Walsh R, Smith M R W, Wright I M
Newmarket Equine Hospital, Newmarket, Suffolk, UK.
Equine Vet J. 2018 Sep;50(5):624-628. doi: 10.1111/evj.12795. Epub 2018 Jan 25.
Osteochondral fragmentation of the dorsoproximal margin of the proximal phalanx is commonly recognised in racing Thoroughbreds. Frequency distribution has been documented in racing Thoroughbreds and Quarter Horses in the USA and in European Warmbloods but no data have been published from the UK. Concurrent intra-articular soft tissue lesions and radiographic accuracy of fragment distribution in racing Thoroughbreds have not previously been reported.
To document frequency distribution of dorsoproximal fragmentation of the proximal phalanx in a UK population of racing Thoroughbreds and to compare this with published data. To document concurrent intra-articular lesions identified arthroscopically and radiographic accuracy of fragment distribution.
A retrospective single centre-based, observational study.
Surgical reports and radiographs of all racing Thoroughbreds that underwent arthroscopic surgery for removal of fragmentation from the dorsoproximal margin of the proximal phalanx at Newmarket Equine Hospital between 2011 and 2015 were reviewed.
Two hundred and forty-two (85.8%) horses were in or being prepared for flat racing. Osteochondral fragmentation of the dorsoproximal aspect of the proximal phalanx was present in 428 fetlock joints of 282 horses, consisting of 194 (45.3%) left and 188 (43.9%) right metacarpophalangeal joints, and 20 (4.7%) left and 26 (6.1%) right metatarsophalangeal joints. Fragmentation was located dorsomedially in 316 (73.8%), dorsolaterally in 32 (7.5%) and biaxially in 80 (18.7%) joints. Concurrent soft tissue lesions were identified in 168 (39.3%) joints. Radiographic evidence of fragmentation was visible in 320 joints (74.8%).
Limited numbers preclude conclusions with respect to yearlings and horses in jump race training.
Dorsoproximal fragmentation of the proximal phalanx occurred most frequently medially and in the forelimbs. Sidedness was not demonstrated. Although similar to previously reported data, variance in limb distribution is evident. Further research is required to determine whether concurrent intra-articular soft tissue lesions are aetiopathogenic or an additional result of the pathological changes leading to fragmentation. Fragmentation site was not always accurately identified radiographically. The Summary is available in Spanish - see Supporting information.
近端指骨背侧近端边缘的骨软骨碎片在纯种赛马中很常见。在美国的纯种赛马和夸特马以及欧洲温血马中已记录了其频率分布,但英国尚未发表相关数据。此前尚未报道纯种赛马中并发的关节内软组织损伤情况以及碎片分布的放射学准确性。
记录英国纯种赛马群体中近端指骨背侧近端碎片的频率分布,并与已发表的数据进行比较。记录关节镜检查发现的并发关节内损伤情况以及碎片分布的放射学准确性。
一项基于单一中心的回顾性观察性研究。
回顾了2011年至2015年间在纽马克特马术医院接受关节镜手术以清除近端指骨背侧近端边缘碎片的所有纯种赛马的手术报告和X光片。
242匹(85.8%)马正在进行平地赛马或正在为此做准备。282匹马的428个跗关节存在近端指骨背侧近端的骨软骨碎片,其中包括194个(45.3%)左掌指关节和188个(43.9%)右掌指关节,以及20个(4.7%)左跖趾关节和26个(6.1%)右跖趾关节。碎片位于背内侧的有316个(73.8%)关节,背外侧的有32个(7.5%)关节,双轴的有80个(18.7%)关节。在168个(占39.3%)关节中发现了并发的软组织损伤。320个关节(占74.8%)有碎片的放射学证据。
数量有限,无法就一岁马和参加跳跃比赛训练的马匹得出结论。
近端指骨背侧近端碎片最常发生在内侧和前肢。未显示出偏向性。尽管与先前报道的数据相似,但肢体分布存在差异。需要进一步研究以确定并发的关节内软组织损伤是病因还是导致碎片形成的病理变化的额外结果。碎片位置通过放射学检查并不总是能准确识别。总结内容有西班牙语版本 - 见补充信息。