Common Disorders of Equine Forelimb

what is most likely to cause lameness in forelimb

foot

what fractures happen in P2

comminuted

chip

palmar process

what causes P2 fractures

trauma

twist injury if comminuted

how are P2 fractures diagnosed

fracture lame

radiographs

how to treat P2 fractures

internal fixation + pastern arthrodesis

coaptation: half limb cast or transfixation pin cast

what is the prognosis of P2 fracture

fair to good depending on success of repair

decreases with coffin joint involvement

what causes proximal interphalangeal (pastern) osteoarthritis

conformation

trauma

OC cysts

how is proximal interphalangeal (pastern) osteoarthritis diagnosed

moderate lameness

characteristic bony swelling

+ to lower limb flexion

abaxial block

radiographs

how to treat pastern joint OA

inject with corticosteroids

arthrodesis with advanced cases

what is the prognosis for pastern joint OA

fair to good

what causes metacarpophalangeal (fetlock) joint OA

athletic use

conformation

trauma

how to diagnose metacarpophalangeal (fetlock) joint OA

lame

+ flexion test

decreased ROM

effusion

block to fetlock or low 4 point

radiographs

what is the prognosis for metacarpophalangeal (fetlock) joint OA

depends on severity

high motion joint, cannot be fused!

where are metacarpophalangeal (fetlock) joint osteochondral fragments found

dorsal

what causes metacarpophalangeal (fetlock) joint osteochondral fragments

trauma, especially jumping and race horses

OCD

how to diagnose metacarpophalangeal (fetlock) joint osteochondral fragments

mild to moderate lameness

fetlock effusion

+ fetlock flexion

radiographs

how is metacarpophalangeal (fetlock) joint osteochondral fragments treated

arthroscopic removal

what is the prognosis of metacarpophalangeal (fetlock) joint osteochondral fragments

good to excellent

medial exostosis of splint bone is from

trauma

what conformation can cause exostosis of splint bones

bench knee

toe out → winging in

how is exostosis of splint bones diagnosed

characteristic swelling

palpation

may or may not have lameness

radiographs

how is exostosis of splint bones treated

benign neglect

rest

NSAIDs

what is the prognosis for exostosis of splint bones

excellent

what causes dorsal metacarpal disease “bucked shins”

race horses in early training

remodeling of MC3 in response to training

how is bucked shins diagnosed

acutely lame with short stride

may have dorsal swelling

pain on palpation

radiographs

nuclear scintigraphy

how to treat bucked shins

NSAIDs

rest 10-14 days (mild)

alter training

shockwave

what si the prognosis for bucked shin

good to excellent

what causes cannon bone fracture

pasture accident in foals

cumulative stress in racehorses

diaphyseal fracture occurs from

step in hole

traumatic accidents

salter harris type II fracture ocurs

above growth plate

what internal fixation used for diaphyseal MC3 fracture

2 plates

what internal fixation used for lateral condylar and proximal palmar MC3 fracture

screws

what internal fixation used for medial condylar MC3 fracture

screws and dorsolateral plate

what is the prognosis of cannon bone fracture

if open → grave

foals → good

in adults, diaphyseal → fair to poor, condylar and proximal palmar → good for life

what are clinical signs associated with carpal joint disorder

+ flexion

reduced ROM

external swellings, bony and effusion

acquired over at the knee and bowed legged

what causes carpal chip fractures

most common fracture in racehorses!!

• hyperextension of limb at speed

how to diagnose carpal chip fractures

mild to moderate lameness

carpal effusion

flexed lateral and flexed skylines radiographs

how to treat carpal chip fractures

arthroscopy!

what is the prognosis of carpal chip fractures

depends on concurrent damage

good if none and acute

poor if extensive and chronic

where commonly gets carpal slab fracture

C3 frontal plane

how to diagnose carpal slab fracture

severe lameness

severe carpal effusion

radiographs

how to treat carpal slab fracture

fixation with arthroscopic guidance

what is the prognosis for carpal slab fractures

fair to good

same issue as for chip fx

what are clinical signs of failure of stay apparatus

dropped elbow

unable to “fix” carpus

inability to extend limb

what causes radial nerve injury

avulsion of brachial plexus

humeral fracture

prolonged lateral recumbency without padding

how to diagnose radial nerve injury

typical stance, unable to extend limb

drags limb

not consistent loss of cutaneous sensation

muscle atrophy after 2-4 weeks

how to treat radial nerve injury

splint to flix limb

NSAIDs

Corticosteroids

what is the prognosis of radial nerve injury

good if function recovers in 6-8 weeks

poor otherwise

what is the most common foal fracture

olecranon fracture

results from a kick

how to diagnose olecranon fracture

failure of stay apparatus

swelling, crepitus

radiographs

how to treat incomplete, non displaced olecranon fracture

stall rest

how to treat complete or displaced olecranon fracture

surgery

what is the prognosis of olecranon fracture

good in foals and adults if not in joint (with surgery)

fair if articular surface involved

guarded if open fracture

What is being shown

Fracture of P2

What is being shown

Pastern joint OA

What is being shown

Metacarpophalangeal (fetlock) joint OA

What is being shown

Fetlock joint osteochondral fragments

What is being shown

Exostosis of splint bone

What is being shown

Exostosis of splint bones

What is this called

Bucked shins

What is being shown

Bucked shins

What type of fracture is this

Diaphyseal

What type of fracture is shown

Condylar

What type of fracture is being shown

Salter Harris type II

What is being shown

Carpal chip fractures

What is being shown

Carpal slab fracture

What is wrong with this horse

Failure of stay apparatus

What is wrong with this horse

Radial nerve injury

What is the issue

Olecranon fracture