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13匹马远节指骨伸肌突碎裂关节镜清理术后的长期预后

Long-term outcome after arthroscopic debridement of distal phalanx extensor process fragmentation in 13 horses.

作者信息

Crowe Oliver M, Hepburn Richard J, Kold Svend E, Smith Roger K

机构信息

Willesley Equine Clinic, Willesley, Gloucestershire, UK.

出版信息

Vet Surg. 2010 Jan;39(1):107-14. doi: 10.1111/j.1532-950X.2009.00608.x.

Abstract

OBJECTIVE

To report long-term outcome after arthroscopic removal of fragmentation of the extensor process of the distal phalanx in horses.

STUDY DESIGN

Case series.

ANIMALS

Adult horses (n=13).

METHODS

Medical records (2003-2004) of horses that had arthroscopic debridement of fragmentation of the extensor process of the distal phalanx were reviewed. Inclusion criteria included: lameness localized to the foot, fragmentation of the extensor process of the distal phalanx debrided arthroscopically, and a follow-up period of > or = 4 years.

RESULTS

Of the 13 horses, lameness was resolved in 11 (85%) initially but distal interphalangeal joint pain recurred in 2 (15%) within 1 year of surgery. Three (23%) other horses were retired because of lameness at other sites during the follow-up period resulting in 46% (6/13) being not lame and in full work after 4 years. Substantial changes were identified at surgery in the contralateral joint of 7 horses, even when fragments were only present unilaterally.

CONCLUSIONS

Arthroscopic debridement of fragmentation of the extensor process of the forelimb distal phalanx has a good short-term prognosis for resolution of lameness and return to work but a more guarded prognosis for long-term soundness.

CLINICAL RELEVANCE

These results allow for more accurate prognostication preoperatively and may support early debridement of fragmentation of the extensor process of the distal phalanx.

摘要

目的

报告马远节指骨伸肌突碎片关节镜下切除术后的长期结果。

研究设计

病例系列。

动物

成年马(n = 13)。

方法

回顾2003 - 2004年对马远节指骨伸肌突碎片进行关节镜清创的病历。纳入标准包括:跛行局限于足部,关节镜下清创远节指骨伸肌突碎片,随访期≥4年。

结果

13匹马中,11匹(85%)最初跛行得到缓解,但2匹(15%)在术后1年内远指间关节疼痛复发。另外3匹(23%)马在随访期间因其他部位跛行而退役,导致46%(6/13)的马在4年后无跛行且能正常工作。7匹马对侧关节在手术时发现有明显变化,即使碎片仅单侧存在。

结论

前肢远节指骨伸肌突碎片的关节镜清创术对跛行缓解和恢复工作有良好的短期预后,但对长期健康状况的预后较谨慎。

临床意义

这些结果有助于术前更准确地预测预后,并可能支持早期对远节指骨伸肌突碎片进行清创。

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