Plating of canine scapular fractures

The purpose in this study was to determine whether there was a significance difference between conservative management and plating of scapular body fractures. Bilateral scapular body fractures were created in 10 dogs. The left scapula in each dog was treated by open reduction and plating of the scapular spine. The right scapula was not treated. Plating enhanced healing and early return of function, but there was no significant difference in the long-term results.     

Catastrophic scapular fractures in Californian racehorses: pathology, morphometry and bone density

Reasons for performing study: To enhance understanding of the nature and pathogenesis of scapular fractures in racehorses. Hypothesis: Scapular fractures in racehorses have a consistent configuration related to sites of pre‐existing stress modelling and remodelling. Methods: Fractured and intact scapulae collected post mortem were examined visually and with computed tomography (CT). Scapular fracture configuration, bone modelling changes and standardised CT morphometry and density measurements were recorded. Statistical comparisons were made between fractured, nonfractured contralateral and control scapulae. Results: Thirty‐nine scapulae from 10 Thoroughbred (TB) and 10 Quarter Horse (QH) racehorses were obtained. All 14 fractured scapulae (from 12 horses) had a consistent comminuted fracture configuration. A complete fracture coursed transversely through the neck of the scapula at the level of the distal aspect of the spine (8.9 ± 0.9 cm proximal to the lateral articular margin of the glenoid cavity). The distal fragment of 13 fractured scapulae was split into 2 major fragments by a fracture in the frontal plane that entered the glenoid cavity (2.8 ± 0.4 cm caudal to the cranial articular margin). Focal areas of periosteal proliferation and/or radiolucency were present in the distal aspect of the scapular spine of all fractured and intact contralateral scapulae, but less commonly (P<0.01) in intact scapula from horses without a scapular fracture. Fractured scapulae had 7–10% lower mean density and 46–104% greater density heterogeneity in the spine adjacent to the transverse fracture compared to control scapulae (P<0.03). Conclusions and clinical relevance: Thoroughbred and QH racehorses have a characteristic scapular fracture configuration that is associated with pre‐existing pathology of the distal aspect of the spine. This location is consistent with scapular stress fractures diagnosed in lame TB racehorses. Catastrophic fracture is the acute manifestation of a more chronic process. Consequently, there are opportunities for early detection and prevention of fatalities.     

STRESS FRACTURES OF THE HUMERUS, RADIUS, AND TIBIA IN HORSES

The medical records, radiographic and nuclear scintigraphic findings of 26 racing horses with 27 stress fracture episodes of the humerus, radius, or tibia were reviewed. The purposes of this study were to describe the radiographic and/or scintigraphic features of stress fractures of the humerus, radius, or tibia, and to evaluate the signalment and history of horses in which stress fracture occurred. Stress fractures of the three long bones examined were primarily seen in 2-and 3-year-old male Thoroughbred horses; commonly, the onset of lameness was immediately following training gallops or racing. There were 13 humeral stress fracture episodes in 12 horses. Ten were in the proximal caudolateral cortex, and three were in the distal craniomedial cortex. Radial stress fractures were seen in three horses, all in the midshaft radius. Tibial stress fractures were diagnosed in 11 horses. They were located in the proximal lateral tibia in six horses, the distal caudolateral tibia in three horses, and the midshaft tibia in three horses. Fifteen stress fractures were diagnosed with radiographs alone, one was diagnosed with scintigraphy alone, nine were diagnosed with radiographs and scintigraphy, and, in two horses, radiographs were negative, but the scintigraphic findings were consistent with stress fracture.     

Fractures of the scapula

Fractures of the scapula are uncommon and the majority of these involve the supraglenoid tubercle in young horses 2 years of age or less. Scapula fractures of the neck or body are rare. Comminuted scapula fractures have been diagnosed in racing breeds (Thoroughbreds and Quarter Horses) and a review of the literature on the different fracture types and their management is presented in this article. The best prognosis for soundness is given for horses treated surgically. The different techniques for surgical management are described here and comments made with reference to nonsurgical management. A residual gait deficit may persist in some horses because of involvement of the suprascapular nerve at the time of injury, during surgery and follow‐up period, the severity of which depends on the degree of nerve trauma.     

Tumoral calcinosis in a dog with chronic renal failure

A 2-year-old male German shepherd dog in poor bodily condition was evaluated for thoracic limb lameness due to a large, firm mass medial to the left cranial scapula. Radiography revealed several large cauliflower-like mineralized masses in the craniomedial left scapula musculature, pectoral region and bilaterally in the biceps tendon sheaths. Urinalysis, haematology and serum biochemistry showed that the dog was severely anaemic, hyperphosphataemic and in chronic renal failure. The dog was euthanased and a full post mortem performed. A diagnosis of chronic renal failure with secondary hyperparathyroidism was confirmed. The mineralised masses were grossly and histopathologically consistent with a diagnosis of tumoral calcinosis. Tumoral calcinosis associated with chronic renal failure that does not involve the foot pads is rarely seen.     

An ex vivo mechanical evaluation of single versus double semitubular plate fixation of a transverse distal-third scapular osteotomy in the dog

OBJECTIVE: To compare single versus double semitubular plate fixation for scapular body fractures. STUDY DESIGN: Ex vivo mechanical study. SAMPLE POPULATION: Eighteen paired cadaveric canine scapulae. METHODS: Transverse scapular body osteotomies were created in the distal third of 18 pairs of scapulae. One scapula of each pair was repaired with a single plate, whereas the contralateral scapula was repaired with 2 plates. Initial strength and stiffness of the constructs were measured in 10 pairs of scapulae. Eight pairs of scapulae underwent cyclic loading and then were subjected to failure testing. RESULTS: Double-plate fixation was significantly stronger (3,899 +/- 632 N) but not stiffer (614 +/- 130 N/mm) than the single-plate fixation (3,238 +/- 935 N and 537 +/- 202 N/mm, respectively). Cyclic loading variables were not significantly different between the 2 methods of fixation. After cyclic loading, double-plate fixation was significantly stronger (2,916 +/- 618 N) than single-plate fixation (2,347 +/- 495 N). There was no significant difference (P =.11) in stiffness between double- versus single-plate fixations: 734 +/- 247 N/mm and 595 +/- 139 N/mm, respectively. CONCLUSIONS: Double-plate fixation was generally stronger and stiffer than single-plate fixation. Because all constructs failed at loads that greatly exceeded those estimated to occur clinically, any difference between the 2 methods of fixation probably is not clinically relevant. CLINICAL RELEVANCE: Single-plate fixation may be of sufficient strength for fixation of scapular body fractures.     

Stress fractures of the tibia and humerus in Thoroughbred racehorses: 99 cases (1992-2000)

OBJECTIVE: To determine clinical characteristics of and outcome in Thoroughbred racehorses with tibial or humeral stress fractures. DESIGN: Retrospective study. ANIMALS: 99 Thoroughbreds with tibial or humeral stress fractures. PROCEDURE: Information obtained from the medical records included history, signalment, and clinical, radiographic, and scintigraphic findings. Outcome was determined by interviewing trainers, performing follow-up examinations, and analyzing race records. RESULTS: Seventy-four tibial stress fractures were identified in 61 Thoroughbreds, and 48 humeral stress fractures were identified in 39 Thoroughbreds (1 horse was included in both groups). Tibial stress fractures occurred most commonly in 2-year-old or unraced horses. Fractures were located in 1 of 3 sites in the tibia (most commonly, the caudolateral cortex of the mid-diaphysis) and 1 of 4 sites in the humerus (most commonly, the caudodistal cortex). Forty-four of 58 (76%) tibial stress fractures and 18 of 32 (56%) humeral stress fractures were identified radiographically. Humeral stress fractures involving the caudodistal cortex were not detected radiographically. Treatment consisted of rest and exercise restriction, and 49 of 61 (80%) horses with tibial stress fractures and 30 of 39 (77%) horses with humeral stress fractures returned to racing. Humeral stress fractures recurred in 6 horses. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that in Thoroughbred racehorses, tibial stress fractures occurred most commonly in unraced 2 year olds, whereas humeral fractures occurred most commonly in older horses that had raced previously. The prognosis for racing following treatment was good.     

Bovine skin lesions of possible filarial origin associated with heavy hornfly infestations (Haematobia meridiana)

Circumscribed, ulcerative skin lesions, usually situated caudal to the scapula, affected cattle in the Republic of Venda during the summer of 1981-82. The occurrence of the lesions was associated with heavy infestations of the hornfly. Haematobia meridiana. Microscopically the lesions were characterized by intense eosinophilic dermatitis. Microfilariae were seen in histological sections of one lesion, but a species identification could not be made. The possible cause of the lesions is discussed.     

Limb Fractures in the Dog and Cat—IV Fractures of the Fore Limb

Abstract— A review is presented of the diagnosis and treatment of fractures of the fore limb in the dog and cat. A series of 200 fractures and dislocations including the scapula (1), humerus (21), ulna (7), radius and ulna (25), metacarpus and phalanges (19) are discussed including methods of external support.
Résumé— Un compte-rendu est présenté sur la diagnose et le traîtement des membres de devant chez le chat et le chien. Une série de 200 fractures et dislocations sont discutées, y compris l'omoplate (1), l'humérus (21), le cubitus (7), le radius et le cubitus (25), le métacarpe et les phalanges (19) de même que les méthodes de support externe.
Zusammenfassung— Ein Überblick wird über die Diagnose und Behandlung von Vorderbein-brüchen bei Hunden und Katzen gegeben. Eine Serie von 200 Brüchen und Verrenkungen, ein-schliesslich Schulterblatt (1), Oberarmknochen (21), Ulna (7), Radius und Ulna (25), Metakarpus und Zehenglieder (19) sowie äusserliche Stützmethoden werden besprochen.     

Repair of a longitudinal scapular fracture in a horse

Objective— To report repair of a longitudinal scapular fracture in a horse.
Study Design— Case report.
Animals— A 2-year-old Paint Horse colt.
Methods— A longitudinal scapular fracture was surgically repaired using four 4.5 mm dynamic compression plates.
Results— An acute longitudinal scapular fracture repaired surgically returned the horse to soundness within 6 months.
Conclusions— Internal fixation of longitudinal scapular fracture is possible with multiple 3–5 hole dynamic compression plates.
Clinical Relevance— Longitudinal fractures of the scapula should be considered when there is lateral instability of the shoulder after trauma. A displaced fracture can be adequately stabilized by internal fixation with a reasonable prognosis for soundness.     

Autologous Platelet Concentrates as a Treatment for Shoulder Injury in a Horse

Shoulder injury is an uncommon cause of lameness in horses. Trauma to the shoulder region may produce bone and soft-tissue damage. The present study describes the case of a severe left shoulder injury caused by blunt trauma in a 6-year-old gelding. Clinical and ultrasonographic examination revealed fracture of the supraglenoid tuberosity of the scapula and of the lesser tubercle of the humerus with fiber disruption and hematoma of the biceps brachii, bicipital bursitis, and suprascapular nerve damage. The gelding was successfully treated with three intralesional injections of autologous platelet concentrates administered at 2-week intervals. Although all these combined injuries took a minimum of 18 to 24 months for full recovery, the gelding reached full recuperation of the affected limb in 10 months. These results suggest that injections of autologous platelet concentrate could provide a therapeutic benefit in the treatment of shoulder bone fractures and soft-tissue injuries in horses.     

Three‐dimensional CT observation of position and movability of the scapula in the horse using carcasses of Falabella

The three‐dimensionally real position and movement of the scapula in the lateral side of the ribcage could not be clarified in the horse, since the body size of the horse is too large to apply the CT scanning and image analysis methods. In this study, therefore, we examined the position and the movability of scapula using a carcass of the Falabella which is one of the smallest breeds of the horse. The whole skeletal system in thoracic part of the Falabella could be three‐dimensionally observed by CT scanning method. The three‐dimensional images show that the scapula cranially slides and the ventral part of the scapula dorso‐cranially rotates, when the shoulder joint moves to the most cranial position as simulation. The three‐dimensional rotation angle was approximately 10 degrees. As a result of comparative osteology of the scapula between Falabella and the large draft horse, the infraspinous fossa was caudally enlarged in the larger draft horse, whereas the Falabella had narrower infraspinous fossa. We suggest that it may be due to the adaptational morphological change in the scapula bearing various body weights among breeds. The three‐dimensional CT image analysis and the simulation in carcass contribute to the analysis of the bone movements of the horse during walking and running locomotion as well as the motion analysis from external functional‐morphological data.     

Results of screw fixation combined with cortical drilling for treatment of dorsal cortical stress fractures of the third metacarpal bone in 56 Thoroughbred racehorses.

The purpose of this study was to evaluate screw fixation with cortical drilling as a surgical treatment for dorsal cortical stress fractures of MCIII in the Thoroughbred racehorse. Details of age, sex, limb affected, fracture assessment, and post operative recommendations were obtained from medical records and radiographs. Fracture healing was assessed radiographically at the time of screw removal. Performance evaluation was determined from race records obtained from The Jockey Club Information System, Lexington, Kentucky. Fifty-six Thoroughbred racehorses were treated surgically for stress fracture of MCIII with screw fixation and cortical drilling. Stress fractures occurred primarily in the left front limb of the male 3-year-olds, in the dorsolateral cortex of the middle third of MCIII. Ninety-seven percent of the fractures travelled in a dorsodistal to palmaroproximal direction. Median period to screw removal was 2.0 months. Evaluation at time of screw removal revealed 98% of single stress fractures of the left front limb were healed radiographically. Median period to resume training was 2.75 months (single stress fractures); median period to race was 7.62 months. There was no statistically significant difference in earnings/start before and after surgical intervention. Of the 63 fractures treated, two recurred. There were no catastrophic failures, and no incisional infections.     

The re-emergence of bluetongue

Fractures are a common cause of loss among Thoroughbred racehorses. A large proportion of these injuries occurs in the absence of a specific traumatic event and show typical characteristics of stress fractures. The fractures show a high degree of consistency in their morphology; they frequently share the same locations as incomplete cracks and they are often associated with pre-existing pathology (periosteal and endosteal new bone formation and intracortical remodelling). Bone is able to adapt to changes in its mechanical environment. Studies of the Thoroughbred racehorse show modification of the geometric properties of the third metacarpal bone in response to training. These modifications are associated with reduced bone strains. Intense training before the adaptive response is completed and bone strain reduced increases the risk of fatigue damage. Fatigue of bone is associated with progressive microdamage, which is important in the pathogenesis of stress fractures. However, the biological repair mechanism of bone (remodelling) is also instrumental in the development of stress fractures. Horses exercised before bone repair is complete are likely to be at significantly greater risk of sustaining a catastrophic stress fracture. A number of key questions regarding the importance of microdamage, remodelling and training schedules in the prevention of stress fractures are addressed in this review.     

Bilateral calcaneal stress fractures in two cats

Two cats that developed bilateral calcaneal stress fractures are reported. One cat developed lameness associated with incomplete fractures at the base of both calcanei, both of which progressed to acute, complete fractures 2 months later. The second cat presented with acute complete calcaneal fracture, with evidence of remodelling of the contralateral calcaneus, which subsequently fractured two years later. The calcaneal fractures were successfully stabilised with lateral bone plates in each case. Stress fractures were suspected because of the bilateral nature, the simple and similar configuration, the consistent location of the fractures, the absence of other signs of trauma in both cases and the suspected insidious onset of the lameness. The feline calcaneus is susceptible to stress fracture, and cats presenting with calcaneal fractures without evidence of trauma should be evaluated for concurrent skeletal pathology.     

Thoracic wall and pulmonary trauma in dogs sustaining fractures as a result of motor vehicle accidents

The records of 267 dogs seen at the University of Minnesota Veterinary Teaching Hospital for fractures resulting from motor vehicle accidents were examined to determine the prevalence and types of thoracic wall and pulmonary trauma associated with such cases. Results were analyzed for type and prevalence of thoracic wall and pulmonary injury, and for the prevalence of such injury in dogs with and without extrathoracic injury, in dogs with fractures of single vs multiple bones, in dogs with single fractures of specific bones, in dogs with fractures in the cranial vs the caudal one half of the body, and in dogs with fractures ipsilateral vs contralateral to thoracic injury. The overall prevalence of thoracic wall and pulmonary trauma was 38.9%; pulmonary contusions, pneumothorax, and fractured ribs were the most common injuries. More than 1 type of thoracic wall or pulmonary injury was diagnosed in 57.7% of the cases. Of the dogs with thoracic injury, 24% also had extrathoracic injuries; 16.5% of dogs without thoracic injury had extrathoracic injuries, not including fractures. Of the dogs with fractures of 1 bone, 36.3% had thoracic injuries. Of the dogs with fractures of more than 1 bone, 42.3% had thoracic injuries. The prevalence of thoracic wall and pulmonary trauma was significantly associated with the site of the fracture (cranial vs caudal and ipsilateral vs contralateral); significant association with the specific bone fractured was also seen for some fractures.     

Stress Fractures of the Acetabulum in 26 Racing Greyhounds

Acetabular fractures in 26 racing Greyhounds were reviewed. All fractures occurred during racing or training and were unrelated to any external trauma. All fractures had similar configurations, were minimally displaced, and involved only the acetabulum. Affected dogs were young (16-36 months). Fractures occurred unilaterally (22 dogs) and bilaterally (4 dogs). There was no sex predilection, and both right and left sides were equally represented. Bilateral fractures were associated with retraining between the occurrence of the first and second fractures. Radiographically, a fracture line was consistently visible in the caudal third of the acetabulum. Fractures in gross specimens resembled an inverted "Y." Results of histologic evaluation of two fractured acetabula showed changes characteristic of a nonunion fracture. Microfractures were evident in the grossly normal acetabulum opposite the fractured side. Evidence obtained from this study suggests a common pathogenesis of the fractures related to tremendous repetitive stresses produced during running. Greyhounds with unilateral acetabular fractures may provide a reproducible model for future studies of stress fractures in animals and humans because of the high incidence of bilateral fractures that develop during retraining. Surgical repair of the acetabular stress fracture was more successful than conservative management in returning the dogs to competitive racing.     

Chondrosarcoma in a simmental cow: Clinical, ultrasonographic, radiographic and pathological findings

Clinical, ultrasonographic, radiographic and pathological findings of a chondrosarcoma diagnosed in an 8-year-old Simmental cow are reported. The primary site was located in the cartilage of the right scapula at the angulus cranialis. The tumour had already spread to the lungs at the time of diagnosis. This is the first report of a bovine scapula chondrosarcoma.     

Descriptive epidemiology of fractures occurring in British Thoroughbred racehorses in training

REASONS FOR PERFORMING STUDY: Musculoskeletal injury is the major cause of days lost from training and wastage in Thoroughbred racehorses. Little scientific information is available on the majority of injuries occurring in training. OBJECTIVES: To estimate the incidence of fractures in British racehorses in training and describe the occurrence of different fracture types and bones involved. METHODS: Thirteen UK racehorse trainers participated in a prospective study, providing data on horses in their care for 2 years. Details on horses, their daily exercise and fracture occurrence were recorded. RESULTS: A total of 1178 horses provided 12,893 months at risk. Nontraumatic fracture incidence was 1.15/100 horse months (95% CI = 0.98, 1.35) and 78% of fractures occurred during training. A wide variety of fracture types and bones were involved, although at least 57% were stress fractures. Pelvic and tibial stress injuries accounted for 28% of fractures diagnosed. CONCLUSIONS: It is important to study injuries in training as well as in racing. The number of stress fractures suggests that training regimes for young Thoroughbreds could often be improved to create a more robust skeleton, able to withstand injury. POTENTIAL RELEVANCE: Studying injuries in racehorses in training can provide a scientific basis for the design of safer training regimes.     

Anatomical variation of habitat‐related changes in scapular morphology

The mammalian forelimb is adapted to different functions including postural, locomotor, feeding, exploratory, grooming and defence. Comparative studies on morphology of the mammalian scapula have been performed in an attempt to establish the functional differences in the use of the forelimb. In this study, a total of 102 scapulae collected from 66 species of animals, representatives of all major taxa from rodents, sirenians, marsupials, pilosa, cetaceans, carnivores, ungulates, primates and apes, were analysed. Parameters measured included scapular length, width, position, thickness, area, angles and index. Structures included supraspinous and infraspinous fossae, scapular spine, glenoid cavity, acromium and coracoid processes. Images were taken using computed tomographic (CT) scanning technology (CT‐Aquarium, Toshiba and micro CT‐LaTheta, Hotachi, Japan), and measurement values were acquired and processed using Avizo computer software and CanvasTM 11 ACD systems. Statistical analysis was performed using Microsoft Excel 2013. Results obtained showed that there were differences in morphological characteristics of scapula between mammals with arboreal locomotion and living in forest and mountainous areas and those with leaping and terrestrial locomotion living in open habitat or savannah. Differences were seen in the ratio of maximum length and maximum width, the orientation of scapular spine and the horizontal length of acromion and coracoid processes. The cause for the statistical grouping of the animals and the way the scapular shape covaries with habitat and to the type of locomotion and speed are discussed in detail.