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Topic:Orthopedics
Orthopedics in horses involves the study and treatment of disorders affecting the musculoskeletal system, including bones, joints, ligaments, tendons, and muscles. This field addresses a range of conditions, from developmental disorders and degenerative diseases to traumatic injuries. Common orthopedic issues in horses include fractures, osteoarthritis, tendonitis, and ligament injuries. Diagnostic techniques such as radiography, ultrasonography, and MRI are employed to assess these conditions. Treatment options may include surgical intervention, physical therapy, and pharmacological management. This page compiles peer-reviewed research studies and scholarly articles that explore the diagnosis, treatment, and management of orthopedic conditions in equine patients.
A biomechanical comparison of headless tapered variable pitch and AO cortical bone screws for fixation of a simulated lateral condylar fracture in equine third metacarpal bones. To compare drilling, tapping, and screw-insertion torque, force, and time for the 4.5-mm AO and 6.5-mm Acutrak Plus (AP) bone screws, and to compare the mechanical shear strength and stiffness of a simulated complete lateral condylar fracture of the equine third metacarpal bone (MC3) stabilized with either an AO or AP screw. Methods: In vitro biomechanical assessment of screw-insertion variables, and shear failure tests of a bone-screw-stabilized simulated lateral condylar fracture. Methods: Eight pairs of cadaveric equine MC3s Methods: Metacarpi were placed in a fixture and centered on a biax...
[Extracorporal shock wave therapy in veterinary medicine]. This article gives a general overview on a new therapy in equine orthopedics. In human medicine extracorporal shock wave therapy (ESWT) is used for lithotripsy of stones of the urologic system and also in orthopedics. In equine medicine the therapy is almost exclusively applied for the treatment of orthopedic problems. The main indications are proximal suspensory desmitis (PSD), lesions of tendons and ligaments, osteoporotic changes and spavin. In this paper the mode of action of shock waves and the different shock wave devices are discussed. Also, some information about an ongoing clinical tr...
The surgical technique and the age of the horse both influence the outcome of mosaicplasty in a cadaver equine stifle model. Six pieces of grafts, 6.5 mm in diameter, 20 mm in length, were taken from each of 170 cadaver hindlimbs, using the cranial surface of the medial femoral trochlea for harvesting. The age of the horses varied between 4 months and 23 years. 30 limbs under the age of 12 years were selected for transplantation. Three of six grafts were transplanted into the medial femoral condyle using different combinations of tunnel depth and dilation. With ageing, a significant decline in transplantability was detected. In general, mosaicplasty cannot be recommended in horses above 11 years. Based on a previous...
Evaluation of a tapered-sleeve transcortical pin to reduce stress at the bone-pin interface in metacarpal bones obtained from horses. To evaluate stiffness and bone-pin interface stress for a transcortical tapered-sleeve pin (TSP) that incorporates bilateral tapered sleeves over a transcortical pin. Methods: 14 third metacarpal bones (MCIII) collected from adult horses of various breeds. Methods: Each MCIII was cut in half to provide 2 test specimens. Pins (conventional and TSP) of 3 diameters (6.35, 7.94, and 9.50 mm) were inserted in specimens (3 specimens for each diameter and each type of pin). The test fixture simulated a typical sidebar-span skeletal fixation device for horses. Single cycle load-deflection tests were p...
Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of three 4.5-mm and two 5.5-mm cortical screws. To compare the biomechanical characteristics and mode of failure of 2 parallel-screw techniques for proximal interphalangeal joint arthrodesis in horses. Methods: Randomized block design, blocking for horse (1-5), method of screw fixation (three 4.5-mm vs two 5.5-mm), side (left limb vs right limb), and end (front limb vs hind limb). Constructs were loaded to failure in 3-point bending in a dorsal-to-palmar (plantar) direction. Methods: Twenty limbs (10 limb pairs) from 5 equine cadavers. Methods: A combined aiming device was used to facilitate consistent screw placement. Three parallel 4.5-mm...
Screw fixation in lag fashion of equine cadaveric metacarpal and metatarsal condylar bone specimens: a biomechanical comparison of shaft and cortex screws. To compare acute fixation stability and insertion effort of cortex bone screws with and without a shaft inserted in lag fashion in equine metacarpal (metatarsal, MC(T)III) bone. Methods: Screw types with independent variables of screw diameter (4.5 or 5.5 mm) and shaft type (without shaft, with 20-mm shaft, or with 25-mm shaft) were studied. Bone specimens cut from distal equine MC(T)III condyles were used. After screw insertion in lag fashion into 2 bone blocks with an instrumented device, shear tests were conducted in a mechanical testing machine. Outcome variables of peak insertion torque, ...
Use of an external ring fixator for correction of an acquired angular limb deformity in a donkey. Numerous techniques for surgical correction of angular limb deformities in horses involving an osteotomy of the affected bone and stabilization with an internal fixation device have been described. However, because the osteotomy typically has to be performed at the level of the physis, leaving little bone between the physis and the nearest joint, stabilizing the osteotomy by use of internal fixation devices may be difficult. In horses with severe chronic angular limb deformities, the amount of soft-tissue contracture may make it impossible to correct the deformity during a single procedure wit...
In vitro comparison of the use of two large-animal, centrally threaded, positive-profile transfixation pin designs in the equine third metacarpal bone. To compare the in vitro holding power and associated microstructural damage of 2 large-animal centrally threaded positive-profile transfixation pins in the diaphysis of the equine third metacarpal bone. Methods: 25 pairs of adult equine cadaver metacarpal bones. Methods: Centrally threaded positive-profile transfixation pins of 2 different designs (ie, self-drilling, self-tapping [SDST] vs nonself-drilling, nonself-tapping [NDNT] transfixation pins) were inserted into the middiaphysis of adult equine metacarpal bones. Temperature of the hardware was measured during each step of insertion with ...
Anesthetic management with sevoflurane and oxygen for orthopedic surgeries in racehorses. Eighty-five thoroughbred racehorses with various types of fracture were subjected to arthroscopic surgery (44 horses) or internal fixation (41 horses) under sevoflurane anesthesia. The mean end-tidal sevoflurane concentration during anesthesia ranged from 2.5 to 2.8%. PaCO2 was maintained between 50 and 65 mmHg by controlled ventilation. The mean arterial blood pressure was maintained above 65 mmHg by infusion of dobutamine and fluids, however, heart rate significantly increased with time. Recovery from anesthesia was calm and smooth in almost all cases. No apparent complication was observed d...
Scintigraphic detection of equine orthopedic infection using Tc-HMPAO labeled leukocytes in 14 horses. The aim of this study was to evaluate the diagnostic value of 99mTc-HMPAO leukocyte scintigraphy (LS) by means of a retrospective review of its use in 14 horses that were evaluated for orthopedic infection as a cause of lameness. A total of 17 LS exams were performed in 14 horses. LS studies were positive in 10 of 14 horses. A bacterial infection was confirmed with cytology or culture in 9 of 10 positive horses. Negative LS studies occurred in 4 of 14 horses. Necropsy confirmed the lack of infection in 2 of the 4 horses. Other clinical data and a favorable clinical outcome supported a negative...
In vitro biomechanical properties of 2 compression fixation methods for midbody proximal sesamoid bone fractures in horses. To evaluate 2 methods of midbody proximal sesamoid bone repair--fixation by a screw placed in lag fashion and circumferential wire fixation--by comparing yield load and the adjacent soft-tissue strain during monotonic loading. Methods: Experimental study. Methods: 10 paired equine cadaver forelimbs from race-trained horses. Methods: A transverse midbody osteotomy of the medial proximal sesamoid bone (PSB) was created. The osteotomy was repaired with a 4.5-mm cortex bone screw placed in lag fashion or a 1.25-mm circumferential wire. The limbs were instrumented with differential variable relucta...
In vitro cyclic biomechanical properties of an interlocking equine tibial nail. To determine cyclic biomechanical properties of gap osteotomized adult equine tibiae stabilized with an equine interlocking nail (EIN). Methods: In vitro experimental biomechanical investigation. Methods: Thirteen adult equine cadaveric tibiae. Methods: Adult equine tibiae with transverse, midshaft, 1-cm gap osteotomies, stabilized with an equine interlocking nail, underwent cyclic biomechanical testing in vitro under axial compression, 4-point bending, and torsion. Different specimens were subjected to different load levels that represented estimated in vivo loads at 2 Hz for 740,000 cycles. ...
An in vitro biomechanical investigation of an equine interlocking nail. To determine the mechanical properties of Equine Interlocking Nail (EIN; JD Wheat Veterinary Orthopedic Research Laboratory, University of California, Davis) stabilized osteotomized tibiae and compare these variables with estimated in vivo loads. Methods: In vitro biomechanical investigation. Methods: Twelve adult equine cadaveric tibiae. Methods: EIN-stabilized tibiae were tested monotonically under compression, 3- and 4-point bending, and torsion. Mechanical properties were compared with estimated in vivo loads. Results: EIN-tibial composite mean compressive yield load (11 kN) and bending mo...
Results of bone scintigraphy in racing standardbred horses: 64 cases (1992-1994). To document anatomic patterns of scintigraphic uptake and related orthopedic disease associated with racing activity in Standardbred horses. Methods: Retrospective study. Methods: 64 Standardbred horses evaluated for lameness. Methods: Medical records at the time of discharge were reviewed, and information regarding signalment; history; results of lameness examination, scintigraphy, and radiography; diagnosis; and treatment were obtained. Results: 274 areas of increased radiopharmaceutical uptake were identified. Scintigrams of 218 limbs (106 forelimbs, 112 hind limbs) were available for revie...
Supporting forelimb lameness: clinical judgement vs. computerised symmetry measurement. The aim of this study was to compare supporting forelimb lameness determined by a motion analysis system with the subjective grading of a trained equine orthopaedic surgeon. Trotting on a treadmill, 29 individuals with a supporting forelimb lameness were measured with the SELSPOT II system and judged by the clinician. The vertical motion of the head was measured, analysed using Fourier transform, and the percentages of symmetry determined. The veterinarian evaluated the lameness and graded it according to a clinical routine. Veterinarian and system for motion analysis assigned the lameness to ...
An in vitro biomechanical comparison of an interlocking nail system and dynamic compression plate fixation of ostectomized equine third metacarpal bones. To compare the mechanical properties of two stabilization methods for ostectomized equine third metacarpi (MC3): (1) an interlocking nail system and (2) two dynamic compression plates. Animal or Sample Population-Ten pairs of adult equine forelimbs intact from the midradius distally. Methods: Ten pairs of equine MC3 were divided into two test groups (five pairs each): caudocranial four-point bending and torsion. Interlocking nails (6 hole, 13-mm diameter, 230-mm length) were placed in one randomly selected bone from each pair. Two dynamic compression plates one dorsally (12 hole, 4.5-mm broad)...
Arthroscopic subchondral bone plate microfracture technique augments healing of large chondral defects in the radial carpal bone and medial femoral condyle of horses. To evaluate the effect of arthroscopic subchondral bone microfracture on healing of large chondral defects in horses. Methods: Short- (4 months) and long-term (12 months) in vivo experimental chondral defect model. Methods: 10 horses, aged 2 to 5 years. Methods: Each horse had a 1 cm2 full-thickness chondral defect created in both radial carpal bones and both medial femoral condyles. One carpus and one femoral condyle of each horse had the subchondral bone plate under the defect perforated using an orthopedic awl. All horses were exercised, five horses were evaluated after 4 months and five ho...
Diurnal variation and age differences in the biochemical markers of bone turnover in horses. Biochemical markers of bone turnover provide sensitive, rapid, and noninvasive monitoring of bone resorption and formation. Serum concentrations of osteocalcin (OC) reflect rates of bone formation, and urinary concentrations of the pyridinium crosslinks pyridinoline (Pyd) and deoxypyridinoline (Dpd) are specific and sensitive markers of bone resorption. These markers are age-dependent and are used to detect and monitor changes in the rates of bone turnover in a variety of orthopedic diseases in humans and may prove to have similar application in horses. This study examined age differences and ...
The effect of orthopaedic shoeing on the force exerted by the deep digital flexor tendon on the navicular bone in horses. This study quantifies both the intended effect of orthopaedic shoeing to decrease the load on the navicular bone and the eventual undesired effects on gait performance. The compressive force exerted by the deep digital flexor tendon on the navicular bone and on the quality of the trot and redistribution of forces over the flexor tendons and the suspensory ligament were studied as a function of orthopaedic shoeing in 12 sound Dutch Warmblood horses. A modified CODA-3 gait analysis system and a force plate were used to quantify objectively the load on the lower limb. The quality of the trot was ...
A comparison of the Synthes 4.5-mm cannulated screw and the Synthes 4.5-mm standard cortex screw systems in equine bone. To determine risk of failure of the Synthes 4.5-mm cannulated screw system instrumentation in equine bone and to compare its application with the Synthes 4.5-mm standard cortex screw system. Methods: The maximum insertion torque of the cannulated and standard cortex screw systems were compared with the ultimate torsional strengths of the equipment. Pullout strength and ultimate tensile load of cannulated and standard cortex screws were also determined. Methods: Paired equine cadaver third metacarpal and third carpal bones. Methods: Maximum insertion torque and ultimate torsional strengths were...
Results of bone scintigraphy in horses used for show jumping, hunting, or eventing: 141 cases (1988-1994). To determine anatomic patterns and clinical importance of increased radiopharmaceutical uptake in bones of horses used for show jumping, hunting, and eventing. Methods: Retrospective study. Methods: 141 horses evaluated because of lameness. Methods: Medical records were reviewed, and information on results of physical examination, radiography, and scintigraphy were obtained. Scintigrams were evaluated to identify areas of increased radio-pharmaceutical uptake. Results: 834 areas of increased radiopharmaceutical uptake were identified. Scintigraphy of the vertebral column was performed in 78 ho...
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...
Effect of copper supplementation on the evidence of developmental orthopaedic disease in pasture-fed New Zealand Thoroughbreds. The effect of copper status on the evidence of bone and cartilage lesions was investigated in 21 Thoroughbred foals. The foals and their dams were grazed on pasture containing 4.4-8.6 mg Cu/kg dry matter (DM). Four treatment groups were created by randomly allocating mares and their foals to either copper supplemented (0.5 mg Cu/kg liveweight (LW)/day), or control (pasture only) groups. This experimental design allowed the effect of copper supplementation of mare and foal to be examined independently. Parameters of bone and cartilage development were assessed in the foals both in vivo, and at ...
In vitro pullout strength of screws inserted in adult equine third metacarpal bone after overdrilling a 4.5-mm threaded insertion hole. To determine and compare the in vitro pullout strength of 5.5-mm cortical versus 6.5-mm cancellous bone screws inserted in the diaphysis and metaphysis of adult equine third metacarpal (MCIII) bones, in threaded 4.5-mm cortical bone screw insertion holes that were then overdrilled with a 4.5-mm drill bit to provide information relevant to the selection of a replacement screw if a 4.5-mm cortical screw is stripped. Methods: In vitro pullout tests of 5.5-mm cortical and 6.5-mm cancellous screws in equine MCIII bones. Methods: Two independent cadaver studies each consisting of 14 adult equine MCI...
Long-term consequences of experimental desmotomy of the accessory ligament of the deep digital flexor tendon in adult horses. To evaluate clinical and biomechanical consequences of desmotomy of the accessory ligament (AL) of the deep digital flexor tendon (DDFT) of equine forelimbs and determine whether this procedure is a viable treatment for chronic desmitis of the AL-DDFT. Methods: 6 adult Standardbred trotters. Methods: Biomechanical recordings obtained before and 6 months after desmotomy were compared. Walk and trot joint angles, ground reaction forces, peak joint moments, and tendon forces were assessed. Results: Within 10 days after surgery, all horses were sound at a trot. Swelling, increased carpal flexion i...
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...
Recidivism in equestrian trauma. A 3-year chart survey and questionnaire was conducted of equestrian-injured patients at a regional trauma center to determine patterns and consequences of injury and rate of recidivism. Ninety-two patients (95 encounters) were treated; most were young (mean age, 27 +/- 11 years) women (84%) riders sustaining falls (80%). Most injuries were orthopedic (47%); 19 per cent of patients required hospital admission. There was one death. Helmet use was documented in only 34 per cent. Eighty-one per cent of patients responded to a follow-up telephone survey; 36 per cent recounted additional accidents (...
Biomechanical comparison of the Herbert and AO cortical bone screws for compression of an equine third carpal bone dorsal plane slab osteotomy. To assess feasibility of insertion of 4.5-mm Herbert cannulated bone screws (HS) using fluoroscopic guidance and compare the mechanical shear strength of these HS and 4.5-mm AO cortical bone screws (AO) for fixation of dorsal plane slab osteotomies in equine cadaver third carpal bones (C3). Methods: Eight equine cadavers. Methods: Bone mineral composition and density of contralateral C3 were confirmed to be equivalent using dual-energy x-ray absorptiometry. A standard 10-mm C3 slab osteotomy was reduced using HS or AO instrumentation under fluoroscopic guidance. Specimens were loaded in shear ...
Surgical treatment of subchondral cystic lesions of the third metacarpal bone: results in 15 horses (1986-1994). Subchondral cystic lesions (SCLs) in the condyle of the third metacarpal bone (MCIII) were surgically treated in 15 horses. The median age at presentation was 18 months (range 10 months-12 years) with 10 of 15 horses less than age 2 years. The SCLs were confined to the front limbs in all cases with 2 horses having bilateral lesions. Lesions were isolated to the medial condyle(s) of MCIII in 13 of 15 horses; a cystic lesion occurred in the lateral condyle in one horse and in the sagittal ridge in one horse. One horse with bilateral lesions had an additional cystic lesion located in the right me...
