Medullary decompression of the radius as treatment for lameness in a horse.
Abstract: Increased intraosseous pressure (IOP) is a well-characterized source of pain in humans that can be successfully treated by medullary decompression. This report describes the clinical and diagnostic findings, treatment and successful outcome of a horse with a four week long, non-weight bearing lameness secondary to suspected traumatically-induced increased IOP in the left radius. Scintigraphic examination characterized by severe increase in radiopharmaceutical uptake within the affected radius aided in the initial localization of the source of lameness. Decompression of the affected radius was performed by drilling two 3.2 mm tracts through the lateral bone cortex into the medullary cavity. Intramedullary pressure in the radius was measured (37-39 mmHg). Dramatic clinical improvement was observed after surgical decompression of the affected bone and the horse showed full recovery and returned to previous exercise use by 12 months after treatment. Gradual decrease in radial radiopharmaceutical uptake was observed during the following year. Increased IOP should be considered as a cause of lameness in horses and scintigraphic examination may aid in its diagnosis. Medullary decompression may be a successful treatment in some cases.
Publication Date: 2013-04-24 PubMed ID: 23612719DOI: 10.3415/VCOT-12-09-0123Google Scholar: Lookup
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Summary
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The research article presents a case study of a horse treated for lameness through medullary decompression of the radius, due to suspected trauma-induced increased intraosseous pressure (IOP). The horse recovered and returned to normal exercise usage within 12 months post-treatment.
Introduction and Diagnosis
- The horse in the study was found to be suffering from a non-weight bearing lameness for four weeks, suspected to be caused by traumatically-induced increased intraosseous pressure (IOP) in the left radius. The IOP was thought to be the source of pain, a condition well-studied in humans.
- A scintigraphic examination was conducted to initially locate the source of lameness, marked by a severe increase in radiopharmaceutical uptake within the affected radius. Scintigraphy is a diagnostic technique in which a two-dimensional picture of a body radiation source is obtained through the use of radioactive isotopes.
Surgical Procedure
- Decompression of the affected radius was performed by drilling two 3.2 mm tracts through the lateral bone cortex into the medullary cavity. This is to alleviate the pressure and resultant pain from the heightened IOP.
- The intramedullary pressure within the radius was measured at 37-39 mmHg during the procedure.
Post-Treatment Recovery
- After the surgical decompression, there was significant clinical improvement in the horse’s condition.
- The horse was able to return to its previous exercise use by 12 months after the treatment, indicating full recovery.
- A continued gradual decrease in radial radiopharmaceutical uptake was also observed during the following year of recovery, which may suggest the reduction in inflammation and the healing of the affected radius.
Conclusion
- The study concludes that increased IOP should be considered as a possible cause of lameness in horses.
- The use of scintigraphic examination can help in diagnosing such cases.
- For some horses, medullary decompression may serve as a successful treatment for lameness caused by increased IOP.
Cite This Article
APA
Rubio-Martínez LM, Carstens A.
(2013).
Medullary decompression of the radius as treatment for lameness in a horse.
Vet Comp Orthop Traumatol, 26(4), 311-317.
https://doi.org/10.3415/VCOT-12-09-0123 Publication
Researcher Affiliations
- Department of Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, Republic of South Africa. luis.rubiomartinez@hotmail.com
MeSH Terms
- Animals
- Decompression, Surgical / veterinary
- Horses / injuries
- Lameness, Animal / diagnosis
- Lameness, Animal / surgery
- Male
- Pain / etiology
- Pain / surgery
- Pain / veterinary
- Periosteum / surgery
- Pressure
Citations
This article has been cited 1 times.- Zhao Y, Zhang G, Song Q, Fan L, Shi Z. Intramedullary core decompression combined with endoscopic intracapsular decompression and debridement for pre-collapse non-traumatic osteonecrosis of the femoral head. J Orthop Surg Res 2023 Jan 2;18(1):6.
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