FREE SHIPPING over $40
OVER 9000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Home / Equine Research Bank / Equine Vet J / Arthroscopic evaluation of the metacarpophalangeal and metat...
Equine veterinary journal2020; 53(4); 746-751; doi: 10.1111/evj.13343

Arthroscopic evaluation of the metacarpophalangeal and metatarsophalangeal joints in horses with parasagittal fractures of the proximal phalanx.

Abstract: Fractures of the proximal phalanx are one of the most common long bone fractures of Thoroughbred racehorses. Although the degree of disruption and damage to the articular surface is generally considered a major prognostic determinant, associated arthroscopic findings have not previously been reported. Objective: To describe the metacarpo/metatarsophalangeal (MCP/MTP) joint lesions associated with parasagittal fractures of the proximal phalanx arthroscopically identified at the time of fracture repair and compare radiographic and arthroscopic appearance of complete fractures. Methods: Retrospective case series. Methods: Case records and arthroscopic images of horses with parasagittal fractures of the proximal phalanx admitted to Newmarket Equine Hospital from 2007 to 2017 were analysed. Results: 81 MCP/MTP joints in 78 horses underwent arthroscopic evaluation concurrent to parasagittal fracture repair. Tears of the joint capsule and dorsal synovial plica were noted in 43 cases. Arthroscopy identified articular incongruity in three horses where fracture displacement was not predicted at all on pre-operative radiographs, and incongruity in additional plane(s) to the radiographic displacement in 14 horses. Concurrent osteochondral fragmentation and disruption of cartilage were present in some cases. Conclusions: As a retrospective study, the arthroscopic data available for review were variable. Arthroscopic assessment of fracture reduction and joint congruency was evaluated in all cases but there was variation in the completeness of evaluation of the entire dorsal joint space of the fetlock joint. This may have led to the underestimation of soft tissue lesions in these cases. Conclusions: Some horses suffering from parasagittal proximal phalanx fractures have concurrent tearing of the joint capsule and/or dorsal plica, which may have relevance in the acute course of events resulting in the development of fractures. Fracture displacement and incongruency at the articular surface cannot confidently be excluded pre-operatively by radiographs alone.
© 2020 EVJ Ltd.
Get Full Text
Publication Date: 2020-09-24 PubMed ID: 32885508DOI: 10.1111/evj.13343Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
LinkedInCopy
  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research paper investigates the joint lesions in horses associated with fractures of the proximal phalanx, and assesses the precision of pre-operative radiographs in predicting these fractures through an analysis of case records and arthroscopic images from Newmarket Equine Hospital over a decade.

Objective and Methodology Employed

  • The study aimed to uncover and describe the lesions in the metacarpo/metatarsophalangeal (MCP/MTP) joint in horses suffering from parasagittal fractures of the proximal phalanx.
  • The researchers carried out a retrospective analysis of case records and arthroscopic images, obtained from horses admitted to Newmarket Equine Hospital between 2007 and 2017.
  • The study also sought to compare the appearances of complete fractures as seen on radiographic images and arthroscopies, assessing the precision of the former in predicting the fractures.

Findings of the Research

  • Out of 78 horses studied, arthroscopic evaluation showed that 81 MCP/MTP joints exhibited signs of parasagittal fracture repair.
  • In 43 cases, tears were observed in the joint capsule and dorsal synovial plica.
  • Articular incongruity, unanticipated by pre-operative radiographs, was identified during arthroscopy in three horses, and incongruity in additional planes was identified in 14 horses, in relation to the radiographic displacement.
  • In some instances, concurrent osteochondral fragmentation and disruption of cartilage were also present.

Conclusions Drawn in the Study

  • Due to the variability of available arthroscopic data and incompleteness of evaluation of the entire dorsal joint space of the fetlock joint, soft tissue lesions could have been underestimated.
  • Fracture displacement and incongruity on the articular surface cannot confidently be ascertained through pre-operative radiographs alone.
  • The study implies that some horses suffering from parasagittal proximal phalanx fractures also have concurrent tearing of the joint capsule and/or dorsal plica. This observation could have implications in studying the acute course leading to the development of such fractures.

Cite This Article

APA
James FM, Smith MRW, Wright IM. (2020). Arthroscopic evaluation of the metacarpophalangeal and metatarsophalangeal joints in horses with parasagittal fractures of the proximal phalanx. Equine Vet J, 53(4), 746-751. https://doi.org/10.1111/evj.13343

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 53
Issue: 4
Pages: 746-751

Researcher Affiliations

James, Frances M
  • Newmarket Equine Hospital, Newmarket, UK.
Smith, Matthew R W
  • Newmarket Equine Hospital, Newmarket, UK.
Wright, Ian M
  • Newmarket Equine Hospital, Newmarket, UK.

MeSH Terms

  • Animals
  • Arthroscopy / veterinary
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / surgery
  • Fractures, Bone / veterinary
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / surgery
  • Horses
  • Metatarsophalangeal Joint
  • Retrospective Studies

References

This article includes 24 references
  1. Parkin TDH. Epidemiology of racetrack injuries in racehorses.. Vet Clin North Am: Eq Pract 2008;24:1-19.
  2. Bathe AP. 245 Fractures in Thoroughbred racehorses: results of a 2-year prospective study in Newmarket.. Proc Am Ass Equine Practnrs 1994;40:175.
  3. Ramzan PHL, Palmer L. Musculoskeletal injuries in Thoroughbred racehorses: a study of three large training yards in Newmarket, UK (2005-2007).. Vet J 2011;187:325-9.
  4. Johnson BJ, Stover SM, Daft BM, Kinde H, Read DH, Barr BC. Causes of death in racehorses over a 2 year period.. Equine Vet J 1994;26:327-30.
  5. Smith MRW, Wright IM. Radiographic configuration and healing of 121 fractures of the proximal phalanx in 120 Thoroughbred racehorses (2007-2011).. Equine Vet J 2014;46:81-7.
  6. Smith MRW, Wright IM. Are there radiologically identifiable prodromal changes in Thoroughbred racehorses with parasagittal fractures of the proximal phalanx?. Equine Vet J 2013;46:88-91.
  7. Holcombe SJ, Schneider RK, Bramlage LR, Gabel AA, Bertone AL, Beard WL. Lag screw fixation of noncomminuted sagittal fractures of the proximal phalanx in racehorses: 59 cases (1973-1991).. J Am Vet Med Assoc 1995;206:1195-9.
  8. Ellis DR, Simpson DJ, Greenwood RE, Crowhurst JS. Observations and management of fractures of the proximal phalanx in young Thoroughbreds.. Equine Vet J 1987;19:43-9.
  9. Markel MD, Richardson DW. Noncomminuted fractures of the proximal phalanx in 69 horses.. J Am Vet Med Assoc 1985;186:573-9.
  10. Fackelman GE. Sagittal fractures of the first phalanx (P1) in the horse: fixation by the lag screw principle.. Vet Med Small Anim Clinician 1973;68:622-36.
  11. Gabel AA, Bukowiecki CF. Fractures of the phalanges.. Vet Clin North Am Large Anim Pract 1983;5:233-60.
  12. Nixon AJ. Phalanges and the Metacarpophalangeal and Metatarsophalangeal Joints.. 2012, pp 1300-24.
  13. Richardson DW. Fractures of the Proximal Phalanx.. 1996, pp 117-28.
  14. Richardson DW. Arthroscopically assisted repair of articular fractures.. Clin Tech Eq Pract 2002;1:211-7.
  15. Richardson DW. Third metacarpal and metatarsal bones.. 2012, pp 1325-38.
  16. McIlwraith CW, Nixon AJ, Wright IM. Diagnostic and Surgical Arthroscopy of the Metacarpophalangeal and Metatarsophalangeal Joints.. 2015, pp 111-76.
  17. Swor TM, Watkins JP, Bahr A, Honnas CM. Results of plate fixation of type 1b olecranon fractures in 24 horses.. Equine Vet J 2003;35:670-5.
  18. Getty R. General Syndesmology (Arthrology).. 1975, pp 34-8.
  19. White NA. Synovial pad proliferation in the metacarpophalangeal joint.. 1990, pp 555-8.
  20. Dabareiner RM, White NA, Sullins KE. Metacarpophalangeal joint synovial pad proliferation.. Vet Surg 1996;25:199-206.
  21. Martig S, Chen W, Lee PVS, Whitton RC. Bone fatigue and its implications for injuries in racehorses.. Equine Vet J 2014;46:408-15.
  22. O'Hare LM, Cox PG, Jeffery N, Singer ER. Finite element analysis of stress in the equine proximal phalanx.. Equine Vet J 2012;45:273-7.
  23. Noble P, Singer ER, Jeffery NS. Does subchondral bone of the equine proximal phalanx adapt to race training?. J Anat 2016;229:104-13.
  24. Richardson DW, Dyson SJ. The Metacarpophalangeal Joint.. 2011, pp 394-410.
Subscribe to our newsletter
Join 99,357 horse owners like you who receive our email updates on horse health and nutrition.