The phalanx in horses refers to the bones within the digit, specifically the proximal, middle, and distal phalanges, commonly known as the pastern, short pastern, and coffin bones, respectively. These bones are integral to the horse's limb structure and function, contributing to movement and weight-bearing capabilities. The health and integrity of the phalanges are critical for equine locomotion and performance. Conditions affecting the phalanges, such as fractures, osteoarthritis, or developmental disorders, can significantly impact a horse's mobility and quality of life. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, biomechanics, pathology, and clinical management of phalanx-related conditions in horses.
Changoor A, Garon M, Quenneville E, Savard P, Buschmann MD, Hurtig MB.To perform non-invasive Electroarthrography (EAG) on live horses and establish relationships between EAG and direct measurements of cartilage streaming potentials in weight bearing areas of the equine metacarpophalangeal joint. Methods: EAG was performed bilaterally on the metacarpophalangeal joints of live horses (n = 3). Separate experiments used metacarpophalangeal joint explants (n = 11) to measure EAG obtained during simulated loading followed by direct measurements of cartilage streaming potentials on joint surfaces using the Arthro-BST probe. Joints were assigned to relatively norma...
Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K.Injuries of the sagittal groove of the proximal phalanx (P1) in equine athletes are considered to predominantly occur due to chronic bone stress overload. Objective: To describe the range of abnormalities that is present in the sagittal groove in a large group of horses diagnosed with sagittal groove disease (SGD) on low-field MRI. Methods: Retrospective, cross-sectional. Methods: Medical records were searched to identify initial MRI images of horses diagnosed with SGD and these were blindly evaluated using a semi-quantitative grading scheme and novel SGD MRI classification system reflecting p...
Steiner J, Richter H, Kaufmann R, Ohlerth S.Single-source dual energy (SSDECT) and detector-based spectral computed tomography (DBSCT) are emerging technologies allowing the interrogation of materials that have different attenuation properties at different energies. Both technologies enable the calculation of effective atomic number (EAN), an index to determine tissue composition, and electron density (ED), which is assumed to be associated with cellularity in tissues. In the present prospective observational study, EAN and ED values were determined for 16 zones in normal subchondral and trabecular bone of 37 equine cadaver limbs. Using...
Koshyk A, Pohl AJ, Takahashi Y, Scott WM, Sparks HD, Edwards WB.Fractures of the equine metacarpophalangeal (MCP) joint are among the most common and fatal injuries experienced by racehorses. These bone injuries are a direct result of repetitive, high intensity loading of the skeleton during racing and training and there is consensus that they represent a mechanical fatigue phenomenon. Existing work has found the fatigue life of bone to be strongly determined by bone microarchitecture and the resulting stressed volume (i.e., the volume of bone stressed above assumed yield). The purpose of this study was to quantify the influence of bone microarchitecture o...
Ciamillo SA, Wulster KB, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF.Catastrophic injuries of the fetlock joints occur in Thoroughbred racehorses and are preceded by stress-induced bone injury. Early detection of subchondral bone injury is essential to prevent irreversible damage or bone failure. Objective: To investigate the use of standing, robotic cone-beam computed tomography (CBCT) for assessing longitudinal changes in subchondral bone morphology and pathology of the fetlock joints associated with race training in young Thoroughbreds. Methods: Observational cohort study. Methods: Forty-one 2-year-old Thoroughbred racehorses were recruited prior to the star...
Khaledi KA, Mirshahi A, Sardari K, Azizzadeh M, Ghasemi S.The Turkmen horse is one of the oldest breeds in the world with unique characteristics in agility, endurance and jump, being publicly acclaimed. Laminitis affects the limbs and decreases athletic performance. Radiographic evaluation is essential to confirm the sinking diagnosis in every breed of a horse suffering from laminitis. Since no information about distal phalanx radiographic measurements in this breed has been reported, the current study was designed and conducted. In the present study, 24 clinically sound registered Turkmen horses of both sexes (15 mares and nine stallions) were selec...
Germonpré J, Vandekerckhove LMJ, Raes E, Chiers K, Jans L, Vanderperren K.In this proof-of-concept study, the post-mortem feasibility of dual-energy computed tomography (DECT) in the detection of bone edema-like lesions in the equine foot is described in agreement with the gold standard imaging technique, which is magnetic resonance imaging (MRI). Unassigned: A total of five equine cadaver feet were studied, of which two were pathological and three were within normal limits and served as references. A low-field MRI of each foot was performed, followed by a DECT acquisition. Multiplanar reformations of DECT virtual non-calcium images were compared with MRI for the de...
Westman S, Cullen TE, Bergstrom TC, Edwards LA, Garcia TC, Stover SM.To evaluate the effect of the application of a novel fiberglass-glue cast (FGC) on the fracture gap width in experimentally created type III distal phalanx fractures in cadaveric specimens under simulated physiologic loads. Methods: Ex vivo biomechanical laboratory study. Methods: Nine unilateral adult equine cadaver forelimbs. Methods: Type III distal phalanx fractures were created in forelimb specimens, which maintained distal components of the passive stay apparatus. The fracture gap was measured at 5%, 20%, 25%, 50%, 75%, and 95% of fracture length (palmar articular border to solar margin)...
Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K.Evolution of magnetic resonance imaging (MRI) findings in horses with sagittal groove disease (SGD) of the proximal phalanx is relatively sparsely described. This retrospective, descriptive, longitudinal study describes the findings of sequential low-field MRI fetlock examinations in horses with SGD of the proximal phalanx using a classification system. Twenty-nine horses were included, predominantly warmbloods used for show jumping (79%). For 29 limbs re-examined during the initial rehabilitation period, classification remained constant (n = 18), increased (n = 2), decreased (n = 7), and fluc...
Reiser V, Reiser A, Licka TF.To identify and measure radiolucencies at the solear margin of the distal phalanx in radiographs of healthy and laminitic hooves. Methods: Clinical records and dorsoproximal-palmarodistal radiographs of equine forelimbs with radiological diagnoses of either laminitis (n = 40, L) or navicular syndrome (n = 40, NS). Methods: Outlines of the radiolucent structures at the solar margin were drawn in ImageJ, and a customized novel plugin "Arteries Analyzer/ImageJ" was used for measurements. The diverging radiolucencies outside the terminal arc of the distal phalanx were differentiated as arterial ch...
Larsen CD, Wilkinson TE, Roberts GD, Guess SC, Mattoon JS, Sanz MG.To evaluate the radiographic thickness of the dorsal hoof wall in normal draft horse feet. Methods: 33 adult draft horses with no history of laminitis, no clinically obvious lameness, and visibly unremarkable front feet were included. Methods: This was a prospective, descriptive study of clinically normal draft horses' front feet. Lateromedial radiographs were acquired of the front feet. A ratio of the dorsal hoof wall thickness to the length of the distal phalanx (DHWP3 ratio) was calculated. Results: The dorsal hoof wall thickness to length of the distal phalanx was calculated as 0.33 ± 0.0...
Pige C, Spriet M, Perez-Nogues M, Katzman S, Le Jeune S, Galuppo L. F-sodium fluoride ( F-NaF) positron emission tomography (PET) has been validated as a useful imaging technique in the racehorse fetlock. The use of F-NaF PET in the nonracehorse fetlock has not been reported. Objective: To describe F-NaF PET findings in nonracehorse fetlocks, to compare with computed tomography (CT) findings and to compare PET findings between horses with and without fetlock pain. Methods: Retrospective observational study. Methods: All horses undergoing F-NaF PET and CT imaging of the fetlock between October 2016 and March 2021 were included in the study. Medical records ...
Colgate VA, Robinson N, Barnett TP, Bathe AP, Coleridge MOD, Smith LCR, Payne RJ.Repair of sagittal proximal phalanx (P1) and parasagittal metacarpal/metatarsal III (MC/MTIII) fractures has evolved over recent decades from a procedure carried out solely under general anaesthesia, to one commonly performed under standing sedation. To date, standing fracture repair has not been evaluated for large cohorts. Objective: To determine short-term (survival to discharge) and long-term (return to racing) outcomes of horses undergoing standing repair of MC/MTIII and P1 fractures, and to compare pre-surgical and post-surgical racing performance. Methods: Single-centre retrospective co...
Lin ST, Foote AK, Bolas NM, Peter VG, Pokora R, Patrick H, Sargan DR, Murray RC.Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early identification and characterisation of fissures using non-invasive imaging could be of clinical value. Thirty-three equine cadaver limbs underwent standing cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, low-field magnetic resonance imaging (MRI), and macro/histo-pathological examination. Imaging diagnoses of fissures were compared to microscopic examination. Imaging features of fissures were described. Histopathological fin...
Parkin TD, Clegg PD, French NP, Proudman CJ, Riggs CM, Singer ER, Webbon PM, Morgan KL.The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt flat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the...
Caudron I, Miesen M, Grulke S, Vanschepdael P, Leroy P, Serteyn D.The authors used a new radiological method to assess asymmetrical articular compression of the interphalangeal joints. This method was based on the measurements of 3 angles obtained on dorsopalmar radiographs. Variations of these angles were studied during experimental asymmetrical bearing on unshod feet. It was concluded that 2 angles were interesting parameters to assess asymmetrical articular compression and to define the position of the phalanx in the horny box. Furthermore, variations of these angles induced by experimental asymmetrical bearing were compared without shoe, with a standard ...
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...
Vail TB, McIlwraith CW.An intraarticular osteochondral chip fracture of the distal dorsolateral aspect of the right hind middle phalanx in a 4-year-old Dutch Warmblood gelding was removed arthroscopically. Accessibility and visibility of the fragment were excellent, and there was minimal soft tissue trauma.
Németh F, Back W.The walking cast was used to repair 46 fractures of long bones (distal radius and tibia, metacarpus and metatarsus) and 10 fractures of first phalanx of 35 horses and 21 ponies. The walking cast proved to be highly effective. Even heavily comminuted and 'hopeless' fractures, which could not be treated with osteosynthesis, were treated successfully, because the weight of the animal, a common failure factor in large animal orthopaedics, was relieved from the injured leg. Immediate full weight bearing was possible post operatively. In five cases the walking cast was used in combination with osteo...
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...
Németh F, Back W.The walking cast was used to repair 46 fractures of long bones (distal radius and tibia, metacarpus and metatarsus) and 10 fractures of first phalanx of 35 horses and 21 ponies. The walking cast proved to be highly effective. Even heavily comminuted and 'hopeless' fractures, which could not be treated with osteosynthesis, were treated successfully, because the weight of the animal, a common failure factor in large animal orthopaedics, was relieved from the injured leg. Immediate full weight bearing was possible post operatively. In five cases the walking cast was used in combination with osteo...
Lin ST, Foote AK, Bolas NM, Peter VG, Pokora R, Patrick H, Sargan DR, Murray RC.Fissure in the third metacarpal/tarsal parasagittal groove and proximal phalanx sagittal groove is a potential prodromal pathology of fracture; therefore, early identification and characterisation of fissures using non-invasive imaging could be of clinical value. Thirty-three equine cadaver limbs underwent standing cone-beam (CB) computed tomography (CT), fan-beam (FB) CT, low-field magnetic resonance imaging (MRI), and macro/histo-pathological examination. Imaging diagnoses of fissures were compared to microscopic examination. Imaging features of fissures were described. Histopathological fin...
Vail TB, McIlwraith CW.An intraarticular osteochondral chip fracture of the distal dorsolateral aspect of the right hind middle phalanx in a 4-year-old Dutch Warmblood gelding was removed arthroscopically. Accessibility and visibility of the fragment were excellent, and there was minimal soft tissue trauma.
Caudron I, Miesen M, Grulke S, Vanschepdael P, Leroy P, Serteyn D.The authors used a new radiological method to assess asymmetrical articular compression of the interphalangeal joints. This method was based on the measurements of 3 angles obtained on dorsopalmar radiographs. Variations of these angles were studied during experimental asymmetrical bearing on unshod feet. It was concluded that 2 angles were interesting parameters to assess asymmetrical articular compression and to define the position of the phalanx in the horny box. Furthermore, variations of these angles induced by experimental asymmetrical bearing were compared without shoe, with a standard ...
Parkin TD, Clegg PD, French NP, Proudman CJ, Riggs CM, Singer ER, Webbon PM, Morgan KL.The risk of fatal distal limb fractures in thoroughbreds racing in the UK was calculated and shown to vary considerably between the different types of race. Flat turf racing was associated with the lowest risk (0.4 per 1000 starts) and national hunt flat racing was associated with the highest risk (2.2 per 1000 starts). The types of fracture were classified by detailed radiographic and postmortem examinations of all the cases recorded over two years, and the distribution of the different types of fracture in the five main types of racing was examined. Overall, lateral condylar fractures of the...
Colgate VA, Robinson N, Barnett TP, Bathe AP, Coleridge MOD, Smith LCR, Payne RJ.Repair of sagittal proximal phalanx (P1) and parasagittal metacarpal/metatarsal III (MC/MTIII) fractures has evolved over recent decades from a procedure carried out solely under general anaesthesia, to one commonly performed under standing sedation. To date, standing fracture repair has not been evaluated for large cohorts. Objective: To determine short-term (survival to discharge) and long-term (return to racing) outcomes of horses undergoing standing repair of MC/MTIII and P1 fractures, and to compare pre-surgical and post-surgical racing performance. Methods: Single-centre retrospective co...
Pige C, Spriet M, Perez-Nogues M, Katzman S, Le Jeune S, Galuppo L. F-sodium fluoride ( F-NaF) positron emission tomography (PET) has been validated as a useful imaging technique in the racehorse fetlock. The use of F-NaF PET in the nonracehorse fetlock has not been reported. Objective: To describe F-NaF PET findings in nonracehorse fetlocks, to compare with computed tomography (CT) findings and to compare PET findings between horses with and without fetlock pain. Methods: Retrospective observational study. Methods: All horses undergoing F-NaF PET and CT imaging of the fetlock between October 2016 and March 2021 were included in the study. Medical records ...
Reiser V, Reiser A, Licka TF.To identify and measure radiolucencies at the solear margin of the distal phalanx in radiographs of healthy and laminitic hooves. Methods: Clinical records and dorsoproximal-palmarodistal radiographs of equine forelimbs with radiological diagnoses of either laminitis (n = 40, L) or navicular syndrome (n = 40, NS). Methods: Outlines of the radiolucent structures at the solar margin were drawn in ImageJ, and a customized novel plugin "Arteries Analyzer/ImageJ" was used for measurements. The diverging radiolucencies outside the terminal arc of the distal phalanx were differentiated as arterial ch...
Larsen CD, Wilkinson TE, Roberts GD, Guess SC, Mattoon JS, Sanz MG.To evaluate the radiographic thickness of the dorsal hoof wall in normal draft horse feet. Methods: 33 adult draft horses with no history of laminitis, no clinically obvious lameness, and visibly unremarkable front feet were included. Methods: This was a prospective, descriptive study of clinically normal draft horses' front feet. Lateromedial radiographs were acquired of the front feet. A ratio of the dorsal hoof wall thickness to the length of the distal phalanx (DHWP3 ratio) was calculated. Results: The dorsal hoof wall thickness to length of the distal phalanx was calculated as 0.33 ± 0.0...
Westman S, Cullen TE, Bergstrom TC, Edwards LA, Garcia TC, Stover SM.To evaluate the effect of the application of a novel fiberglass-glue cast (FGC) on the fracture gap width in experimentally created type III distal phalanx fractures in cadaveric specimens under simulated physiologic loads. Methods: Ex vivo biomechanical laboratory study. Methods: Nine unilateral adult equine cadaver forelimbs. Methods: Type III distal phalanx fractures were created in forelimb specimens, which maintained distal components of the passive stay apparatus. The fracture gap was measured at 5%, 20%, 25%, 50%, 75%, and 95% of fracture length (palmar articular border to solar margin)...
Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K.Evolution of magnetic resonance imaging (MRI) findings in horses with sagittal groove disease (SGD) of the proximal phalanx is relatively sparsely described. This retrospective, descriptive, longitudinal study describes the findings of sequential low-field MRI fetlock examinations in horses with SGD of the proximal phalanx using a classification system. Twenty-nine horses were included, predominantly warmbloods used for show jumping (79%). For 29 limbs re-examined during the initial rehabilitation period, classification remained constant (n = 18), increased (n = 2), decreased (n = 7), and fluc...
Ciamillo SA, Wulster KB, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF.Catastrophic injuries of the fetlock joints occur in Thoroughbred racehorses and are preceded by stress-induced bone injury. Early detection of subchondral bone injury is essential to prevent irreversible damage or bone failure. Objective: To investigate the use of standing, robotic cone-beam computed tomography (CBCT) for assessing longitudinal changes in subchondral bone morphology and pathology of the fetlock joints associated with race training in young Thoroughbreds. Methods: Observational cohort study. Methods: Forty-one 2-year-old Thoroughbred racehorses were recruited prior to the star...
Germonpré J, Vandekerckhove LMJ, Raes E, Chiers K, Jans L, Vanderperren K.In this proof-of-concept study, the post-mortem feasibility of dual-energy computed tomography (DECT) in the detection of bone edema-like lesions in the equine foot is described in agreement with the gold standard imaging technique, which is magnetic resonance imaging (MRI). Unassigned: A total of five equine cadaver feet were studied, of which two were pathological and three were within normal limits and served as references. A low-field MRI of each foot was performed, followed by a DECT acquisition. Multiplanar reformations of DECT virtual non-calcium images were compared with MRI for the de...
Koshyk A, Pohl AJ, Takahashi Y, Scott WM, Sparks HD, Edwards WB.Fractures of the equine metacarpophalangeal (MCP) joint are among the most common and fatal injuries experienced by racehorses. These bone injuries are a direct result of repetitive, high intensity loading of the skeleton during racing and training and there is consensus that they represent a mechanical fatigue phenomenon. Existing work has found the fatigue life of bone to be strongly determined by bone microarchitecture and the resulting stressed volume (i.e., the volume of bone stressed above assumed yield). The purpose of this study was to quantify the influence of bone microarchitecture o...
Khaledi KA, Mirshahi A, Sardari K, Azizzadeh M, Ghasemi S.The Turkmen horse is one of the oldest breeds in the world with unique characteristics in agility, endurance and jump, being publicly acclaimed. Laminitis affects the limbs and decreases athletic performance. Radiographic evaluation is essential to confirm the sinking diagnosis in every breed of a horse suffering from laminitis. Since no information about distal phalanx radiographic measurements in this breed has been reported, the current study was designed and conducted. In the present study, 24 clinically sound registered Turkmen horses of both sexes (15 mares and nine stallions) were selec...
Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K.Injuries of the sagittal groove of the proximal phalanx (P1) in equine athletes are considered to predominantly occur due to chronic bone stress overload. Objective: To describe the range of abnormalities that is present in the sagittal groove in a large group of horses diagnosed with sagittal groove disease (SGD) on low-field MRI. Methods: Retrospective, cross-sectional. Methods: Medical records were searched to identify initial MRI images of horses diagnosed with SGD and these were blindly evaluated using a semi-quantitative grading scheme and novel SGD MRI classification system reflecting p...
Steiner J, Richter H, Kaufmann R, Ohlerth S.Single-source dual energy (SSDECT) and detector-based spectral computed tomography (DBSCT) are emerging technologies allowing the interrogation of materials that have different attenuation properties at different energies. Both technologies enable the calculation of effective atomic number (EAN), an index to determine tissue composition, and electron density (ED), which is assumed to be associated with cellularity in tissues. In the present prospective observational study, EAN and ED values were determined for 16 zones in normal subchondral and trabecular bone of 37 equine cadaver limbs. Using...
Changoor A, Garon M, Quenneville E, Savard P, Buschmann MD, Hurtig MB.To perform non-invasive Electroarthrography (EAG) on live horses and establish relationships between EAG and direct measurements of cartilage streaming potentials in weight bearing areas of the equine metacarpophalangeal joint. Methods: EAG was performed bilaterally on the metacarpophalangeal joints of live horses (n = 3). Separate experiments used metacarpophalangeal joint explants (n = 11) to measure EAG obtained during simulated loading followed by direct measurements of cartilage streaming potentials on joint surfaces using the Arthro-BST probe. Joints were assigned to relatively norma...
