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采用三钻孔技术对患有跗关节远端骨关节炎的马进行跗关节远端关节融合术:54例病例(1990 - 1999年)

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

作者信息

Dechant Julie E, Baxter Gary M, Southwood Louise L, Crawford William H, Jackman Bradley R, Stashak Ted S, Trotter Gayle W, Hendrickson Dean A

机构信息

Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.

出版信息

J Am Vet Med Assoc. 2003 Dec 15;223(12):1800-5. doi: 10.2460/javma.2003.223.1800.

Abstract

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.

摘要

目的

评估采用三钻孔技术诱导患关节融合术治疗跗关节远端骨关节炎(OA)马匹的长期临床疗效,确定与疗效相关的任何术前或手术因素,并描述与该技术相关的任何并发症。

设计

回顾性研究。

动物

54匹马。

方法

查阅病历,获取有关特征、用途、病史、体格检查和跛行检查结果、手术技术及术后护理的信息。检查X光片并对OA严重程度进行分级。通过术后至少13个月与马主进行电话访谈获取随访信息。

结果

32匹(59%)马取得成功疗效,6匹(11%)术后有所改善但未恢复正常,16匹(30%)术后未改善。疗效与之前关节内注射的使用呈负相关。术后并发症较少。

结论及临床意义

结果表明,采用三钻孔技术进行跗关节远端关节融合术可成功治疗马匹的跗关节远端OA。跗关节远端OA晚期的马匹可能疗效较差,对于术前伴有后肢跛行其他病因的马匹以及已有跗骨近端关节疾病的马匹,该手术可能益处不大。

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