FREE SHIPPING over $40
OVER 10000 FIVE-STAR REVIEWS
5% OFF ALL SUBSCRIPTIONS
100% HAPPINESS GUARANTEE
Analyze Diet
0
Veterinary research communications2026; 50(6); 543; doi: 10.1007/s11259-026-11487-8

Successful outcome of open distal interphalangeal joint luxation in equids treated by surgical debridement without internal implants.

Abstract: The distal interphalangeal joint (DIPJ) plays a crucial role in the function of the hoof and digit. Dislocations and subluxations in this region are rare and primarily of traumatic origin. Methods: This case report aims to describe two unusual cases of open DIPJ dislocation, including clinical presentation, diagnostic workup, treatment, and long-term follow-up. Both animals presented with open traumatic distal interphalangeal joint (DIPJ) luxation. In Case 1, the animal received initial care on the property 5 h post-trauma and presented with joint exposure and articular surface contact with the ground. In Case 2, the animal was referred to the veterinary hospital without prior care, 3 h post-trauma, but there was no contact of the articular surface with the ground. Both animals showed grade 5/5 lameness (AAEP). The animals underwent general anesthesia, joint lavage, regional intravenous perfusion with antibiotics, debridement of devitalized tissues, skin synthesis, and immobilization with synthetic casting. During immediate recovery and hospitalization, a grade 4/5 lameness persisted. Long-term radiographic control revealed the development of degenerative joint disease in both animals. After 3 and 2 years, respectively, animals 1 and 2 showed persistent lameness (grade 2/5) with an absence of local sensitivity. Conclusions: The conservative treatment employed in these cases of open DIPJ luxation proved effective for the maintenance of the patients' lives, and although the infectious pathological process invariably progressed to osteoarthritis, the evolution of the clinical conditions allowed for light exercise and maintenance of reproductive activity.
© 2026. The Author(s).
Get Full Text
Publication Date: 2026-08-29 PubMed ID: 42667499PubMed Central: PMC13526076DOI: 10.1007/s11259-026-11487-8Google 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
  • Case Reports

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.

Objective Overview

  • This research article reports on two cases of open distal interphalangeal joint (DIPJ) dislocations in horses treated successfully using surgical debridement without internal implants.
  • The study highlights long-term outcomes emphasizing survival, function, and management of complications such as osteoarthritis.

Detailed Explanation

Background and Importance

  • The distal interphalangeal joint (DIPJ) is critical for the normal function of the hoof and digit in horses, affecting their mobility and weight-bearing ability.
  • Dislocations or subluxations of the DIPJ are rare and usually result from trauma, which can severely impact the animal’s locomotion and welfare.
  • Open luxations (dislocations with joint exposure and possible contamination) present a high risk of infection and poor prognosis, often requiring intensive treatment approaches.

Case Presentation

  • Two equids presented with traumatic open DIPJ luxation:
    • Case 1: Animal received initial treatment approximately 5 hours post-trauma at the site of injury. The injury involved joint exposure with the articular surface in direct contact with the ground, increasing contamination risk.
    • Case 2: Animal referred to a veterinary hospital without initial care, 3 hours post-trauma. Despite no direct contact of the joint surface with the ground, there was still an open luxation.
  • Both animals showed severe lameness (graded 5/5 according to AAEP scale), indicating marked impairment of locomotion due to the injury.

Treatment Protocol

  • Treatment was conservative, avoiding use of internal fixation implants, and involved several key steps:
    • General anesthesia to allow surgical access and reduce animal stress.
    • Joint lavage to clean out contaminants and infected material, reducing infection risk.
    • Regional intravenous perfusion of antibiotics targeting the affected limb to enhance local infection control.
    • Surgical debridement to remove devitalized (dead) soft tissues, which can serve as infection sources if left untreated.
    • Skin synthesis (suturing) to close the wound and reduce further exposure.
    • Immobilization with synthetic casting to stabilize the joint externally and aid healing.
  • Immediately after treatment and during hospitalization, lameness improved marginally to grade 4/5, indicating partial functional recovery.

Long-Term Outcomes

  • Follow-up radiographic evaluations demonstrated degenerative joint disease (osteoarthritis) developing as a consequence of the joint injury and infection.
  • At 2 and 3 years post-treatment, animals exhibited persistent but improved lameness (grade 2/5), meaning mild to moderate impairment remained.
  • Importantly, absence of local sensitivity around the joint indicated resolution of pain or inflammation.
  • Despite osteoarthritis, clinical evolution allowed the animals to perform light exercise comfortably and maintain reproductive activities, indicating good quality of life and functional recovery.

Conclusions and Clinical Significance

  • The cases demonstrate that conservative treatment involving surgical debridement without the use of internal implants can be effective in managing open DIPJ luxation in equids.
  • Although osteoarthritis development was unavoidable due to the infectious process and joint trauma, survival and functional improvement were achieved.
  • This treatment approach can be considered a viable option in similar traumatic open joint injuries to preserve life and maintain some degree of function and utility in affected horses.
  • These results are valuable as they contribute to evidence-based management of rare and complex orthopedic injuries in equine veterinary medicine.

Cite This Article

APA
Ferrari LC, Apolonio EVP, de Oliveira-Gonçalves SL, Rambo ALA, Bergamasco JV, Alonso JM, Watanabe MJ, Alves ALG. (2026). Successful outcome of open distal interphalangeal joint luxation in equids treated by surgical debridement without internal implants. Vet Res Commun, 50(6), 543. https://doi.org/10.1007/s11259-026-11487-8

Publication

Veterinary research communications
ISSN: 1573-7446
NlmUniqueID: 8100520
Country: Switzerland
Language: English
Volume: 50
Issue: 6
PII: 543

Researcher Affiliations

Ferrari, L C
  • Department of Veterinary Surgery and Animal Reproduction, São Paulo State University - UNESP, Botucatu, São Paulo, Brazil. lorena.c.ferrari@unesp.br.
Apolonio, E V P
  • Department of Veterinary Surgery and Animal Reproduction, São Paulo State University - UNESP, Botucatu, São Paulo, Brazil.
de Oliveira-Gonçalves, S L
  • Department of Veterinary Medicine, Faculty of Animal Science and Food Engineering, University of São Paulo, Pirassununga, São Paulo, Brazil.
Rambo, A L A
  • Department of Veterinary Surgery and Animal Reproduction, São Paulo State University - UNESP, Botucatu, São Paulo, Brazil.
Bergamasco, J V
  • Department of Veterinary Surgery and Animal Reproduction, São Paulo State University - UNESP, Botucatu, São Paulo, Brazil.
Alonso, J M
  • Department of Animal Medicine, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Watanabe, M J
  • Department of Veterinary Surgery and Animal Reproduction, São Paulo State University - UNESP, Botucatu, São Paulo, Brazil.
Alves, A L G
  • Department of Veterinary Surgery and Animal Reproduction, São Paulo State University - UNESP, Botucatu, São Paulo, Brazil.

MeSH Terms

  • Animals
  • Debridement / veterinary
  • Joint Dislocations / veterinary
  • Joint Dislocations / surgery
  • Horses / injuries
  • Horses / surgery
  • Male
  • Lameness, Animal / surgery
  • Female
  • Treatment Outcome
  • Toe Joint / surgery
  • Toe Joint / injuries
  • Horse Diseases / surgery

Conflict of Interest Statement

Declarations. None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper. Competing interests: The authors declare no competing interests.

References

This article includes 35 references
  1. Anderson JR, Phelan MM, Clegg PD, Peffers MJ, Rubio-Martinez LM. Synovial Fluid Metabolites Differentiate between Septic and Nonseptic Joint Pathologies. J Proteome Res 17(8):2735–2743.
    doi: 10.1021/acs.jproteome.8b00190pmc: PMC6092013pubmed: 29969035google scholar: lookup
  2. Anderson JR, Smagul A, Simpson D, Clegg PD, Rubio-Martinez LM, Peffers MJ. The synovial fluid proteome differentiates between septic and nonseptic articular pathologies. J Proteom 202103370.
    doi: 10.1016/j.jprot.2019.04.020pmc: PMC6549134pubmed: 31028944google scholar: lookup
  3. Anshul, Malhotra N, Kumar A, Rohilla J, Sinha K N. Comparative Evaluation of Intraarticular Facet Joint Injection Versus Medial Branch Block in Patients With Low Back Pain: A Randomised Controlled Study. Cureus 15(11):e49232.
    doi: 10.7759/cureus.49232pmc: PMC10746869pubmed: 38143628google scholar: lookup
  4. Balaam TM, Miller S. Severe open metacarpophalangeal joint luxation in a mule foal. Equine Vet Educ 19(10):528–531.
    doi: 10.2746/095777307X229309google scholar: lookup
  5. Borges LPB, dos Santos GMA, Oliveira RA, da Silva LO, de Souza LA, Perdigao HH, Guimaraes MM, Silveira JAS, Duarte MD, Teixeira PPM. Metacarpophalangeal joint luxation with joint capsule rupture and bone exposure in a horse. Vet Med 65(7):309–313.
    doi: 10.17221/170/2019-VETMEDgoogle scholar: lookup
  6. Brogniez L, Launois T, Perrin R, Horn L, Clegg P, Coomer R, Gabriel A, Mesnil S, Carstanjen B, Desbrosse F, Kirschvink N, Vandeweerd JM. Treatment of a severe distal forelimb wound presenting with extensive laceration and distal interphalangeal joint luxation in a donkey. Pferdeheilkunde 28(2): 160–166.
  7. Chan CC, Murphy H, Munroe GA. Treatment of chronic digital septic tenosynovitis in 12 horses by modified open annular ligament desmotomy and passive open drainage. Vet Rec 147(14):388–393.
    doi: 10.1136/vr.147.14.388pubmed: 11073001google scholar: lookup
  8. Clayton HM. Biomechanics of the distal interphalangeal joint. J Equine Vet Sci 30(8):401–405.
    doi: 10.1016/j.jevs.2010.07.007google scholar: lookup
  9. de Souza TC, Burford J, Busschers E, Freeman S, Suthers JM. Multicenter study investigating long-term survival after synovial lavage of contaminated and septic synovial structures in horses presented to 10 UK referral hospitals. Vet Surg 53(6):1083–1092.
    doi: 10.1111/vsu.14107pubmed: 38863154google scholar: lookup
  10. Ehrle A, Lischer CJ, Lasarzik J, Einspanier R, Bondzio A. Synovial Fluid and Serum Concentrations of Interleukin-1 Receptor Antagonist and Interleukin-1ß in Naturally Occurring Equine Osteoarthritis and Septic Arthritis. J Equine Vet Sci 35(10):815–822.
    doi: 10.1016/j.jevs.2015.07.023google scholar: lookup
  11. Fraser BSL, Bladon BM. Tenoscopic surgery for treatment of lacerations of the digital flexor tendon sheath. Equine Vet J 36(6):528–531.
    doi: 10.2746/0425164044877396pubmed: 15460078google scholar: lookup
  12. Frisbie DD, Johnson SA. Medical treatment in joint disease. .
  13. Heer C, Fürst AE, Chicca FD, Jackson MA. Comparison of 3D-assisted surgery and conservative methods for treatment of type III fractures of the distal phalanx in horses. Equine Veterinary Educ 32:42–51.
    doi: 10.1111/eve.13232google scholar: lookup
  14. . The Anatomical Differences between the Donkey and the Horse. .
  15. Honnas CM, Acvs D, Welch RD, Ford TS, Vacek JR, Watkins JP. Septic Arthritis of the Distal Interphalangeal Joint in 12 Horses. Vet Surg 21(4):261–268.
    doi: 10.1111/j.1532-950x.1992.tb00061.xpubmed: 1455633google scholar: lookup
  16. Janicek JC, Keegan KG. What is your diagnosis? Subluxation of DIPJ. J Am Vet Med Assoc 230(9):1307–1308.
    doi: 10.2460/javma.230.9.1307pubmed: 17472553google scholar: lookup
  17. Ketzner KM, Stewart AA, Byron CR, Stewart M, Gaughan EM, Vanharreveld PD, Lillich JD. Wounds of the pastern and foot region managed with phalangeal casts: 50 cases in 49 horses (1995–2006). Aust Vet J 87(9):363–368.
    doi: 10.1111/j.1751-0813.2009.00471.xpubmed: 19703138google scholar: lookup
  18. Lescun TB, Morisset SM, Fugaro MN, Blevins WE. Facilitated ankylosis of the distal interphalangeal joint in a foal. Aust Vet J 82(5):282–285.
    doi: 10.1111/j.1751-0813.2004.tb12704.xpubmed: 15181928google scholar: lookup
  19. McIlwraith CW, Kawcak C, Baxter GM, Goodrich LR, Valberg SJ. Principles of Musculoskeletal Disease. In: Baxter GM (ed) Adams and Stashak’s Lameness in Horses, 7th edn. Wiley-Blackwell, pp 801–874.
  20. Mitchell CF, Fugler LA, Eades SC. The management of equine acute laminitis. Vet Med (Auckl) 6:39–47.
    doi: 10.2147/VMRR.S39967pmc: PMC6067769pubmed: 30101095google scholar: lookup
  21. Morton AJ. Diagnosis and treatment of septic arthritis. The Veterinary clinics of North America. Equine Pract 21(3):627–vi.
    doi: 10.1016/j.cveq.2005.08.001pubmed: 16297725google scholar: lookup
  22. Nixon AJ, Ducharme NG, Bertone AL. Fractures of the Distal Phalanx. In: Nixon AJ (ed) Equine Fracture Repair, 2nd edn. Wiley Online Library, pp 219–241.
    doi: 10.1002/9781119108757.ch14google scholar: lookup
  23. O’Toole G, Kaplan HB, Kolter R. Biofilm formation as microbial development. Annu Rev Microbiol 54:49–79.
    doi: 10.1146/annurev.micro.54.1.49pubmed: 11018124google scholar: lookup
  24. Pezzanite LM, Hendrickson DA, Dow S, Stoneback J, Chow L, Krause D, Goodrich L. Intra-articular administration of antibiotics in horses: Justifications, risks, reconsideration of use and outcomes. Equine Vet J 54(1):24–38.
    doi: 10.1111/evj.13502pubmed: 34459027google scholar: lookup
  25. Pille F, Martens A, Oosterlinck M, Dumoulin M, Dewulf J, Gasthuys F. A retrospective study on 195 horses with contaminated and infected synovial cavities. Vlaams Diergeneeskd Tijdschr 2(78):97–104.
    doi: 10.21825/vdt.87503google scholar: lookup
  26. Raayat Jahromi A, Vajdi N. Successful Management of Severe Open Metacarpophalangeal Joint Dorsal Luxation in a Horse. J Equine Vet Sci 1(48):48–51.
    doi: 10.1016/j.jevs.2016.08.011google scholar: lookup
  27. Reevs MJ, Yovich JV, Turner AS. Miscellaneous Conditions of the Equine Foot. Vet Clin North Am Equine Pract 1(5):221–242.
    doi: 10.1016/S0749-0739(17)30612-0pubmed: 2565157google scholar: lookup
  28. Redden RF. Preventing laminitis in the contralateral limb of horses with nonweight-bearing lameness. Clin Techniques Equine Pract 3(1):57–63.
    doi: 10.1053/j.ctep.2004.07.005google scholar: lookup
  29. Trickett RW, Brock J, Shewring DJ. The non-operative management of bony mallet injuries. J Hand Surg Eur 46(5):460–465.
    doi: 10.1177/1753193421992986pubmed: 33588631google scholar: lookup
  30. van Zadelhoff C, Schwarz T, Smith S, Engerand A, Taylor S. Identification of Naturally Occurring Cartilage Damage in the Equine Distal Interphalangeal Joint Using Low-Field Magnetic Resonance Imaging and Magnetic Resonance Arthrography. Front Vet Sci 6508.
    doi: 10.3389/fvets.2019.00508pmc: PMC6999043pubmed: 32064268google scholar: lookup
  31. Whisenant KD, Ruggles AJ, Stefanovski D, Woodie JB, Hopper SA, Embertson RM. Prognosis for survival to discharge and racing performance in Thoroughbred foals treated for single joint septic arthritis (2009–2016). Equine Vet J 55(4):607–617.
    doi: 10.1111/evj.13892pubmed: 36210723google scholar: lookup
  32. Wright IM, Smith MRW, Humphrey DJ, Eaton-Evans TCJ, Hillyer MH. Endoscopic surgery in the treatment of contaminated and infected synovialtrickett cavities. Equine Vet J 35(6):613–619.
    doi: 10.2746/042516403775467225pubmed: 14515964google scholar: lookup
  33. Yovich JV, Turner AS, Stashak TS, McIlwraith CW. Luxation of the metacarpophalangeal and metatarsophalangeal joints in horses. Equine Vet J 19(4):295–298.
    doi: 10.1111/j.2042-3306.1987.tb01414.xpubmed: 3622457google scholar: lookup
  34. Zubrod CJ, Schneider RK. Arthrodesis techniques in horses. Vet Clin North Am Equine Pract 3(21):691–711.
    doi: 10.1016/j.cveq.2005.07.004pubmed: 16297728google scholar: lookup
  35. Zubrod CJ, Schneider RK. Arthrodesis of the distal Interphalangeal Joint. In: Nixon AJ (ed) Equine Fracture Repair, 2nd edn. Wiley Online Library, pp 257–263.
    doi: 10.1002/9781119108757.ch16google scholar: lookup

Citations

This article has been cited 0 times.
Subscribe to our newsletter
Join 106,698 horse owners like you who receive our email updates on horse health and nutrition.