Busschers Evita, Richardson Dean W
Department of Clinical Studies, New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348-1692, USA.
J Am Vet Med Assoc. 2006 Mar 15;228(6):909-13. doi: 10.2460/javma.228.6.909.
A 16-year-old Thoroughbred gelding was examined because of chronic right forelimb lameness.
On radiographs of the right front foot, the distal interphalangeal (DIP) joint space was narrow, and osteophytes and periarticular bony proliferation indicative of severe osteoarthritis were seen. Arthrodesis of the right DIP joint was recommended to improve the horse's comfort on the limb.
The horse was anesthetized, and palmar and dorsal arthroscopic approaches were used to remove as much of the articular cartilage as was accessible. Holes were then drilled through the dorsal aspect of the hoof wall, and 3 transarticular, 5.5-mm cortical screws were placed in lag fashion through these holes across the distal phalanx and into the middle phalanx. Defects in the hoof wall were filled with gentamicin-impregnated polymethyl methacrylate plugs and sealed with cyanoacrylate. Eight months after surgery, fusion of the DIP joint was evident radiographically and the horse was sound at a walk.
Transarticular placement of cortical screws through a dorsal hoof wall approach combined with arthroscopically guided cartilage removal can result in fusion of the DIP joint in horses.
一匹16岁的纯种马 gelding 因右前肢慢性跛行接受检查。
在右前足的X光片上，远侧指间（DIP）关节间隙变窄，可见骨赘和关节周围骨质增生，提示严重骨关节炎。建议对右DIP关节进行关节固定术以提高马匹该肢体的舒适度。
对马匹实施麻醉，采用掌侧和背侧关节镜入路尽可能多地切除可触及的关节软骨。然后在蹄壁背侧钻孔，以拉力方式通过这些孔将3枚5.5毫米的皮质骨螺钉穿过远节指骨置入中节指骨。蹄壁缺损处用庆大霉素浸渍的聚甲基丙烯酸甲酯塞填充，并用氰基丙烯酸酯密封。术后8个月，X光片显示DIP关节融合明显，马匹行走时状态良好。
通过背侧蹄壁入路经关节置入皮质骨螺钉并结合关节镜引导下的软骨切除可导致马匹DIP关节融合。
