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马掌指关节和跖趾关节侧副韧带断裂:17例(1999 - 2005年)

Rupture of collateral ligaments in metacarpophalangeal and metatarsophalangeal joints in horses: 17 cases (1999--2005).

作者信息

Tenney Wade A, Whitcomb Mary Beth

机构信息

William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California, Davis, CA 95616, USA.

出版信息

J Am Vet Med Assoc. 2008 Aug 1;233(3):456-62. doi: 10.2460/javma.233.3.456.

Abstract

OBJECTIVE

To characterize ruptures of collateral ligaments (CLs) in metacarpophalangeal and metatarsophalangeal joints in horses.

DESIGN

Retrospective case series.

ANIMALS

17 horses with ruptured CLs.

PROCEDURES

Data were obtained from medical records, including signalment, history, clinical signs, ultrasonographic and radiographic findings, treatment, and outcome. Additional follow-up information was obtained from owners or referring veterinarians.

RESULTS

The lateral CL was ruptured in 11 horses; the medial CL was ruptured in 6 horses. Ultrasonography revealed ipsilateral rupture of the short and long components of the CL in 11 horses and rupture of only 1 component in 6 horses. No biaxial ruptures were detected, but 9 horses had desmitis of the CL on the nonruptured side of the affected joint. All horses were lame (lameness score range, 2/5 to 4/5). Joint instability was palpable in 9 horses; only 4 horses had episodes of joint luxation. Avulsion fractures were identified radiographically in 6 horses and ultrasonographically in another 2 horses. Stress radiography revealed joint instability in 10 horses. Horses were managed by stall confinement, limb immobilization, and gradual return to exercise. Eight horses returned to riding, 2 resumed breeding, 2 were retired, 2 were euthanized, and 3 were doing well 86 to 139 days after injury.

CONCLUSIONS AND CLINICAL RELEVANCE

Ultrasonographic examination is indicated in horses with acute lameness and swelling at the metacarpophalangeal or metatarsophalangeal joint, particularly when stress radiography cannot be performed or findings are equivocal. Affected horses can be conservatively managed. Prognosis for athletic use may be better than originally believed.

摘要

目的

描述马掌指关节和跖趾关节侧副韧带(CLs)断裂的特征。

设计

回顾性病例系列研究。

动物

17例CLs断裂的马。

方法

从病历中获取数据,包括信号、病史、临床症状、超声和放射学检查结果、治疗及预后。从马主或转诊兽医处获取额外的随访信息。

结果

11匹马的外侧CL断裂;6匹马的内侧CL断裂。超声检查显示,11匹马的CL短、长成分同侧断裂,6匹马仅1个成分断裂。未检测到双轴断裂,但9匹马在患关节未断裂侧有CL腱炎。所有马均跛行(跛行评分范围为2/5至4/5)。9匹马可触及关节不稳定;仅4匹马有关节脱位发作。6匹马经放射学检查发现撕脱骨折,另外2匹马经超声检查发现。应力放射学检查显示10匹马关节不稳定。对马进行厩舍圈养、肢体固定并逐渐恢复运动管理。8匹马恢复骑行,2匹马恢复配种,2匹马退役,2匹马实施安乐死,3匹马在受伤后86至139天情况良好。

结论及临床意义

对于掌指关节或跖趾关节急性跛行和肿胀的马,尤其是无法进行应力放射学检查或检查结果不明确时,应进行超声检查。患马可采用保守治疗。运动用途的预后可能比最初认为的要好。

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