Treatment of radial fractures in adult horses: an analysis of 15 clinical cases

Fifteen cases of radial fractures in adult horses weighing more than 300 kg are discussed. Four of the horses were destroyed on humane grounds immediately because of a poor prognosis and expense of internal fixation; and two horses at five days and five weeks, respectively after treatment by cast application was initiated. Internal fixation was used in nine horses but of these only two horses recovered completely and resumed their former activities. In eight cases, two plates were applied, one lateral or medial and the other cranial. The internal fixation techniques of all nine horses were scrutinised and suggestions made for the future treatment of radial fractures. These suggestions are (1) the use of ASIF 5.5 mm cortical bone screws using the total width or thickness of the bone in each case. (2) Application of the dynamic condylar screw with its plate in distal or proximal fractures to allow more support. (3) Incorporation of a cancellous bone graft to the fracture. (4) Possible table recovery to prevent breakdown of the fixation during recovery. It is important that bone plates are applied over the total length of the bone. The fact that only two out of 15 horses survived and recovered completely underlines the problems associated with treatment of radial fractures in the adult horse.     

Femoral fracture repair complicated by vascular injury in a foal

A comminuted, mid-diaphyseal femoral fracture was diagnosed radiographically in a 4-month-old Quarter Horse colt. Disruption of the distal blood supply was suspected, as evidenced by coolness and diminished pulses of the distal portion of the limb. The fracture was repaired by compression plating but the foal's condition continued to deteriorate. A femoral arteriogram of the affected limb was obtained. Positive contrast agent was visible only as far as the mid-shaft of the femur. The foal was euthanatized and the postmortem examination revealed a transected popliteal artery accounting for ischemic necrosis of the distal limb.     

Assessment of stiffness and strength of 4 different implants available for equine fracture treatment: a study on a 20 degrees oblique long-bone fracture model using a bone substitute

OBJECTIVE: To compare the mechanical properties of 4 stabilization methods for equine long-bone fractures: dynamic compression plate (DCP), limited contact-DCPlate (LC-DCP), locking compression plate (LCP), and the clamp-rod internal fixator (CRIF--formerly VetFix). STUDY DESIGN: In vitro mechanical study. SAMPLE POPULATION: Bone substitute material (24 tubes) was cut at 20 degrees to the long axis of the tube to simulate an oblique mid-shaft fracture. METHODS: Tubes were divided into 4 groups (n=6) and double plated in an orthogonal configuration, with 1 screw of 1 implant being inserted in lag fashion through the "fracture". Thus, the groups were: (1) 2 DCP implants (4.5, broad, 10 holes); (2) 2 LC-DCP implants (5.5, broad, 10 holes); (3) 2 LCP implants (4.5/5.0, broad, 10 holes) and 4 head locking screws/plate; and (4) 2 CRIF (4.5/5.0) and 10 clamps in alternating position left and right of the rod. All constructs were tested in 4-point bending with a quasi-static load until failure. The implant with the interfragmentary screw was always positioned on the tension side of the construct. Force, displacement, and angular displacement at the "fracture" line were determined. Construct stiffness under low and high loads, yield strength, ultimate strength, and maximum angular displacement were determined. RESULTS: None of the implants failed; the strength of the bone substitute was the limiting factor. At low loads, no differences in stiffness were found among groups, but LCP constructs were stiffer than other constructs under high loads (P=.004). Ultimate strength was lowest in the LCP group (P=.01), whereas yield strength was highest for LCP constructs (409 N m, P=.004). CRIF had the lowest yield strength (117 N m, P=.004); no differences in yield strength (250 N m) were found between DCP and LC-DCP constructs. Differences were found for maximum angular displacement at the "fracture" line, between groups: LPC相似文献   

Compensatory load redistribution of horses with induced weightbearing hindlimb lameness trotting on a treadmill

REASONS FOR PERFORMING STUDY: The compensatory mechanisms of horses with weightbearing hindlimb lameness are still not fully understood. HYPOTHESIS: That weightbearing, unilateral hindlimb lameness would not only alter stride characteristics to diminish structural stress in the affected limb but also induce compensatory load adjustments in the other supporting limbs. OBJECTIVE: To document the load and time shifting mechanisms of horses with unilateral weightbearing hindlimb lameness. METHODS: Reversible lameness was induced in 8 clinically sound horses by applying a solar pressure model. Three degrees of lameness (subtle, mild and moderate) were induced and compared with the nonlame (sound) control measurement. Vertical ground reaction forces were recorded for all 4 limbs simultaneously on an instrumented treadmill. RESULTS: Compared to the sound situation, moderate hindlimb hoof lameness induced a decrease in stride duration (-3.3%) and stride impulse (-3.1%). Diagonal impulse decreased selectively in the lame diagonal stance (-7.7%). Within the diagonal limb pair, vertical impulse was shifted to the forelimb during the lame diagonal stance (+6.5%) and to the hindlimb during the sound diagonal stance (+3.2%). Peak vertical force and vertical impulse decreased in the lame limb (-15%), but only vertical impulse increased in the contralateral hindlimb (+5.7%). Stance duration was prolonged in both hindlimbs (+2.5%). Suspension duration was reduced to a greater extent after push-off of the lame diagonal limb pair (-21%) than after the sound diagonal limb pair (-9.2%). CONCLUSIONS: Four compensatory mechanisms could be identified that served to reduce structural stress, i.e. peak vertical force on the affected limb: 1) reduction of the total vertical impulse per stride; 2) diagonal impulse decreased selectively in the lame diagonal; 3) impulse was shifted within the lame diagonal to the forelimb and in the sound diagonal to the hindlimb; and 4) the rate of loading and peak forces were reduced by prolonging the stance duration. POTENTIAL RELEVANCE: Load shifting mechanisms are not only effective in diminishing peak forces in the affected limb, but also suppress compensatory overload in other limbs. Selected force and time parameters allow the unequivocal identification of the lame limb. Future studies have to examine how far these compensatory mechanisms may be generalised for other defined orthopaedic problems in the hindlimb.     

The association between heart rate, heart rate variability, endocrine and behavioural pain measures in horses suffering from laminitis

The objective of this study was to compare the stress response of horses suffering from laminitis after short- and long-term treatment with the intent to evaluate power spectral analysis of heart rate variability (HRV) for pain monitoring. Data were collected from 19 horses with acute or chronic exacerbating laminitis without known primary disease before and after treatment with non-steroidal anti-inflammatory drugs (NSAID). Recordings were carried out the day after admission to the equine hospital. Measurements were repeated on day 7 of the treatment. The recorded parameters included a clinical orthopaedic index (OLPI: Obel-grade plus hoof tester score), frequency of weight-shifting between contralateral limbs, mean beat-to-beat interval (R-R) duration, standard deviation of continuous R-R intervals, low- (LF) and high-frequency (HF) components of HRV, sympatho-vagal balance (LF/HF), and plasma concentration of cortisol, adrenalin and noradrenalin. The LF represents mainly sympathetic influences on the heart whereas HF is mediated by the parasympathetic tone. Weight-shifting and OLPI decreased significantly with treatment. The LF normalized units (n.u.) decreased after NSAID from 60.41 +/- 21.42 to 51.12 +/- 19.81 and was 49.33 +/- 22.64 on day 7, whereas HF n.u. increased from 35.07 +/- 20.02 to 43.14 +/- 18.30 and was 45.98 +/- 23.00 on day 7. Hormone levels showed no tendency to change with treatment. The OLPI was only correlated with LF/HF, LF and HF (R = 0.57, 0.55 and -0.54 respectively). Significant negative correlations existed between HFn.u. and weight-shifting frequency (R = -0.37), HFn.u. and adrenalin (R = -0.47), and HFn.u. and noradrenalin (R = 0.33). The LFn.u. only correlated positively with adrenalin. Cortisol levels were poorly associated with the other parameters. Determination of the sympatho-vagal influences on cardiac function may offer complementary information for reliable assessment of pain and may represent a valuable alternative method to catecholamine measurements.     

Do hoof cracks represent a superficial hoof-problem?

Fifty-four horses with hoof cracks were referred to the Equine Hospital of the University of Zurich, for treatment. The horses were admitted because of lameness or other symptoms caused by the cracks. Deep or complicated quarter cracks were the most common type of cracks diagnosed. Poor conformation and abnormal hoof shape were the most important causes of hoof crack development, whereas injury to the coronary band was a less frequently encountered cause. Effective treatment of this problem includes corrective shoeing, removing horn from the weight-bearing surface as well as from the crack with a Dremel tool and immobilization of the borders of the crack. However, even with such a therapy, the recurrence rate of hoof cracks was with 20% very high.     

The art of horseshoeing--between empiricism and science

To correctly shoe a horse requires the farriers to have a good working knowledge of postural anomalies and movement patterns, as well as of the different concepts of horseshoeing and to be able to apply the appropriate technique to every individual horse they shoe. The correct technique for specific problem cases is frequently a subject of debate amongst specialists and many theories would benefit from objective gait analyses. The case study presented examines the influence of different shoeing conditions on selected gait analysis parameters. The measurements were conducted on a Warmblood mare: (A) shod with long toes, (B) properly trimmed without shoes, (C) conventionally shod with rolled toes and finally (D) shod using the 4-point technique. Data on force-, time- and distance parameters were recorded using an instrumented treadmill. First contact and breakover of the hooves were documented using high-speed videography. A long toe resulted in a prolongation of the breakover time and, therefore, in a prolongation of the second half of the stance phase. Additionally, the prolonged stance duration associated with an unaltered force impulse, led to decreased force peaks. It was possible to objectively record differences between the trimmed, unshod foot, the shod long-toe and the shod rolled toe configurations. The differences between the rolled toe and the 4 point shoe however, were minimal. Gait analysis is a technique well suited for objective evaluation of different shoeing techniques under standardised conditions.     

The effect of hoof trimming on radiographic measurements of the front feet of normal Warmblood horses

The understanding of the normal position of the third phalanx (P3) and the distal sesamoid bone in relation to the size and shape of the hoof capsule in sound horses is helpful in the diagnosis of equine foot lameness. Some measurements on radiographs used to define the position of the pedal bone within the hoof capsule are significantly influenced by hoof trimming and the height of the withers. In this study, the front hooves of 40 Warmblood horses were radiographed twice, eight weeks apart, both before and after their hooves were trimmed by an experienced farrier. Using the software programme Metron PX, 22 parameters on the lateromedial view and 16 parameters on the dorsopalmar view were measured and the effect of hoof trimming and height of the withers were calculated, respectively. Some of the hoof parameters showed mild positive correlation with the height of the withers. In 70% of the horses the left hoof capsule and P3 were significantly larger than the right. Hoof trimming had a remarkable influence on hoof conformation, especially for parameters in the toe region. Of all the measurements that describe the position of the third phalanx (P3) in relation to the hoof capsule, the distances between the distal tip of P3 to the solar surface of the foot, P3 to the tip of the toe and P3 to the point of break-over showed the greatest differences before and after trimming. The database of the present study can be used by farriers and veterinarians as a guideline for routine and corrective shoeing of Warmblood horses.     

Laryngeal mask airway insertion requires less propofol than endotracheal intubation in dogs

OBJECTIVE: To compare the doses of propofol required for insertion of the laryngeal mask airway (LMA) with those for endotracheal intubation in sedated dogs. STUDY DESIGN: Randomized prospective clinical study. Animals Sixty healthy dogs aged 0.33-8.5 (3.0 +/- 2.3, mean +/- SD) years, weighing 2.2-59.0 (23.4 +/- 13.6, mean +/- SD) kg, presented for elective surgery requiring inhalation anaesthesia. METHODS: Animals were randomly assigned to receive either a LMA or an endotracheal tube. Pre-anaesthetic medication was intravenous (IV) glycopyrrolate (0.01 mg kg(-1)) medetomidine (10 microg kg(-1)) and butorphanol (0.2 mg kg(-1)). Repeated IV propofol injections (1 mg kg(-1) in 30 seconds) were given until LMA insertion or endotracheal intubation was achieved, when the presence or absence of laryngospasm, the respiratory rate (fr) and the total dose of propofol used were recorded. RESULTS: The total propofol dose (mean +/- SD) required for LMA insertion (0.53 +/- 0.51 mg kg(-1)) was significantly lower than for endotracheal intubation (1.43 +/- 0.57 mg kg(-1)). The LMA could be inserted without propofol in 47% of dogs; the remainder needed a single 1 mg kg(-1) bolus (n = 30). Endotracheal intubation was possible without propofol in 3.3% of the dogs, 47% needed one bolus and 50% required two injections (n = 30). The f(r) (mean +/- SD) was 18 +/- 6 and 15 +/- 7 minute(-1) after LMA insertion and intubation, respectively. CONCLUSION AND CLINICAL RELEVANCE: Laryngeal mask airway insertion requires less propofol than endotracheal intubation in sedated dogs therefore propofol-induced cardiorespiratory depression is likely to be less severe. The LMA is well tolerated and offers a less invasive means of securing the upper airway.