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Topic:Equine Diseases

Equine diseases encompass a wide range of health conditions that can affect horses, including infectious diseases, metabolic disorders, and genetic conditions. These diseases can impact the overall health, performance, and well-being of horses. Common equine diseases include equine influenza, equine herpesvirus, laminitis, and equine metabolic syndrome. Diagnosis and management of these diseases often require a combination of clinical evaluation, laboratory testing, and appropriate treatment strategies. This page gathers peer-reviewed research studies and scholarly articles that explore the etiology, pathophysiology, diagnosis, and treatment options for various equine diseases, providing valuable insights for veterinarians and researchers in the field.
Viral testing of 10 cases of Theiler’s disease and 37 in-contact horses in the absence of equine biologic product administration: A prospective study (2014-2018).
Journal of veterinary internal medicine    December 6, 2018   Volume 33, Issue 1 258-265 doi: 10.1111/jvim.15362
Tomlinson JE, Tennant BC, Struzyna A, Mrad D, Browne N, Whelchel D, Johnson PJ, Jamieson C, Löhr CV, Bildfell R, McKenzie EC, Laverack M, Renshaw RW....A novel equine parvovirus (EqPV-H) was recently discovered in the equine liver with Theiler's disease. Objective: To determine the prevalence of EqPV-H infection in naturally occurring Theiler's disease cases and in-contact horses in the absence of historical equine biologic product administration. Methods: Ten cases of Theiler's disease from 6 separate properties were included in the study, based on the criteria of acute onset of clinical signs of liver failure with laboratory or histopathologic findings characteristic of Theiler's disease and no history of receiving an equine biologic produc...
Strangles, convalescent Streptococcus equi subspecies equi M antibody titers, and presence of complications.
Journal of veterinary internal medicine    December 6, 2018   Volume 33, Issue 1 275-279 doi: 10.1111/jvim.15388
Delph KM, Beard LA, Trimble AC, Sutter ME, Timoney JF, Morrow JK.Streptococcus equi subspecies equi infection elicits M protein antibody titers in equids. Interpretation of titers is not generally accepted. Objective: The magnitude of S. equi M protein (SeM) antibody titer after infection (titer ≥1:12 800) will be useful to monitor for the presence of complications or the risk of development of complications. Methods: Forty-eight horses on 1 farm involved in strangles outbreak. Methods: Clinical and observational study. S. equi M protein antibody titers were measured on all horses 8 weeks after infection and select horses 12 and 28 weeks after infecti...
Allergen-specific immunoglobulin E in sera of horses affected with insect bite hypersensitivity, severe equine asthma or both conditions.
Journal of veterinary internal medicine    December 6, 2018   Volume 33, Issue 1 266-274 doi: 10.1111/jvim.15355
Verdon M, Lanz S, Rhyner C, Gerber V, Marti E.Genetic, epidemiologic, and clinical evidence suggests that, in horses, there are manifestations of hypersensitivity that can occur together. Objective: To investigate whether concurrent insect bite hypersensitivity (IBH) and severe equine asthma (EA) is associated with higher allergen-specific and total serum immunoglobulin E (IgE) concentrations than only EA or IBH. Methods: Healthy control horses (C, n = 40), horses with IBH (IBH, n = 24), severe EA (EA, n = 18), and both conditions (IBH/EA, n = 23) were included. Methods: In our retrospective comparative study, sera from ho...
Viral testing of 18 consecutive cases of equine serum hepatitis: A prospective study (2014-2018).
Journal of veterinary internal medicine    December 5, 2018   Volume 33, Issue 1 251-257 doi: 10.1111/jvim.15368
Tomlinson JE, Kapoor A, Kumar A, Tennant BC, Laverack MA, Beard L, Delph K, Davis E, Schott Ii H, Lascola K, Holbrook TC, Johnson P, Taylor SD....Three flaviviruses (equine pegivirus [EPgV]; Theiler's disease-associated virus [TDAV]; non-primate hepacivirus [NPHV]) and equine parvovirus (EqPV-H) are present in equine blood products; the TDAV, NPHV, and EqPV-H have been suggested as potential causes of serum hepatitis. Objective: To determine the prevalence of these viruses in horses with equine serum hepatitis. Methods: Eighteen horses diagnosed with serum hepatitis, enrolled from US referral hospitals. Methods: In the prospective case study, liver, serum, or both samples were tested for EPgV, TDAV, NPHV, and EqPV-H by PCR. Results: Bot...
Antigen-specific CD4+ and CD8+ T-cell responses in PBMC from pony mares immunized with either native or recombinant zona pellucida vaccines.
Theriogenology    December 5, 2018   Volume 126 106-113 doi: 10.1016/j.theriogenology.2018.12.012
Joonè CJ, Schulman ML, Fosgate GT, Plagis TA, Crafford JE, Gupta SK, Bertschinger HJ.Few studies have investigated the cell mediated immune response during zona pellucida-based immunocontraception, despite hypothesized cytotoxic T-cell involvement in ovarian dysfunction associated with these vaccines. This study aimed to investigate antigen-specific anamnestic responses of helper (CD4) and cytotoxic (CD8) T-lymphocytes in peripheral blood mononuclear cells (PBMC) isolated from pony mares before and after their treatment with native porcine zona pellucida (pZP), recombinant pZP3 and pZP4 antigens (reZP) or adjuvanted saline. Mares were randomly assigned to pZP, reZP and control...
Factors associated with prolonged treatment days, increased veterinary visits and complications in horses with subsolar abscesses.
The Veterinary record    December 4, 2018   Volume 184, Issue 8 251 doi: 10.1136/vr.104138
Cole SD, Stefanovski D, Towl S, Boyle AG.There is a lack of epidemiological studies about equine subsolar (hoof) abscesses even though they are among one of the most common causes of acute, severe lameness. The goals of this study were to (1) describe the equine subsolar abscess patient population of the University of Pennsylvania's New Bolton Center's Field Service and (2) to determine the factors that are associated with increased veterinary visits, prolonged treatment and complications. Descriptive statistics were performed on data collected from 160 cases of equine subsolar abscess. Inferential statistics were performed on a subs...
Burkholderia mallei: The dynamics of networks and disease transmission.
Transboundary and emerging diseases    December 4, 2018   Volume 66, Issue 2 715-728 doi: 10.1111/tbed.13071
Cárdenas NC, Galvis JOA, Farinati AA, Grisi-Filho JHH, Diehl GN, Machado G.Glanders is a highly infectious zoonotic disease caused by Burkholderia mallei. The transmission of B. mallei occurs mainly by direct contact, and horses are the natural reservoir. Therefore, the identification of infection sources within horse populations and animal movements is critical to enhance disease control. Here, we analysed the dynamics of horse movements from 2014 to 2016 using network analysis in order to understand the flow of animals in two hierarchical levels, municipalities and farms. The municipality-level network was used to investigate both community clustering and the bala...
Neuromyotonia in a horse.
Journal of veterinary internal medicine    December 3, 2018   Volume 33, Issue 1 287-291 doi: 10.1111/jvim.15353
Zakia LS, Palumbo MIP, Teixeira RBC, Resende LAL, Soares MP, de Oliveira-Filho JP, Amorim RM, Borges AS.This article describes the clinical and electromyographic findings of neuromyotonia in a 19-month-old male crossbred Quarter Horse that presented with stiffness and muscle asymmetry in the hind limbs as well as sacrococcygeal, paravertebral, and gluteal myokymia. An electromyographic study showed spontaneous continuous muscle fiber activity with high-frequency discharges, fibrillations, positive sharp waves, fasciculation potentials, and complex repetitive discharges. Histological examination of the gluteal muscle showed a mixed neurogenic and myopathic pattern. The findings are consistent wit...
Molecular characterisation of equid alphaherpesvirus 1 strains isolated from aborted fetuses in Poland.
Virology journal    December 3, 2018   Volume 15, Issue 1 186 doi: 10.1186/s12985-018-1093-5
Matczuk AK, Skarbek M, Jackulak NA, Bażanów BA.Equid alphaherpesvirus 1 (EHV-1) is one of the main infectious causative agents of abortion in mares and can also be associated with stillbirth, neonatal foal death, rhinopneumonitis in young horses and a neurological disorder called equine herpesvirus myeloencephalopathy (EHM). The neuropathogenicity of the virus was shown to be significantly higher in EHV-1 strains that carry a single nucleotide point (SNP) mutation in the ORF30, which encodes a catalytic subunit of viral DNA polymerase (ORF30 D). Another gene, ORF68 is frequently used for phylogenetic analysis of EHV-1. 27 EHV-1 strains iso...
Factors associated with survival, laminitis and insulin dysregulation in horses diagnosed with equine pituitary pars intermedia dysfunction.
Equine veterinary journal    December 3, 2018   Volume 51, Issue 4 440-445 doi: 10.1111/evj.13041
Horn R, Bamford NJ, Afonso T, Sutherland M, Buckerfield J, Tan RHH, Secombe CJ, Stewart AJ, Bertin FR.Pituitary pars intermedia dysfunction (PPID) is a commonly described endocrine disorder in higher latitudes of the Northern hemisphere but the description of the disease at lower latitudes and in the Southern hemisphere is limited. Objective: Document the clinical features of PPID at different Australian latitudes and climates, and investigate factors associated with survival, laminitis and insulin dysregulation (ID). Methods: Retrospective study of 274 equids from eight institutions across Australia. Methods: A diagnosis of PPID was based on endogenous ACTH, overnight dexamethasone suppressio...
Usefulness of digital and optical refractometers for the diagnosis of failure of transfer of passive immunity in neonatal foals.
Equine veterinary journal    December 3, 2018   Volume 51, Issue 4 451-457 doi: 10.1111/evj.13040
Elsohaby I, Riley CB, McClure JT.Neonatal foals with failure of transfer of passive immunity (FTPI) are at higher risk of morbidity and mortality. Successful treatment of FTPI is time-dependent, thus rapid and accurate measurement of serum IgG concentration is important for the management and care of neonatal foals. Objective: To validate the use of digital and optical refractometers for assessing FTPI in neonatal foals and compare the diagnostic performance and level of agreement of the two refractometers to the reference standard radial immunodiffusion (RID) assay. Methods: A retrospective validation study. Methods: Serum s...
Vitrification of equine expanded blastocysts following puncture with or without aspiration of the blastocoele fluid.
Equine veterinary journal    December 3, 2018   Volume 51, Issue 4 500-505 doi: 10.1111/evj.13039
Wilsher S, Rigali F, Couto G, Camargo S, Allen WR.Historically, cryopreservation of equine embryos >300 μm gave poor pregnancy rates until researchers collapsed the blastocoele cavity and aspirated the blastocoele fluid prior to vitrification. Objective: To determine if aspiration of the blastocoele fluid prior to vitrification is essential for post warming survival. Methods: In vivo experiments. Methods: Fifty embryos were recovered on day 7-8 and washed in holding medium (HM; M-199HEPES + 20% FBS + antibiotics). Embryos were punctured using a micromanipulator mounted 30 μm biopsy needle; following this 28 had >90% of their bla...
MicroRNA characterization in equine induced pluripotent stem cells.
PloS one    December 3, 2018   Volume 13, Issue 12 e0207074 doi: 10.1371/journal.pone.0207074
Moro LN, Amin G, Furmento V, Waisman A, Garate X, Neiman G, La Greca A, Santín Velazque NL, Luzzani C, Sevlever GE, Vichera G, Miriuka SG.Cell reprogramming has been well described in mouse and human cells. The expression of specific microRNAs has demonstrated to be essential for pluripotent maintenance and cell differentiation, but not much information is available in domestic species. We aim to generate horse iPSCs, characterize them and evaluate the expression of different microRNAs (miR-302a,b,c,d, miR-205, miR-145, miR-9, miR-96, miR-125b and miR-296). Two equine iPSC lines (L2 and L3) were characterized after the reprogramming of equine fibroblasts with the four human Yamanaka's factors (OCT-4/SOX-2/c-MYC/KLF4). The plurip...
Quantitative Evaluation of Equine Articular Cartilage Using Cationic Contrast-Enhanced Computed Tomography.
Cartilage    December 2, 2018   Volume 12, Issue 2 211-221 doi: 10.1177/1947603518812562
Nelson BB, Stewart RC, Kawcak CE, Freedman JD, Patwa AN, Snyder BD, Goodrich LR, Grinstaff MW.To investigate the diffusion trajectory of a cationic contrast medium (CA4+) into equine articular cartilage, and to assess normal and degenerative equine articular cartilage using cationic contrast-enhanced computed tomography (CECT). In the first experiment (Exp1), equine osteochondral specimens were serially imaged with cationic CECT to establish the diffusion time constant and time to reach equilibrium in healthy articular cartilage. In a separate experiment (Exp2), articular cartilage defects were created on the femoral trochlea (defect joint) in a juvenile horse, while the opposite joint...
Differences in miRNA differential expression in whole blood between horses with sarcoid regression and progression.
Journal of veterinary internal medicine    December 2, 2018   Volume 33, Issue 1 241-250 doi: 10.1111/jvim.15375
Unger L, Jagannathan V, Pacholewska A, Leeb T, Gerber V.Currently no methods are available to predict the clinical outcome of individual horses with equine sarcoid (ES) disease. Objective: To investigate if whole blood microRNA (miRNA) profiles can predict the long-term development of ES tumors. Methods: Five horses with regression and 5 with progression of ES lesions monitored over 5-7 years and 5 control horses free of ES for at least 5 years. Methods: For this cohort study, RNA extracted from whole blood samples from the regression, progression, and control groups was used for high throughput sequencing. Known and novel miRNAs were identified us...
Simultaneous miRNA and mRNA Transcriptome Profiling of Differentiating Equine Satellite Cells Treated with Gamma-Oryzanol and Exposed to Hydrogen Peroxide.
Nutrients    December 2, 2018   Volume 10, Issue 12 1871 doi: 10.3390/nu10121871
Chodkowska KA, Ciecierska A, Majchrzak K, Ostaszewski P, Sadkowski T.Gamma-oryzanol (GO) is a popular supplement for performance horses, dogs, and humans. Previous studies indicated that GO supplementation decreases creatine kinase activity and lactate level after exercise and may affect oxidative stress in Thoroughbred horses. GO may change genes expression in equine satellite cells (ESC). The purpose of this study was to evaluate the effect of GO on miRNA, gene expression, oxidative stress, and cell damage and viability in differentiating ESC pretreated with hydrogen peroxide (H₂O₂). ESCs were obtained from a young horse's skeletal muscle. ESCs were pre-i...
Cloning and Expression of Immunogenic Regions of EMA-1 Gene of Theileria equi From Infected Horses.
Archives of Razi Institute    December 1, 2018   Volume 73, Issue 4 295-303 doi: 10.22092/ari.2017.110581.1132
Ebrahimi M, Hamidinejat H, Tanabandeh MR, Razi Jalali MH, Rasouli A.Diversity among the pathogenic strains of Theileria equi (T. equi), a major agent of equine piroplasmosis, can affect the appropriate detection of parasite and host immunization. Production of recombinant surface proteins from an infected horse in natural endemic area provides a reliable tool for immunodiagnosis of parasite. Regarding this, the present study was targeted toward the cloning, expression, and purification of the immunogenic regions of equine merozoite antigen 1 (EMA-1 gene), as one of the most important immunodominant surface proteins in T. equi, from naturally infected horses in...
Effect of cryopreservation techniques on proliferation and apoptosis of cultured equine ovarian tissue.
Theriogenology    December 1, 2018   Volume 126 88-94 doi: 10.1016/j.theriogenology.2018.11.034
Gastal GDA, Aguiar FLN, Ishak GM, Cavinder CA, Willard ST, Ryan PL, Feugang JM, Gastal EL.Preservation of cellular integrity and its mechanisms after ovarian tissue cryopreservation (OTC) and in vitro culture (IVC) procedures are crucial aspects for the success of preservation and recovery of female fertility. This study aimed to evaluate the effects of two cryopreservation methods (slow-freezing, SF, and vitrification, VIT) on the equine ovarian tissue after 1, 3, and 7 days of IVC by assessing: (i) preantral follicle morphology and distribution of follicle classes; (ii) protein expression of markers of cell proliferation for EGFR and Ki-67; (iii) markers of apoptosis for Bax and...
Meta-analysis of risk factors for racehorse catastrophic musculoskeletal injury in flat racing.
Veterinary journal (London, England : 1997)    December 1, 2018   Volume 245 29-40 doi: 10.1016/j.tvjl.2018.11.014
Hitchens PL, Morrice-West AV, Stevenson MA, Whitton RC.Studies of racehorse injury or fatality in various countries have identified common, and in some cases conflicting, risk factors. We conducted a systematic search of the relevant literature published from 1990 to 2017. Peer-reviewed articles were included if they reported the incidence of fatal or catastrophic musculoskeletal injury (CMI) in Thoroughbred flat races (n=21) or risk factors for CMI (n=65). Pooled effect sizes were estimated using the random-effects DerSimonian-Laird model. The pooled incidence of CMI was 1.17 (95% confidence interval 0.90, 1.44) per 1000 race starts. Almost 300 f...
Management factors and clinical implications of glandular and squamous gastric disease in horses.
Journal of veterinary internal medicine    November 29, 2018   Volume 33, Issue 1 233-240 doi: 10.1111/jvim.15350
Sykes BW, Bowen M, Habershon-Butcher JL, Green M, Hallowell GD.To date, risk factors for equine glandular gastric disease (EGGD) have not been described in Thoroughbred racehorses. Objective: To determine management factors associated with EGGD, identify clinical signs in affected horses, and compare these to equine squamous gastric disease (ESGD). Methods: The study was carried out on 109 Thoroughbred racehorses from 8 training yards (3 in the United Kingdom and 5 in Australia). Methods: Gastroscopic examination alongside a questionnaire regarding management, feeding, exercise, and health. Results: Management factors and clinical signs were different for...
The effect of insulin on equine lamellar basal epithelial cells mediated by the insulin-like growth factor-1 receptor.
PeerJ    November 29, 2018   Volume 6 e5945 doi: 10.7717/peerj.5945
Baskerville CL, Chockalingham S, Harris PA, Bailey SR.In horses and ponies, insulin dysregulation leading to hyperinsulinemia may be associated with increased risk of laminitis, and prolonged infusion of insulin can induce the condition. It is unclear whether insulin may have a direct or indirect effect on the lamellar tissues. Insulin is structurally related to insulin-like growth factor (IGF-1), and can bind the IGF-1 receptor, albeit at a lower affinity than IGF-1. Methods: Immunohistochemistry was performed on formalin-fixed lamellar tissue sections from six normal horses, euthanised for non-research purposes, using an anti-IGF-1 receptor ant...
Sequence and functional variability of Toll-like receptor 9 gene in equines.
Molecular immunology    November 28, 2018   Volume 105 276-282 doi: 10.1016/j.molimm.2018.10.010
Manuja A, Manuja BK, Singha H.Significant structural differences in the extracellular domain of toll-like receptor 9 (TLR9) account for species-specific recognition of its ligand CpG-ODN sequences. TLR9 is extensively studied in human, mice and some domestic animals. The recognition ability appears to be utilized differently by various species and breeds, but so far no comprehensive study exists about the equine TLR9 gene. We characterized TLR9 sequences of Marwari and Zanskari breeds of horses and Poitu donkey. We sequenced and identified the protein coding regions of equine TLR9 and compared with other animals and human ...
MicroRNA fingerprints in serum and whole blood of sarcoid-affected horses as potential non-invasive diagnostic biomarkers.
Veterinary and comparative oncology    November 28, 2018   Volume 17, Issue 1 107-117 doi: 10.1111/vco.12451
Unger L, Gerber V, Pacholewska A, Leeb T, Jagannathan V.Serum and whole blood microRNA (miRNA) fingerprints have been proposed as a new class of non-invasive human cancer biomarkers. In this study, we compared equine sarcoid (ES) disease-specific serum and whole blood miRNA fingerprints and correlated them to miRNA expression in sarcoid tissue. After high throughput sequencing, miRNA differential expression analysis between six ES-affected and five control horses was carried out in serum and whole blood using a DESeq algorithm, accounting for the influence of hemolysis and the white blood cell count. Target gene, pathway prediction and enrichment a...
Associations between endocrine disrupting chemicals and equine metabolic syndrome phenotypes.
Chemosphere    November 26, 2018   Volume 218 652-661 doi: 10.1016/j.chemosphere.2018.11.136
Durward-Akhurst SA, Schultz NE, Norton EM, Rendahl AK, Besselink H, Behnisch PA, Brouwer A, Geor RJ, Mickelson JR, McCue ME.Equine Metabolic Syndrome (EMS) is characterized by abnormalities in insulin regulation, increased adiposity and laminitis, and has several similarities to human metabolic syndrome. A large amount of environmental variability in the EMS phenotype is not explained by commonly measured factors (diet, exercise, and season), suggesting that other environmental factors play a role in EMS development. Endocrine disrupting chemicals (EDCs) are associated with metabolic syndrome and other endocrine abnormalities in humans. This led us to hypothesize that EDCs are detectable in horse plasma and play a ...
Small day 8 equine embryos cannot be rescued by a less advanced recipient mare uterus.
Theriogenology    November 26, 2018   Volume 126 36-40 doi: 10.1016/j.theriogenology.2018.11.026
Cuervo-Arango J, Claes AN, Stout TAE.Equine embryos tolerate an unusually large degree of negative uterine asynchrony (recipient mare up to 5 days behind the donor mare). By contrast, positive asynchrony of more than 2 days results in a high incidence of early embryonic loss (EEL). Day 8 embryos range in diameter from approximately 130-1300 μm, with embryos smaller than 300 μm reported to suffer an increased incidence of EEL. However, it is not known whether this reduced viability is due to intrinsically poor embryo quality, or to inadvertent recipient uterine stage-embryo (positive) asynchrony. To examine whether small emb...
CXCL10 production in equine monocytes is stimulated by interferon-gamma.
Veterinary immunology and immunopathology    November 24, 2018   Volume 207 25-30 doi: 10.1016/j.vetimm.2018.11.016
Schnabel CL, Babasyan S, Freer H, Wagner B.C-X-C motif ligand 10 (CXCL10) is a pro-inflammatory chemokine and has been extensively evaluated in people and mice. In horses, CXCL10 and its involvement in host immunity has rarely been analyzed due to the lack of specific antibodies. We generated a mAb specific for the equine chemokine CXCL10 using hybridoma technology. Antibody specificity was confirmed by intracellular staining and flow cytometric analysis of Chinese Hamster Ovary (CHO) cells expressing equine rCXCL10, while CHO cells expressing equine rCXCL9 were not detected. Native CXCL10 expression in PBMC from horses of different ag...
A prospective multicentre survey of complications associated with equine castration to facilitate clinical audit.
Equine veterinary journal    November 22, 2018   Volume 51, Issue 4 435-439 doi: 10.1111/evj.13035
Hodgson C, Pinchbeck G.Despite the regularity with which castration is performed, the types of complications and current best practice are unknown. Objective: The objective of this study was to perform a prospective audit of routine equine castrations performed in general practice to determine complication rates and factors associated with them. Methods: Multicentre, prospective audit of castrations. Methods: Data on castrations were collected on the day of surgery from 18 veterinary practices; 30-days post-operatively follow-up was obtained and complications recorded. Frequency of complications was reported, and mu...
Relationship between anti-Müllerian hormone and fertility in the mare.
Theriogenology    November 22, 2018   Volume 125 335-341 doi: 10.1016/j.theriogenology.2018.11.005
Ball BA, El-Sheikh Ali H, Scoggin KE, Riddle WT, Schnobrich M, Bradekamp E, Agnew M, Squires EL, Troedsson MHT.The objectives of this study were to evaluate; 1) the stability of measured serum anti-Müllerian hormone (AMH) concentrations in samples after multiple freeze-thaw cycles, 2) the repeatability of AMH concentrations within mares during the same breeding season as well as across breeding seasons, and 3) the relationship between serum AMH concentrations and fertility (measured as first cycle pregnancy rates) in thoroughbred mares. For the first aim, AMH concentrations (n = 9) were examined across four freeze-thaw cycles with no significant change in measured AMH concentrations. For the second ...
Advances in Echocardiography.
Progress in cardiovascular diseases    November 22, 2018   Volume 61, Issue 5-6 389 doi: 10.1016/j.pcad.2018.11.010
Lavie CJ.No abstract available
The prevalence of temporal bone fractures is high in horses with severe temporohyoid osteoarthropathy. Tanner J, Spriet M, Espinosa-Mur P, Estell KE, Aleman M.Temporohyoid osteoarthropathy is a well-recognized cause of equine neurologic disease. Temporal bone fractures associated with temporohyoid osteoarthropathy have been recognized with CT, however, little information is available regarding these fractures. The aims of this retrospective analytical study were to assess the prevalence of these fractures and to describe the specific configurations and associated imaging and clinical features. Fracture of the temporal bone was identified with CT in 16 of 39 included horses. All fractures were unilateral, minimally displaced and extended through the ...