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Veterinary surgery : VS2018; 47(7); 908-915; doi: 10.1111/vsu.12936

Conservative versus surgical treatment of 21 sports horses with osseous trauma in the proximal phalangeal sagittal groove diagnosed by low-field MRI.

Abstract: To compare the outcome following conservative vs surgical management of sports horses with a diagnosis of subchondral bone trauma of the proximal aspect of the proximal phalanx (PP) by low-field MRI. Methods: Retrospective case series. Methods: Twenty-one mature sports horses with evidence of high water signal within the proximal sagittal groove of the PP according to low-field MRI of the fetlock, with no definitive radiographic evidence of fracture. Methods: Medical records (2010-2017) of horses admitted to 2 referral hospitals were reviewed. Historical, clinical, radiographic, and MRI findings and treatment choice were recorded. Conservative management consisted of confinement to a stall followed by gradual reintroduction to exercise. Surgical management consisted of cortical screw fixation across the proximal aspect of the PP. Long-term outcome was determined by telephone questionnaire or by clinical records review. Fisher's exact test was used to compare outcome between the 2 treatment groups. Results: Follow-up was available in 17 of 21 horses in the study, including 8 horses treated conservatively and 9 treated surgically. No difference in outcome was detected in this study; 4 of 8 horses were sound after conservative management, and 5 of 9 horses were sound after surgery (P > .99). Conclusions: Approximately half of the horses that had a diagnosis of osseous trauma within the proximal aspect of PP returned to athletic activity, regardless of conservative or surgical management. Conclusions: The prognosis for return to athletic functions in horses with osseous trauma within the proximal aspect of the PP is guarded.
© 2018 The American College of Veterinary Surgeons.
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Publication Date: 2018-09-14 PubMed ID: 30216476PubMed Central: PMC6690071DOI: 10.1111/vsu.12936Google Scholar: Lookup
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Summary

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The research compares the outcomes of conservative treatment against surgical treatment in sports horses diagnosed with bone injury in the proximal phalangeal sagittal groove by using low-field MRI. They found that approximately half of the injured horses managed to return to athletic activity, regardless of the treatment method.

Study Methodology

  • The researchers performed a retrospective case study on 21 sports horses. These horses were mature and had high water signals within the proximal sagittal groove of the proximal phalanx (PP), as detected by low-field MRI of the fetlock.
  • None of the horses involved in the study had definitive radiographic evidence of fracture.
  • They analyzed the medical records of these horses from the years 2010 to 2017. They reviewed the historical and clinical data, radiographic and MRI findings, as well as the treatment options pursued.
  • Conservative management involved keeping the horse in confinement followed by a gradual reintroduction to exercise. For horses that went under surgical management, cortical screw fixation across the proximal aspect of the PP was performed.
  • The long-term outcomes of the treatment were determined either by a telephone questionnaire or by reviewing the clinical records.

Study Results

  • Out of 21 horses, they were able to gather follow-up data on 17 horses, including 8 that received conservative treatment and 9 that underwent surgery.
  • The study found no significant difference in outcomes between the horses that received conservative management and those that had surgery.
  • Out of the 8 horses that received conservative treatment, 4 made a recovery and were capable of sound movement. Similarly, 5 out of the 9 horses that underwent surgical management could move soundly post-recovery.
  • Approximately half of the horses with an osseous trauma diagnosis in the proximal aspect of the PP were able to return to athletic activity.

Study Conclusion

  • Irrespective of whether conservative or surgical management was employed, about half of the sports horses diagnosed with osseous trauma in the proximal aspect of the PP managed to return to athletic activities.
  • The prognosis for horses with such traumas to return to athletic functionality remained guarded based on these findings.

Cite This Article

APA
Lipreri G, Bladon BM, Giorio ME, Singer ER. (2018). Conservative versus surgical treatment of 21 sports horses with osseous trauma in the proximal phalangeal sagittal groove diagnosed by low-field MRI. Vet Surg, 47(7), 908-915. https://doi.org/10.1111/vsu.12936

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 47
Issue: 7
Pages: 908-915

Researcher Affiliations

Lipreri, Giulia
  • Leahurst Equine Hospital, University of Liverpool, Neston, United Kingdom.
Bladon, Bruce M
  • Donnington Grove Veterinary Group, Newbury, United Kingdom.
Giorio, Maria Elisabetta
  • Donnington Grove Veterinary Group, Newbury, United Kingdom.
Singer, Ellen R
  • Institute of Chronic and Ageing Disease, University of Liverpool, Liverpool, United Kingdom.

MeSH Terms

  • Animals
  • Bone Screws / veterinary
  • Bone and Bones / diagnostic imaging
  • Extremities
  • Female
  • Fractures, Bone / surgery
  • Fractures, Bone / veterinary
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / surgery
  • Horses
  • Magnetic Resonance Imaging / veterinary
  • Male
  • Prognosis
  • Retrospective Studies
  • Sports
  • Treatment Outcome

Grant Funding

  • Horserace Betting Levy Board

Conflict of Interest Statement

The authors declare no conflict of interest related to this report.

References

This article includes 23 references
  1. Dyson S, Nagy A, Murray R. Clinical and diagnostic imaging findings in horses with subchondral bone trauma of the sagittal groove of the proximal phalanx.. Vet Radiol Ultrasound 2011 Nov-Dec;52(6):596-604.
    pubmed: 21831247doi: 10.1111/j.1740-8261.2011.01852.xgoogle scholar: lookup
  2. Ramzan PH, Powell SE. Clinical and imaging features of suspected prodromal fracture of the proximal phalanx in three Thoroughbred racehorses.. Equine Vet J 2010 Mar;42(2):164-9.
    pubmed: 20156254doi: 10.2746/042516409x478695google scholar: lookup
  3. Powell SE. Low-field standing magnetic resonance imaging findings of the metacarpo/metatarsophalangeal joint of racing Thoroughbreds with lameness localised to the region: a retrospective study of 131 horses.. Equine Vet J 2012 Mar;44(2):169-77.
    pubmed: 21696431doi: 10.1111/j.2042-3306.2011.00389.xgoogle scholar: lookup
  4. Gold SJ, Werpy NM, Gutierrez-Nibeyro SD. INJURIES OF THE SAGITTAL GROOVE OF THE PROXIMAL PHALANX IN WARMBLOOD HORSES DETECTED WITH LOW-FIELD MAGNETIC RESONANCE IMAGING: 19 CASES (2007-2016).. Vet Radiol Ultrasound 2017 May;58(3):344-353.
    pubmed: 28281306doi: 10.1111/vru.12488google scholar: lookup
  5. Brünisholz HP, Hagen R, Fürst AE, Kuemmerle JM. Radiographic and Computed Tomographic Configuration of Incomplete Proximal Fractures of the Proximal Phalanx in Horses Not Used for Racing.. Vet Surg 2015 Oct;44(7):809-15.
    pubmed: 26197984doi: 10.1111/vsu.12364google scholar: lookup
  6. Walsh DA, Chapman V. Bisphosphonates for osteoarthritis.. Arthritis Res Ther 2011;13(5):128.
    pmc: PMC3308068pubmed: 21996085doi: 10.1186/ar3448google scholar: lookup
  7. Kuemmerle JM, Auer JA, Rademacher N, Lischer CJ, Bettschart-Wolfensberger R, Fürst AE. Short incomplete sagittal fractures of the proximal phalanx in ten horses not used for racing.. Vet Surg 2008 Feb;37(2):193-200.
    pubmed: 18251814doi: 10.1111/j.1532-950x.2007.00359.xgoogle scholar: lookup
  8. Ross MW. Fetlock lameness. In: Proceedings from the American College of Veterinary Surgeons Veterinary Symposium; November 3‐5, 2011; Chicago, IL, p 93‐102.
  9. Dallap BL, Bramlage LR, Embertson RM. Results of screw fixation combined with cortical drilling for treatment of dorsal cortical stress fractures of the third metacarpal bone in 56 Thoroughbred racehorses.. Equine Vet J 1999 May;31(3):252-7.
    pubmed: 10402141
  10. Wyn‐Jones G. Equine Lameness. Oxford, UK: Blackwell Scientific; 1988.
  11. Werpy N. Low‐field MRI in horses: practicalities and image acquisition. In: Murray RC, ed. Equine MRI. Hoboken, NJ: Wiley‐Blackwell; 2011:75‐99.
  12. 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 Apr 15;206(8):1195-9.
    pubmed: 7768743
  13. Cook JL, Evans R, Conzemius MG, Lascelles BD, McIlwraith CW, Pozzi A, Clegg P, Innes J, Schulz K, Houlton J, Fortier L, Cross AR, Hayashi K, Kapatkin A, Brown DC, Stewart A. Proposed definitions and criteria for reporting time frame, outcome, and complications for clinical orthopedic studies in veterinary medicine.. Vet Surg 2010 Dec;39(8):905-8.
    pubmed: 21133952doi: 10.1111/j.1532-950x.2010.00763.xgoogle scholar: lookup
  14. Martig S, Chen W, Lee PV, Whitton RC. Bone fatigue and its implications for injuries in racehorses.. Equine Vet J 2014 Jul;46(4):408-15.
    pubmed: 24528139doi: 10.1111/evj.12241google scholar: lookup
  15. Noble P, Singer ER, Jeffery NS. Does subchondral bone of the equine proximal phalanx adapt to race training?. J Anat 2016 Jul;229(1):104-13.
    pmc: PMC5341590pubmed: 27075139doi: 10.1111/joa.12478google scholar: lookup
  16. Contino EK, Werpy NM, Morton A. Metacarpophalangeal joint lesions identified on magnetic resonance imaging with lameness that resolved using palmar digital nerve and intra‐articular analgesia. In: Proceedings of the 58th Annual Meeting of the American Association of Equine Practitioners; December 1‐5, 2012; Anaheim, CA, p 534.
  17. Schumacher J, Schumacher J, Schramme MC. Diagnostic analgesia of the equine forefoot. Equine Vet Educ 2004;16:159‐165.
  18. Nagy A, Malton R. Diffusion of radiodense contrast medium after perineural injection of the palmar digital nerves. Equine Vet Educ 2015;27:648‐654.
  19. Arendt EA, Griffiths HJ. The use of MR imaging in the assessment and clinical management of stress reactions of bone in high-performance athletes.. Clin Sports Med 1997 Apr;16(2):291-306.
    pubmed: 9238311doi: 10.1016/s0278-5919(05)70023-5google scholar: lookup
  20. Nye NS, Covey CJ, Sheldon L, Webber B, Pawlak M, Boden B, Beutler A. Improving Diagnostic Accuracy and Efficiency of Suspected Bone Stress Injuries.. Sports Health 2016 May Jun;8(3):278-283.
    pmc: PMC4981068pubmed: 26945021doi: 10.1177/1941738116635558google scholar: lookup
  21. Sofka CM. Imaging of stress fractures.. Clin Sports Med 2006 Jan;25(1):53-62, viii.
    pubmed: 16324973doi: 10.1016/j.csm.2005.08.009google scholar: lookup
  22. Ganiyusufoglu AK, Onat L, Karatoprak O, Enercan M, Hamzaoglu A. Diagnostic accuracy of magnetic resonance imaging versus computed tomography in stress fractures of the lumbar spine.. Clin Radiol 2010 Nov;65(11):902-7.
    pubmed: 20933645doi: 10.1016/j.crad.2010.06.011google scholar: lookup
  23. Groves AM, Cheow HK, Balan KK, Housden BA, Bearcroft PW, Dixon AK. 16-Detector multislice CT in the detection of stress fractures: a comparison with skeletal scintigraphy.. Clin Radiol 2005 Oct;60(10):1100-5.
    pubmed: 16179170doi: 10.1016/j.crad.2005.05.014google scholar: lookup

Citations

This article has been cited 1 times.
  1. Mizobe F, Nomura M, Ueno T, Yamada K. Bone marrow oedema-type signal in the proximal phalanx of Thoroughbred racehorses.. J Vet Med Sci 2019 Apr 16;81(4):593-597.
    doi: 10.1292/jvms.18-0530pubmed: 30828037google scholar: lookup
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