Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
Equine Vet J. 2009 Nov;41(8):794-9. doi: 10.2746/042516409x452170.
There are currently few long-term follow-up data relating to recovery from injury of a collateral ligament (CL) of the distal interphalangeal (DIP) joint and limited information about the effect of associated osseous injury on prognosis.
To describe long-term follow-up results for horses with CL injury, with and without associated osseous injury; and to determine the effect of extracorporeal shock wave therapy (ECSWT) or radial pressure wave therapy (RPWT) on outcome.
Prognosis for return to performance for horses with CL-related osseous injury would be worse than for horses with CL injury alone.
Magnetic resonance images from 313 feet of 289 horses with foot pain and a definitive diagnosis of collateral desmopathy of the DIP joint were analysed retrospectively for presence of osseous abnormality associated with the ligament origin or insertion and the middle and distal phalanges. Horses were assigned to groups according to the combination of their injuries. Type of treatment was recorded and follow-up information obtained. Thirty-two horses with additional sources of lameness were excluded from analysis of outcome.
Follow-up data were available for 182 horses, 55 of which had follow-up information for up to 2 years after presentation. Twenty-seven percent of horses with CL injury alone and 34% of horses with CL related osseous injury returned to their previous performance level. Prognosis for a combination of injuries to multiple soft tissue and osseous structures within the hoof capsule was substantially worse. There was no effect of ECSWT or RPWT on outcome.
The presence of mild to moderate CL related osseous injury does not appear to influence prognosis compared with CL injury alone.
Further studies of a larger number of horses are necessary in order to ascertain if specific types of osseous pathology influence return to performance levels.
目前关于远侧指间关节（DIP）侧副韧带（CL）损伤后的恢复情况，以及与骨损伤相关的预后信息非常有限。
描述 CL 损伤和合并骨损伤的马的长期随访结果；并确定体外冲击波疗法（ESWT）或径向压力波疗法（RPWT）对预后的影响。
与 CL 相关的骨损伤的马的预后恢复至比赛状态会比单纯 CL 损伤的马差。
回顾性分析了 289 匹马的 313 个足部的磁共振图像，这些马均因足部疼痛且被明确诊断为 DIP 关节侧副韧带粘液囊炎。分析了与韧带起点或止点以及中、远节趾骨相关的骨异常。根据损伤的组合将马分为不同的组别。记录了治疗类型，并获得了随访信息。32 匹有其他跛行原因的马被排除在预后分析之外。
182 匹马有随访资料，其中 55 匹在就诊后随访了长达 2 年。单纯 CL 损伤的马中有 27%和合并 CL 相关骨损伤的马中有 34%恢复到了以前的运动水平。同时存在多个蹄壳内的软组织和骨结构损伤的预后明显更差。ESWT 或 RPWT 对预后无影响。
与单纯 CL 损伤相比，轻度至中度 CL 相关骨损伤的存在似乎并不影响预后。
需要对更多的马进行进一步的研究，以确定特定类型的骨病理学是否会影响恢复到比赛水平。
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