal phalanx: findings and surgical treatment in 18 cases. Eighteen cases of septic osteitis of the distal phalanx were diagnosed clinically and confirmed at surgery over a 6 year period (1990-1996). Focal bone lysis was the most common radiographic finding. Sequestra were identified in 4 horses, one of which was associated with a fractured plantar process. All the horses were treated surgically with open debridement. The septic process recurred in 4 horses: one was subjected to euthanasia due to navicular bursa infection, secondary to a pathological fracture, the other 3 horses responded to further debridement. A pathological fracture occurred in ano...
Radiographic assessment of equine interphalangeal joints asymmetry: articular impact of phalangeal rotations (Part I). 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 on a rotation support to study the influence of induced foot rotations on several angles measured from specific radiographs. The results of this work enabled the authors to quantify the rotation of the proximal phalanx compared to the distal, and to determine exactly the possible rotation in the distal interphalangeal joint. It was also observed that, faced with a forced rotation of the foot, t...
Radiographic assessment of equine interphalangeal joints asymmetry: articular impact of asymmetric bearings (Part II). 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...
Effect of three types of half-limb casts on in vitro bone strain recorded from the third metacarpal bone and proximal phalanx in equine cadaver limbs. To determine effect of 3 half-limb casts on bone strains recorded from the proximal phalanx (P-1) and third metacarpal bone (MCIII) of equine cadaver limbs, using a mechanical testing machine. Methods: 12 equine cadaver limbs and 4 live horses. Methods: Bone strains were recorded at middorsal P-1 and the dorsal cortical aspect of the distal third of MCIII while limbs were variably loaded with 100 to 1,000 lb of force. To determine ability of the cast to protect the distal portion of the limb from weight-bearing loads, strains were recorded with the limb in 1 of the 3 casts and with it unsuppor...
Functional anatomy of the cartilage of the distal phalanx and digital cushion in the equine foot and a hemodynamic flow hypothesis of energy dissipation. 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...
Radiographic appearance of the navicular bone and distal interphalangeal joint and their relationship with ossification of the collateral cartilages of the distal phalanx in Finnhorse cadaver forefeet. 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 ...
Effect of different full-limb casts on in vitro bone strain in the distal portion of the equine forelimb. To determine the ability of a full-limb transfixation pin cast to protect the distal portion of the equine forelimb from weight-bearing forces by measuring bone strain in vitro on cadaver limbs loaded in a mechanical testing machine. Methods: 6 forelimbs from 6 horses. Methods: Each limb was instrumented with 3 unidirectional metal foil electrical resistant strain gauges. Gauges were placed on the dorsal aspect of the distal portion of the radius and the mid-dorsal portion of the cortex of the third metacarpal bone and the first phalanx. Each limb was tested 3 times, once supported with a tran...
Evaluation of the variably ossified collateral cartilages of the distal phalanx and adjacent anatomic structures in the Finnhorse with computed tomography and magnetic resonance imaging. 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...
Management of a transverse fracture in the distal phalanx of a horse. A yearling horse was presented with a septic, transverse fracture in the frontal plane of the distal phalanx. The fracture fragment was surgically removed from the parent bone via the sole. The foot was managed by corrective farriery and the horse was able to be ridden for pleasure.
[Anatomy of the fetlock joint in horses by means of joint casts]. The equine fetlock joint cavity shows ten pouches. The dorsal recess, which is oriented to the proximal side, is separated from those three pouches, which show to the distal direction, by several capsular folds. These folds are documented by means of sagittal sections through the fetlock joint. A medial/lateral recess is covered by the deep part of the collateral ligament of the fetlock joint. The collateral ligaments as well as the sesamoidean collateral ligaments are closely connected with the joint capsule, from which two capsular folds are separated. Between the part of the sesamoidean col...
Lag screw fixation of an extensor process fracture in a foal with flexural deformity. 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.
Anatomy of the distal interphalangeal joint of the mature horse: relationships with navicular suspensory ligaments, sensory nerves and neurovascular bundle. The anatomy of the distal interphalangeal (DIP) joint in the adult horse is described in relationship to the suspensory ligaments of the navicular bone, the neurovascular bundle and the sensory nerves to these periarticular regions. Using polymer plastic injections, the synovial cavity of the DIP joint was observed to have a complex relationship to the proximal suspensory or collateral sesamoidean ligament (CSL) of the navicular bone with the cavity forming cranial and caudal compartments around the CSL abaxially. Sensory nerves, as identified by peptide immunocytochemistry and silver/gold chl...
Effects of sex and age on the ossification of the collateral cartilages of the distal phalanx of the Finnhorse and the relationships between ossification and body size and type of horse. 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...
Treatment of a comminuted frontal-plane fracture of the distal phalanx in a horse. Successful treatment of a comminuted frontal plane fracture of the distal phalanx in a horse is described. The bone fractured through the solar canal, close to the insertion of the deep digital flexor tendon. A hoof case was used to reduce bending and tensile stresses on the solar surface by limiting expansion of the hoof wall during weightbearing. In addition, the heel was elevated, using 3 degrees wedge pads incorporated within the hoof cast, to reduce distraction at the fracture site caused by the pull of the deep digital flexor tendon. Two casts were used over a 4-month period. Complete ra...
Accessory ossification centres associated with osteochondral fragments in the extremities of horses. Fifty-six tarsocrural joints and 94 metatarsophalangeal joints were examined, at necropsy, from horses aged < or = 2 years. Osteochondral fragments at the cranial aspect of the intermediate ridge of the distal part of the tibia were seen in six horses, and at the proximoplantar aspect of the proximal phalanx in seven horses. Defects in the proximoplantar aspect of the proximal phalanx without osteochondral fragments were seen in a further two horses. Inflammatory and degenerative changes were not observed in any of the joints examined. From the incidence and natural course of these fragment...
Effects of tendon grip technique (frozen versus unfrozen) on in vitro surface strain measurements of the equine deep digital flexor tendon. To determine effects of tendon grip technique on in vitro surface strain measurements of equine deep digital flexor tendon (DDFT) when loaded in tension. Methods: 12 hind limb DDFT from 8 adult horses (mean age, 9.8 years [range, 4.5 to 17 years]; mean body weight, 472 kg [range, 450 to 509 kg]), with no clinical evidence of hind limb lameness. Methods: After calibration, liquid mercury strain gauges were sutured to plantar surfaces of the tendons at distal (position 1), middle (position 2), and proximal (position 3) metatarsal regions. Each tendon was affixed to a materials testing machine (d...
An unusual case of distal phalanx fracture in a horse. A mature thoroughbred cross gelding with an acute onset forelimb lameness was found to have sustained a fracture to the distal phalanx. The fracture traversed the distal phalanx In a lateromedial direction dividing the phalanx into two halves, dorsally and palmarly and was classed a frontal fracture. The horse was treated conservatively and after 14 months rest it returned to work. Three years later the horse has remained sound.
[Scanning electron microscopy of the synovial membrane of the distal phalangeal joint and the navicular bursa in horses]. 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...
Vascular supply of the tendon of the equine deep digital flexor muscle within the digital sheath. The vascular and microvascular anatomy of the equine deep digital flexor tendon (DDFT) within the digital sheath was studied by injecting the vasculature with either colored latex or barium sulphate for radiographic, microangiographic, histologic, and computed tomographic (CT) evaluation. Consecutive 4-mm thick two-dimensional CT slice data were reconstructed to 3-dimensional volumetric images to enhance spatial evaluation of the blood supply. Gross dissection and angiographic studies identified three major vascular sources. Above the fetlock, the DDFT was supplied by either a branch of the me...
Bilateral hind limb hypoplasia in a foal. Hypoplasia affecting both hind limbs was observed in a neonatal foal. Scintigraphy aided in establishing diagnosis and prognosis. Radiography revealed an abnormally shaped middle phalanx and lack of the distal phalanx and navicular bone in the right hind limb, with an abnormally shaped distal phalanx and navicular bone in the left hind limb. Scintigraphic findings were closely correlated with the radiographic findings. Radiographic and scintigraphic findings were confirmed at postmortem examination.
Vascular perfusion in horses with chronic laminitis. Vascular perfusion casts were used to define and characterise the macroscopic perfusion defects present in the distal digit of 11 horses affected by chronic laminitis. Five clinically normal horses were used as controls. Based on clinical history and clinical status, horses with chronic laminitis were classified as being potentially treatable or clinically refractory. Eleven macroscopic vascular defects were noted in the casts from horses with laminitis. Four types of lesions were identified in the submural laminar circulation, 3 in the coronary bed and 4 were associated with the solar circula...
Characterisation of osseous bodies of the distal phalanx of foals. The distal phalanx and metacarpal physis of both forelimbs of 32 Thoroughbred foals 3-32 weeks of age were radiographed to identify those limbs with osseous bodies at a palmar process (PP) of the distal phalanx. Osseous bodies (ossicles) were identified radiographically in 19% of the foals. Sixteen of the 32 foals were selected for microradiographic and histological evaluation: 6 foals with radiographic evidence of ossicles and 10 foals without. Fourteen ossicles of the PP were observed radiographically. Ossicles were either a triangular bone fragment at the palmar aspect of the distal angle o...
Scintigraphic evaluation of fractures of the distal phalanx in horses: 27 cases (1979-1988). 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...
Qualitative and morphometric radiographic findings in the distal phalanx and digital soft tissues of sound thoroughbred racehorses. Lameness examinations and radiography of the distal phalanx and associated soft-tissue structures of the front feet of 103 Thoroughbred racehorses, 4 to 9 years old, were performed to determine normal radiographic appearance and morphometry. Of 103 horses examined, 41 were used in the study that were without clinical signs of foot problems or lameness, had raced at least twice prior to radiography, and had raced at least twice more in the 6 months after radiography. Lateromedial and dorsoproximal-palmarodistal radiographic views of each front distal phalanx were used to measure 28 bone and sof...