Factors that affect equine wound repair.

The rate and outcome of wound healing are determined by many factors,some of which are already in effect when the horse is first presented to the veterinarian. A thorough understanding of wound healing principles,coupled with clear client communication, should enable the practitioner to minimize the number of additional factors that may exacerbate the initial situation.     

Arthroscopic removal of dorsoproximal chip fractures of the proximal phalanx in standing horses

OBJECTIVE: To report a technique for, and outcome after, arthroscopic removal of dorsoproximal chip fractures of a proximal phalanx in standing horses. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: A total of 104 horses, 1 to 13 years of age, with a dorsoproximal chip fracture of a proximal phalanx. METHODS: Horses were restrained in standing stocks and sedated with intravenous xylazine, detomidine, or a combination of both drugs. Local analgesia was achieved with 2% mepivacaine administered intra-articularly and by subcutaneous infiltration in a crescent-shaped block dorsal to the fetlock. Sterile drapes were placed on the surgical field, and impervious drapes were used on the hoof and floor. Arthroscopic portals were created in the dorsal pouch of the metacarpophalangeal or metatarsophalangeal joints to remove chip fractures. Statistical analysis was performed on race records for all Thoroughbred racehorses and compared with previously published studies. Operative and hospitalization times were compared with those of the general hospital population, and risks associated with general anesthesia were examined. RESULTS: No major operative or postoperative complications occurred. Ninety-one percent of racehorses raced after surgery with 78% returning to race at the same or higher level. CONCLUSION: Standing arthroscopic surgery can be performed successfully to remove dorsoproximal chip fractures of the proximal phalanx. CLINICAL RELEVANCE: Standing arthroscopic surgery is a valid alternative treatment for experienced surgeons to avoid the expense and potential risks associated with general anesthesia.     

Use of a three-drill-tract technique for arthrodesis of the distal tarsal joints in horses with distal tarsal osteoarthritis: 54 cases (1990-1999)

OBJECTIVE: To assess the long-term clinical outcome of horses with distal tarsal osteoarthritis (OA) in which a 3-drill-tract technique was used to induce arthrodesis of the affected joints, identify any preoperative or operative factors associated with outcome, and describe any complications associated with the technique. DESIGN: Retrospective study. ANIMALS: 54 horses. PROCEDURE: Medical records were reviewed for information on signalment, use, history, physical and lameness examination findings, surgical technique, and postoperative care. Radiographs were examined, and severity of OA was graded. Follow-up information was obtained through telephone interviews with owners at least 13 months after the procedure. RESULTS: 32 (59%) horses had a successful outcome, 6 (11%) improved but were not sound after surgery, and 16 (30%) did not improve following surgery. Outcome was negatively associated with the previous use of intra-articular injections. Few postoperative complications were evident. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that distal tarsal OA in horses can be successfully treated by means of distal tarsal arthrodesis with a 3-drill-tract technique. Horses with advanced distal tarsal OA are likely to have poorer outcomes, and the procedure will likely be of minimal benefit in horses with concomitant causes of hind limb lameness prior to surgery and in horses with preexisting proximal intertarsal joint disease.     

Orthopedic Infections in Equine Long Bone Fractures and Arthrodeses Treated by Internal Fixation: 192 Cases (1990–2006)

Objective: To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Study Design: Case series. Animals: Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Methods: Medical records (1990–2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. Results: Of 192 horses (171 [89%] closed, 21 [11%] open fractures), 157 (82%) were discharged from the hospital. Infection occurred in 53 (28% horses), of which 31 (59%) were discharged. Repairs without POI were 7.25 times more likely to be discharged from the hospital. Closed fractures were 4.23 times more likely to remain uninfected and 4.59 times more likely to be discharged from the hospital compared with open fractures. Closed reduction and internal fixation was associated with a 2.5‐fold reduction in rate of POI and a 5.9 times greater chance for discharge from the hospital compared with open reduction and internal fixation. Females had a strong trend for increased POI when compared with colts and stallion but not geldings. Conclusions: Overall rate of POI was 28%. Fracture classification, method of repair, gender, and surgical duration were significant risk factors.     

Transesophageal monitoring of aortic blood flow during nonemergent canine surgeries

Objective: To establish baseline values for descending thoracic aortic blood flow parameters as determined with a transesophageal combined M‐mode and pulsed Doppler ultrasound‐based monitoring method. Design: Preliminary observational study. Setting: University small animal teaching hospital. Animals: The study population consisted of anesthetized canine patients undergoing nonemergent surgeries. Prospectively set criteria for inclusion were adequate body size for placement of the esophageal probe and a nonemergent reason for surgery. The criterion for exclusion was recent trauma. Interventions: Placement of the transesophageal probe. Measurements and main results: Data was collected during 15 surgeries. Data from three dogs was excluded from data analysis (two recently hit by motor vehicles, one recently having undergone a total hip replacement). Each parameter was stable across time within each individual dog. The ranges of the descending thoracic aortic parameters across the 12 nonemergent cases were as follows: blood flow, 0.038–0.085 L min^?1 kg^?1; blood flow per beat, 0.31–0.84 mL kg^?1; blood acceleration, 6–29 m s^2?1; blood peak velocity, 38–105 m s^?1; left ventricular ejection time interval 331–492 ms; and diameter, 0.30–0.93 mm kg^?1. Conclusions: The range of descending thoracic aortic blood flow parameters encountered in this small group of dogs during nonemergent surgeries was broad; however, each parameter was quite stable across time with little change occurring in any dog during monitoring.