Roquet Imma, Lane Easter J, Coomer Richard P C, Ezquerra Luis J, Marsh Chad A, Trostle Steve S, Santschi Elizabeth M
Department of Equine Surgery, Universidad de Extremadura, Caceres, Spain.
Performance Equine Associates, Thackerville, Oklahoma.
Vet Surg. 2017 May;46(4):478-485. doi: 10.1111/vsu.12643. Epub 2017 Mar 22.
To describe the results of screw placement through subchondral lucencies (SCL) of the proximal radius in 8 horses.
Retrospective clinical study.
Horses with cubital SCL causing lameness (n=8).
Medical record review and clinical follow-up.
Eight horses with SCL in the proximal radius causing lameness were treated with a screw placed across the lucency. The horses range in age from 1 to 20 years. In 4 of 8 horses, the lameness had been intermittently severe (apparent at the walk). Lameness was isolated to the cubital joint by intra-articular anesthesia in 5 horses and diagnosed radiographically in all 8. All horses had a 4.5 mm cortical bone screw placed from medial to lateral (6 lag, 2 neutral) across the SCL using fluoroscopic or radiographic control. Postoperative care included stall confinement with hand walking for 30-60 days, followed by an additional 30-60 days of pasture turnout. Radiographic SCL healing (reduction in SCL size) was demonstrated at 3-4 months after surgery in all horses, and 7/8 horses (87.5%) were used as intended (4 performance, 3 pasture turn-out) within 6 months. Lameness in the remaining horse improved initially (dressage) but returned.
A screw placed through the SCL of the proximal-medial radius was effective in reducing or resolving lameness associated with the elbow joint in 7/8 horses (88%). Screw placement in the proximal radius should be considered for horses with lameness caused by an SCL when a quick return to exercise is desired or conservative therapy is ineffective.
描述8匹马经桡骨近端软骨下透亮区(SCL)置入螺钉的结果。
回顾性临床研究。
患有导致跛行的尺骨SCL的马(n = 8)。
病历回顾及临床随访。
8匹因桡骨近端SCL导致跛行的马接受了一枚穿过透亮区的螺钉治疗。这些马的年龄在1至20岁之间。8匹马中有4匹间歇性出现严重跛行(行走时明显)。5匹马通过关节内麻醉确定跛行局限于肘关节,所有8匹马均经X线片诊断。所有马均在透视或X线控制下,从内侧到外侧置入一枚4.5 mm皮质骨螺钉穿过SCL(6枚拉力螺钉,2枚中和螺钉)。术后护理包括在厩舍内限制活动并牵遛30 - 60天,随后再在牧场放牧30 - 60天。所有马在术后3 - 4个月X线片显示SCL愈合(SCL大小减小),8匹马中有7匹(87.5%)在6个月内按预期使用(4匹用于比赛,3匹用于牧场放牧)。其余一匹马的跛行最初有所改善(盛装舞步)但又复发。
经桡骨近端内侧SCL置入螺钉对8匹马中的7匹(88%)减轻或消除与肘关节相关的跛行有效。对于因SCL导致跛行且期望快速恢复运动或保守治疗无效的马,应考虑在桡骨近端置入螺钉。