Bertoni Lélia, Seignour Maeva, de Mira Monica C, Coudry Virginie, Audigie Fabrice, Denoix Jean-Marie
Center of Imaging and Research on Locomotor Affections in Equines, Ecole Vétérinaire d'Alfort, Université Paris-Est, 14430 Goustranville, France.
J Am Vet Med Assoc. 2013 Jul 15;243(2):261-6. doi: 10.2460/javma.243.2.261.
To determine history; clinical, radiographic, ultrasonographic, and scintigraphic features; management; and outcome associated with third trochanter fractures in horses.
Retrospective case series.
8 horses.
Records from 2000 to 2012 were reviewed, and signalment, case history, severity and duration of lameness, results of physical and lameness examinations, imaging findings, management, and outcome were evaluated.
All horses had a history of acute onset of severe lameness. Four of the 8 horses had localizing physical signs of fracture. No specific gait characteristics were identified. Ultrasonographically, there was a single bony fragment displaced cranially in 7 of 8 horses and multiple bony fragments in 1. Concurrent gluteus superficialis muscle enthesopathy was identified in 7 horses. A standing craniolateral-caudomedial 25° oblique radiographic view was obtained in 3 horses to document the lesion and revealed in all 3 horses a simple complete longitudinal fracture between the midlevel and the base of the third trochanter. Nuclear scintigraphy was used to identify the affected area of the limb for further examination in 2 horses. Follow-up revealed that fractures healed with a fibrous union, with persistence of cranial displacement of the fragment. Lameness resolved after nonsurgical management for all horses.
Fracture of the third trochanter should be considered as a cause of hind limb lameness in horses when the proximal portion of the limb is affected. Diagnosis can easily be made with ultrasonography, but nuclear scintigraphy may help in identifying the lesion. Prognosis for return to athletic activity is good after an appropriate period of rest and restricted exercise.
确定马第三转子骨折的病史、临床、放射学、超声和闪烁扫描特征、治疗及预后。
回顾性病例系列研究。
8匹马。
回顾2000年至2012年的记录,评估信号、病史、跛行的严重程度和持续时间、体格检查和跛行检查结果、影像学检查结果、治疗及预后。
所有马匹均有严重跛行急性发作的病史。8匹马中有4匹有骨折的定位体征。未发现特定的步态特征。超声检查显示,8匹马中有7匹马有一个向头侧移位的单一骨碎片,1匹马有多个骨碎片。7匹马同时存在臀浅肌附着点病。3匹马拍摄了站立位颅外侧-尾内侧25°斜位X线片以记录病变,所有3匹马均显示第三转子中部和基部之间有一处简单的完全纵向骨折。2匹马使用核素闪烁扫描来确定肢体的受影响区域以便进一步检查。随访发现骨折通过纤维性愈合,碎片仍持续向头侧移位。所有马匹经非手术治疗后跛行均消失。
当马的肢体近端受到影响时,第三转子骨折应被视为后肢跛行的一个原因。超声检查可轻松做出诊断,但核素闪烁扫描可能有助于识别病变。经过适当的休息和限制运动后,恢复运动活动的预后良好。