Use of electrocautery probes in arthroscopic removal of apical sesamoid fracture fragments in 18 Standardbred horses.

The research focuses on developing a technique using electrocautery probes for the arthroscopic removal of apical sesamoid fracture fragments in horses. The study found the method to be an effective and safe option for intra-articular dissection, resulting in a successful return to racing for a majority of the horses after recovery.

Study Objective and Methodology

• The main objective of this research was to formulate a novel approach to arthroscopically excise apical sesamoid fracture fragments in Standardbred horses with the help of electrocautery probes. Such fractures are apparently common in racehorses, but their removal can be intricate and complicated.
• The study featured 18 Standardbred horses, ranging in age from 2 to 8 years. They underwent arthroscopic surgery for the removal of the fracture fragments using hook and loop electrocautery probes.
• The procedure involved the distension of the metacarpo-phalangeal joints with a 1.5% glycine solution. Then, with arthroscopic guidance, the ligament attachments to the apical fragment were transected using a hook electrocautery probe. Subsequently, the soft tissue attachments to the fragment were transected with a loop electrocautery probe.
• The removed fragments involved bones from both hind limbs (16 cases) and forelimbs (2 cases), with most fractures occurring in lateral proximal sesamoid bones.

Results and Conclusions

• None of the horses experienced any significant complications during or after the surgery.
• The use of electrocautery probes facilitated an easy and precise dissection of all soft tissue attachments to the apical sesamoid fracture fragments. This finding implies an efficient use of electrocautery probes for such procedures.
• The follow-up period ranged from 7 to 44 months, during which it was found that 10 out of 14 horses returned to racing. Among the horses that raced before surgery, 7 out of 9 raced again post-surgery and 3 out of 5 horses that hadn’t raced before surgery started racing afterwards. This indicates that the surgery had a high success rate in terms of recovery and return to normalcy.
• The study concluded that the arthroscopic excision of apical sesamoid fracture fragments can effectively be accomplished using electrocautery probes. Therefore, arthroscopic electrosurgery with these probes is posited as a safe and reliable alternative for intra-articular dissection in horses.