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Topic:Surgery

Surgery for horses encompasses a range of procedures performed to diagnose, treat, or manage various medical conditions. These procedures may involve soft tissue or orthopedic interventions and require specialized techniques to accommodate the unique anatomical and physiological characteristics of equines. Common surgical procedures in horses include colic surgery, fracture repair, and arthroscopy. The success of equine surgery depends on numerous factors, including the type of procedure, the horse's overall health, and post-operative care. This page compiles peer-reviewed research studies and scholarly articles that explore surgical techniques, outcomes, and advancements in equine surgical practices.
Long-term outcome after implantation of a suprachoroidal cyclosporine drug delivery device in horses with recurrent uveitis.
Veterinary ophthalmology    September 16, 2010   Volume 13, Issue 5 294-300 doi: 10.1111/j.1463-5224.2010.00807.x
Gilger BC, Wilkie DA, Clode AB, McMullen RJ, Utter ME, Komaromy AM, Brooks DE, Salmon JH.To determine the long-term efficacy, complications, and duration of effect of a cyclosporine (CsA) suprachoroidal implant (CSI) in horses with equine recurrent uveitis (ERU). Methods: Horses with ERU were treated with a 6-mm diameter, 25 mg, reservoir matrix CsA implant in the deep sclera adjacent to the suprachoroidal space. Horses with follow-up >1 year were examined for frequency of uveitis episodes, complications, and vision at last recheck. Results: Data from 151 eyes of 133 horses from the USA and Europe that had CsA devices implanted for ERU were reviewed. Follow-up time ranged from 13 ...
Vertical dimensions of suspended horses.
Equine veterinary journal    September 14, 2010   Volume 42, Issue 8 758-761 doi: 10.1111/j.2042-3306.2010.00167.x
Clutton RE, Chase-Topping M, Squires R, Lawson H, Minard H, Rose S.The dimensions of anaesthetised hobbled horses during suspension and transfer onto the operating table are unknown. These data are required for the cost-effective construction of equine surgical facilities. Objective: To measure the distance from the toe to dependent back margin (Bsusp) and poll (Psusp) of anaesthetised suspended horses and correlate them with readily obtained measures from standing animals. Methods: Digital photographs of suspended horses were taken in the anaesthesia induction box at a fixed position that allowed trigonometric determination of Bsusp and Psusp. These values w...
Mitomycin C, with or without surgery, for the treatment of ocular squamous cell carcinoma in horses.
The Veterinary record    September 8, 2010   Volume 167, Issue 10 373-376 doi: 10.1136/vr.c3815
Malalana F, Knottenbelt D, McKane S.Ocular lesions in horses, confirmed as squamous cell carcinoma, were treated topically with mitomycin C. Fourteen horses with confirmed ocular squamous cell carcinoma, three of which were affected bilaterally, were included in the study. Eight of the affected eyes were treated topically with mitomycin C alone; in the other nine eyes, the tumours were surgically removed and topical treatment with mitomycin C was then applied. The treatment protocol consisted of 0.2 ml of 0.04 per cent mitomycin C instilled into the conjunctival sac of the affected eye, every six hours, in rounds of seven days o...
Hand-assisted laparoscopic removal of a nephroblastoma in a horse.
The Canadian veterinary journal = La revue veterinaire canadienne    September 3, 2010   Volume 51, Issue 6 637-639 
Romero A, Rodgerson DH, Fontaine GL.A 3-year-old Thoroughbred was presented for evaluation of hematuria post exercise. On physical examination, an enlarged kidney was identified, as well as serum biochemical abnormalities such as an elevated creatine kinase (CK) and hypoalbuminemia. The kidney was removed laparoscopically and a nephroblastoma was identified. Un Thoroughbred âgé de 3 ans est présenté pour évaluation de l’hématurie après l’effort. À l’examen physique, un rein enflé est identifié ainsi que des anomalies biochimiques sériques comme une créatine kinase (CK) élevée et l’hypoalbuminémie. Le rein...
Right dorsal colon resection and bypass for treatment of right dorsal colitis in a horse.
Veterinary surgery : VS    September 2, 2010   Volume 39, Issue 7 879-883 doi: 10.1111/j.1532-950X.2010.00723.x
Lane JK, Cohen JM, Zedler ST, Hollis AR, Southwood LL.To describe a novel surgical technique for management of right dorsal colitis in the horse. Methods: Clinical report. Methods: 14-year-old Warmblood gelding. Methods: The horse was referred for treatment of a stromal abscess and signs of right dorsal colitis. Plasma chemistry revealed marked hypoproteinemia. Abdominal ultrasonographic examination showed a thickened right dorsal colon (RDC). Medical treatment was unsuccessful. With the horse in left lateral recumbency under general anesthesia, an approach to the right side of the abdomen through a 16th rib resection was made. The thoracic cavit...
Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases.
Equine veterinary journal    August 26, 2010   Volume 43, Issue 3 280-287 doi: 10.1111/j.2042-3306.2010.00183.x
Smith MR, Wright IM.A minimally invasive arthroscopic technique for removal of fractures of the lateral malleolus of the tibia is considered to be beneficial but data to this effect are required. Objective: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically feasible, provides a comprehensive evaluation of the tarsocrural joint and enables removal of remote comminuted fragments and disrupted short collateral ligaments. The technique is associated with low patient morbidity, requires only short periods of hospitalisation and affords a good prognosis to affected horses. Methods: T...
Extraction of cheek teeth using a lateral buccotomy approach in 114 horses (1999-2009).
Equine veterinary journal    August 26, 2010   Volume 43, Issue 3 348-353 doi: 10.1111/j.2042-3306.2010.00169.x
O'Neill HD, Boussauw B, Bladon BM, Fraser BS.There are few published data regarding the success rates of cheek tooth (CT) removal by lateral buccotomy in the horse. Objective: A retrospective study of 114 horses admitted to 2 private equine referral hospitals over a 10 year period (1999-2009), which underwent CT removal via a lateral buccotomy. Methods: Hospital records were analysed and details including case details, presenting complaint and results of all diagnostic tests and surgical reports were documented. Information obtained during post operative reassessment was also available for analysis. Long-term follow-up information (>2 mo...
The use of small (2.7 mm) screws for arthroscopically guided repair of carpal chip fractures.
Equine veterinary journal    August 26, 2010   Volume 43, Issue 3 270-279 doi: 10.1111/j.2042-3306.2010.00178.x
Wright IM, Smith MR.Removal of large chip fractures of the carpal bones and the osteochondral deficits that result, have been associated with a worse prognosis than removal of small fragments in similar locations. Objective: Reducing the articular defects by repair of large osteochondral fragments may have advantages over removal. Methods: Horses with osteochondral chip fractures that were of sufficient size and infrastructure to be repaired with small (2.7 mm diameter) AO/ASIF cortex screws were identified and repair effected by arthroscopically guided internal fixation. Results: Thirty-three horses underwent su...
Comparison of conventional and alternative arthroscopic approaches to the palmar/plantar pouch of the equine distal interphalangeal joint.
Equine veterinary journal    August 26, 2010   Volume 43, Issue 3 265-269 doi: 10.1111/j.2042-3306.2010.00176.x
Fowlie JG, O'Neill HD, Bladon BM, O'Meara B, Prange T, Caron JP.The conventional arthroscopic approach to the palmar/plantar aspect of the distal interphalangeal joint (DIPJ) may result in the inadvertent penetration of the digital flexor tendon sheath (DFTS) and the navicular bursa (NB). This iatrogenic communication would be undesirable subsequent to arthroscopic lavage of a septic DIPJ. Objective: A lateral/medial approach to the palmar/plantar aspect of the DIPJ will result in a significantly lower rate of inadvertent penetration of the DFTS and NB, whilst still providing adequate intra-articular evaluation. Methods: The conventional palmar/plantar app...
The effect of isotonic multiple electrolyte infusions during anesthesia on blood gas and enzymatic values in horses.
Polish journal of veterinary sciences    August 25, 2010   Volume 13, Issue 2 287-292 
Stopyra A, Jałyński M, Sobiech P, Chyczewski M, Holak P, Lew M.General equine anesthesia is accompanied by the risk of complications and even death. The majority of general anesthetics used in veterinary practice lead to arterial hypotension, decreased capillary perfusion and ventilatory depression leading to pathological changes referred to as postanesthetic myopathy. In this study an attempt was made to analyze changes in the perioperative and postoperative acid-base equilibrium and blood enzymatic activity in horses, subject to the intensity of the applied fluid therapy. The horses were divided into two groups: I--administered Ringer's solution during ...
Laparoscopic techniques for investigating the equine oviduct.
Equine veterinary journal    August 23, 2010   Volume 43, Issue 1 106-111 doi: 10.1111/j.2042-3306.2010.00143.x
Köllmann M, Rötting A, Heberling A, Sieme H.The diagnostic and therapeutic options for oviduct disorders in the mare are limited. The current best techniques require exploratory surgery under general anaesthesia or flank laparotomy. Objective: The orthograde flushing of the oviduct for diagnostic or therapeutic options is possible using laparoscopic techniques in the standing sedated mare. Methods: Development of a laparoscopic technique for catheterisation of the infundibulum and flushing of the oviduct (sterile methylene blue solution) in the standing sedated mare was examined in 2 experiments. The first involved a transvaginal laparo...
Colic in geriatric compared to mature nongeriatric horses. Part 2: Treatment, diagnosis and short-term survival.
Equine veterinary journal    August 19, 2010   Volume 42, Issue 7 628-635 doi: 10.1111/j.2042-3306.2010.00085.x
Southwood LL, Gassert T, Lindborg S.Owners and veterinarians are often concerned about mortality of geriatric horses following colic surgery. Objective: To compare treatment, diagnosis and short-term survival for geriatric compared to mature nongeriatric horses with colic. Methods: Medical records of horses admitted with a presenting complaint of colic between 2000 and 2006 were reviewed. Geriatric horses were aged ≥16 years (n = 300) and subcategorised as age ≥20 years (n = 134). Mature nongeriatric horses were age 4-15 years (n = 300). Information obtained included medical (included horses subjected to euthanasia without s...
Considerations for pacing of the cricoarytenoid dorsalis muscle by neuroprosthesis in horses.
Equine veterinary journal    August 19, 2010   Volume 42, Issue 6 534-540 doi: 10.1111/j.2042-3306.2010.00115.x
Ducharme NG, Cheetham J, Sanders I, Hermanson JW, Hackett RP, Soderholm LV, Mitchell LM.The success rate of prosthetic laryngoplasty is limited and may be associated with significant sequelae. Nerve muscle pedicle transplantation has been attempted but requires a year before function is restored. Objective: To determine the optimal parameters for functional electrical stimulation of the recurrent laryngeal nerve in horses. Methods: An experimental in vivo study was performed on 7 mature horses (2-21 years). A nerve cuff was placed on the distal end of the common trunk of the recurrent laryngeal nerve (RLN). In 6 horses the ipsilateral adductor branch of RLN was also transected. T...
Arthroscopic removal of fractures of the lateral malleolus of the tibia in the tarsocrural joint: a retrospective study of 13 cases.
Equine veterinary journal    August 19, 2010   Volume 42, Issue 6 558-562 doi: 10.1111/j.2042-3306.2010.00103.x
O'Neill HD, Bladon BM.There is limited information on the treatment of lateral malleolus (LM) fractures in the horse, with no previously published case series for the outcome following arthroscopic removal of such fractures. This report reviews and evaluates findings of a retrospective study of 13 horses admitted to a private equine referral hospital over a 10 year period (1999-2009) that underwent arthroscopic removal of fractures of the LM. Hospital records were reviewed and details including patient history, aetiology of the fracture and limb affected, results of all diagnostic tests and surgical reports were do...
A cadaver study comparing two approaches to perform a maxillary nerve block in the horse.
Equine veterinary journal    August 19, 2010   Volume 42, Issue 8 721-725 doi: 10.1111/j.2042-3306.2010.00080.x
Bardell D, Iff I, Mosing M.Anaesthesia of the maxillary nerve of the horse has been described using several approaches, but sparse data exist to evaluate the accuracy of these methods. Objective: This study compared 2 previously described approaches to the maxillary nerve to assess their relative accuracies. Methods: Thirty severed heads from horse cadavers were arranged to approximate the position of a live horse. Methylene blue (0.25 or 0.1 ml) was injected using a 19 gauge 90 mm spinal needle by one of 2 approaches, the method used being randomly allocated in each instance. Method ANG: angulated needle insertion on t...
Romifidine as a constant rate infusion in isoflurane anaesthetized horses: a clinical study.
Veterinary anaesthesia and analgesia    August 18, 2010   Volume 37, Issue 5 425-433 doi: 10.1111/j.1467-2995.2010.00556.x
Devisscher L, Schauvliege S, Dewulf J, Gasthuys F.To evaluate the effects of a constant rate infusion (CRI) of romifidine on the requirement of isoflurane, cardiovascular performance and recovery in anaesthetized horses undergoing arthroscopic surgery. Methods: Randomized blinded prospective clinical trial. Methods: Thirty horses scheduled for routine arthroscopy. Methods: After premedication (acepromazine 0.02 mg kg(-1), romifidine 80 microg kg(-1), methadone 0.1 mg kg(-1)) and induction (midazolam 0.06 mg kg(-1) ketamine 2.2 mg kg(-1)), anaesthesia was maintained with isoflurane in oxygen. Horses were assigned randomly to receive a CRI of s...
Cutaneous schwannomas in 22 horses.
Veterinary pathology    August 17, 2010   Volume 48, Issue 2 433-442 doi: 10.1177/0300985810377072
Schöniger S, Valentine BA, Fernandez CJ, Summers BA.Schwannomas are uncommonly recognized in horses. This study describes cutaneous schwannomas in 22 horses aged 8 to 25 years: 12 male, 7 female, and 3 of unknown sex. The horses had solitary cutaneous masses: 9 on the head, 3 on the neck, and the others on the shoulder, hip, thorax, abdomen, rump, extremities, or tail. The location of 1 tumor was unknown. The dermal tumors were well demarcated and expansile. Twelve had a multinodular pattern, whereas 10 formed a single nodule. Antoni A areas were observed in all tumors, and 10 tumors contained Antoni B areas. In Antoni A areas, the densely pack...
Functional electrical stimulation of the left recurrent laryngeal nerve using a vagus nerve stimulator in a normal horse.
Veterinary journal (London, England : 1997)    August 17, 2010   Volume 189, Issue 3 346-348 doi: 10.1016/j.tvjl.2010.07.008
Vanschandevijl K, Nollet H, Vonck K, Raedt R, Boon P, Roost D, Martens A, Deprez P.The aim of this study was to assess the feasibility of implanting an existing vagus nerve stimulating (VNS) electrode around the recurrent laryngeal nerve. The stimulus response characteristics required to achieve abduction of the ipsilateral arytenoid by the VNS electrode in the normal horse could then be determined. The electrode was wound around the left recurrent laryngeal nerve at the cervical level and connected to a pulse generator. Stimulus response characteristics were obtained by measuring stimulated arytenoid displacement endoscopically in the standing, non-sedated horse. A full and...
Extraluminal, C shaped polyethylene prostheses in two ponies with tracheal collapse.
Veterinary surgery : VS    August 14, 2010   Volume 39, Issue 6 776-783 doi: 10.1111/j.1532-950X.2010.00715.x
Busschers E, Epstein KL, Holt DE, Parente EJ.To describe the surgical technique, complications, and outcome after use of extraluminal prostheses in 2 ponies with severe tracheal collapse. Methods: Clinical report. Methods: Ponies (n=2) with severe tracheal collapse. Methods: A ventral median approach was used to expose the trachea from the larynx to the manubrium. Extraluminal, high-density polyethylene, C-shaped prostheses were sutured to the dorsal tracheal membrane and tracheal rings to provide external tracheal support. Results: The surgical approach provided good tracheal access and placement of the rings was uncomplicated. Initial ...
Removal of 11 incompletely erupted, impacted cheek teeth in 10 horses using a dental alveolar transcortical osteotomy and buccotomy approach.
Veterinary surgery : VS    August 12, 2010   Volume 39, Issue 7 884-890 doi: 10.1111/j.1532-950X.2010.00724.x
Tremaine WH, McCluskie LK.To describe surgical technique and outcome in 10 horses with impacted cheek teeth that were removed by a transcortical osteotomy and buccotomy technique. Methods: Case series. Methods: Horses (n=10) with impacted cheek teeth. Methods: Medical records (2002-2008) of horses with impacted cheek teeth requiring removal were reviewed; surgical technique and outcome were determined. Results: Exodontia of 11 cheek teeth was performed surgically in 10 horses; 3 horses had complications (residual swelling of the mandible) that resolved and all horses returned to their previous use. Conclusions: Transco...
Farriery for chronic laminitis.
The Veterinary clinics of North America. Equine practice    August 12, 2010   Volume 26, Issue 2 407-423 doi: 10.1016/j.cveq.2010.04.008
O'Grady SE.Laminitis is considered chronic once the distal phalanx has displaced within the hoof capsule. Chronic laminitis generally occurs as a direct sequel to acute laminitis. Clinical evaluation of chronic laminitis is best performed with a thorough clinical examination and radiography. The mainstay of hoof care is therapeutic farriery. In this article, the goals and principles of hoof care, the appropriate trim and various shoes that form the bulk of farriery for chronic laminitis, and surgical treatments are discussed.
Laser vaporization of the dorsal turbinate as an alternative method of accessing and evaluating the paranasal sinuses.
Veterinary surgery : VS    August 12, 2010   Volume 39, Issue 7 891-899 doi: 10.1111/j.1532-950X.2010.00728.x
Morello SL, Parente EJ.To report a technique for stoma creation into the conchofrontal sinus (CFS) through the dorsal turbinate and to evaluate stoma as a site for sinoscopy. Methods: Prospective experimental study. Methods: Cadaveric equine heads (n=2) and normal adult horses (5). Methods: Technique feasibility was established on 2 cadaver heads. A diode laser fiber with a contact probe was passed into the nasal passage through a custom built, laser introducer rod (LIR). A videoendoscope was passed ventral to the LIR. A site on the caudal, medial aspect of the turbinate overlying the dorsal conchal sinus (DCS) was ...
Evaluation of a transvaginal laparoscopic natural orifice transluminal endoscopic surgery approach to the abdomen of mares.
Veterinary surgery : VS    August 12, 2010   Volume 39, Issue 7 873-878 doi: 10.1111/j.1532-950X.2010.00722.x
Alford C, Hanson R.To report natural orifice transluminal endoscopic surgery (NOTES) using laparoscopic and endoscopic instrumentation transvaginally into the mare's abdomen and identify structures visible using this approach. Methods: Descriptive experimental study. Methods: Mares (n=8). Methods: A standing, transvaginal approach was made in the cranial vaginal vault at either the 1 (right; 4 mares) or 11 (left; 4 mares) o'clock position relative to the cervix. The abdomen was visually explored and the viscera evaluated using a 2 m flexible endoscope followed by a 62 cm laparoscope. Incisional healing was monit...
In vitro comparison of two centrally threaded, positive-profile transfixation pin designs for use in third metacarpal bones in horses.
American journal of veterinary research    August 3, 2010   Volume 71, Issue 8 976-981 doi: 10.2460/ajvr.71.8.976
Bubeck KA, García-Lopez JM, Jenei TM, Maranda LS.To compare heat generation during insertion, pullout strength, and associated microdamage between a self-tapping positive profile transfixation pin (STTP) and nontapping positive profile transfixation pin (NTTP). Methods: 30 pairs of third metacarpal bones (MC3s) from adult equine cadavers. Methods: One MC3 of each pair was assigned to the STTP group; the other was assigned to the NTTP group. The assigned pin was inserted into the diaphysis in a lateral to medial direction. Bone temperature increase during pilot-hole drilling and pin insertion was recorded at 1 mm from the final thread positio...
Thoracoscopic lung biopsies in heaves-affected horses using a bipolar tissue sealing system.
Veterinary surgery : VS    August 3, 2010   Volume 39, Issue 7 839-846 doi: 10.1111/j.1532-950X.2010.00720.x
Relave F, David F, Leclère M, Alexander K, Hélie P, Meulyzer M, Lavoie JP, Marcoux M.To validate the use of the LigaSure™ Vessel Sealing System (LVSS) to perform thoracoscopic lung tissue biopsies in heaves-affected horses. Methods: Prospective clinical study. Methods: Heaves-affected horses (n=12). Methods: Lung biopsies (n=34) were collected with the LVSS (2-4 biopsies/horse) in horses with and without clinical signs of heaves. Thoracoscope (13th intercostal space [ICS]) and 2 instruments (between the 12-15th ICS) portals were used. Selected clinical and arterial blood gas variables were monitored. Postoperative pneumothorax was evaluated. Depth of thermal injury to the su...
Standing lateral thoracotomy in horses: indications, complications, and outcomes.
Veterinary surgery : VS    August 3, 2010   Volume 39, Issue 7 847-855 doi: 10.1111/j.1532-950X.2010.00713.x
Hilton H, Aleman M, Madigan J, Nieto J.To describe the indications for, complications arising from, and outcome of horses that had standing lateral thoracotomy for pleural or pericardial disease. Methods: Case series. Methods: Horses (n=16). Methods: Medical records (January 1990-December 2008) of sedated standing horses that had lateral thoracotomy were reviewed. Clinical and surgical findings, perioperative and short-term complications were recorded. Long-term (>6 months) outcome was determined through telephone conversations with owners and veterinarians. Results: Mean (±SD) horse age was 6.6±5.3 years (range, 1-15 years). ...
Pythium insidiosum: an overview.
Veterinary microbiology    July 24, 2010   Volume 146, Issue 1-2 1-16 doi: 10.1016/j.vetmic.2010.07.019
Gaastra W, Lipman LJ, De Cock AW, Exel TK, Pegge RB, Scheurwater J, Vilela R, Mendoza L.Pythium insidiosum is an oomycete pathogenic in mammals. The infection occurs mainly in tropical and subtropical areas, particularly in horses, dogs and humans. Infection is acquired through small wounds via contact with water that contains motile zoospores or other propagules (zoospores or hyphae). The disease, though described as emerging has in fact already been described since 1884. Depending on the site of entry, infection can lead to different forms of pythiosis i.e. a cutaneous, vascular, ocular, gastrointestinal and a systemic form, which is rarely seen. The infection is not contagious...
Outcome and long-term follow-up of 20 horses undergoing surgery for caecal impaction: a retrospective study (2000-2008).
Equine veterinary journal    July 20, 2010   Volume 42, Issue 5 388-392 doi: 10.1111/j.2042-3306.2010.00087.x
Smith LC, Payne RJ, Boys Smith SJ, Bathe AP, Greet TR.If untreated, caecal impaction may progress to rupture of the caecum and reports of long-term outcome for horses undergoing surgery for caecal impaction are required. Objective: To describe short- and long-term complication rates for horses undergoing surgery for caecal impaction in an otherwise life-threatening gastrointestinal condition. Methods: Case records were reviewed for horses undergoing surgery for caecal impaction. Horses were included in the study if an abnormally large, fluid-distended or feed-impacted caecum was the primary diagnosis at surgery and excluded if the caecum had alre...
Risk factors for incisional complications after exploratory celiotomy in horses: do skin staples increase the risk?
Veterinary surgery : VS    July 20, 2010   Volume 39, Issue 5 616-620 doi: 10.1111/j.1532-950X.2009.00636.x
Torfs S, Levet T, Delesalle C, Dewulf J, Vlaminck L, Pille F, Lefere L, Martens A.To assess risk factors for celiotomy incisional infection in horses, especially the use of staples for skin closure. Methods: Case series. Methods: Horses (n=356) that had 1 exploratory celiotomy for colic and survived >2 weeks after surgery between March 1, 2004 and December 31, 2007. Methods: Incisions were classified as "normal" (no complication, only edema, serous drainage lasting <24 hours) or as "surgical site infection (SSI)" (persistent serosanguinous drainage or purulent drainage with or without positive bacterial culture). All possible risk factors, including method of skin closure (...
Size and geometry of apical sesamoid fracture fragments as a determinant of prognosis in Thoroughbred racehorses.
Equine veterinary journal    July 20, 2010   Volume 43, Issue 4 412-417 doi: 10.1111/j.2042-3306.2010.00134.x
Kamm JL, Bramlage LR, Schnabel LV, Ruggles AJ, Embertson RM, Hopper SA.Analysis was performed to examine a method for refining the preoperative prognosis for horses that had surgery to remove apical fractures of the proximal sesamoid bones (PSBs). Objective: To determine if: 1) there was a difference in size or configuration of apical fractures between the different anatomical locations of the PSBs, which have been shown to affect the prognosis; and 2) the size or configuration could predict the prognosis for racehorses with these fractures. Methods: The study included 110 weanlings and yearlings and 56 training racehorses that underwent surgery to remove apical ...
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