Santschi Elizabeth M, Whitman Jeremy L, Prichard Michael A, Lopes Marco A F, Pigott John H, Brokken Matthew T, Jenson Paul W, Johnson Christopher R, Morrow Chris, Brusie Robert W, Juzwiak James S, Morehead James P
Department of Clinical Sciences, Kansas State University, Manhattan, Kansas.
Equine Medical Associates, Lexington, Kentucky.
Vet Surg. 2020 May;49(4):778-786. doi: 10.1111/vsu.13387. Epub 2020 Feb 7.
To describe subchondral lucencies (SCL) in the equine proximal tibia, several treatment options, and clinical outcomes.
Retrospective study.
Seventeen horses with proximal tibial SCL.
Medical record and radiograph review. Follow-up was obtained via examination and radiography when possible and by telephone and race records when required. The median duration of follow-up was 20 months (range, 0-48).
Proximal tibial SCL were associated with lameness in 14 of 17 horses. Subchondral lucencies were primary in 11 horses and secondary to an ipsilateral medial femoral condyle SCL in six horses. One foal with a primary SCL was euthanized because of osteomyelitis. Six horses ≤1 year old with primary SCL were managed with exercise restrictions only; SCL in three horses without lameness decreased in size, whereas three horses with lameness did not improve. One young horse treated with surgical debridement failed to improve and was euthanized. Lameness resolved in three horses with primary tibial SCL treated with screw fixation. Screw fixation of secondary SCL in five horses led to a reduction in SCL size and degree of lameness.
Primary tibial SCL healed with rest in 3 non-lame young horses with small SCL, but was not successful in lame horses with larger SC. Radiographic size and associated lameness improved or resolved with screw fixation in primary and secondary proximal tibial SCL.
Primary tibial SCL that did not cause lameness healed with conservative management, but persistent primary and secondary tibial SCL required screw fixation to reduce lameness.
描述马胫骨近端的软骨下透亮区(SCL)、几种治疗选择及临床结果。
回顾性研究。
17匹患有胫骨近端SCL的马。
查阅病历和X光片。尽可能通过检查和X光片进行随访,必要时通过电话和比赛记录进行随访。随访的中位时间为20个月(范围0 - 48个月)。
17匹马中有14匹的胫骨近端SCL与跛行有关。11匹马的软骨下透亮区为原发性,6匹马的软骨下透亮区继发于同侧股骨内侧髁SCL。1匹患有原发性SCL的幼驹因骨髓炎而实施安乐死。6匹≤1岁患有原发性SCL的马仅采用运动限制进行管理;3匹无跛行的马的SCL大小减小,而3匹有跛行的马没有改善。1匹接受手术清创治疗的幼马病情未改善,实施安乐死。3匹接受螺钉固定治疗的原发性胫骨SCL马的跛行症状消失。5匹继发性SCL马的螺钉固定导致SCL大小减小和跛行程度减轻。
3匹SCL较小且无跛行的年轻马通过休息,原发性胫骨SCL愈合,但对于SCL较大的跛行马则未成功。原发性和继发性胫骨近端SCL通过螺钉固定,X线片显示的大小及相关跛行症状得到改善或消失。
未引起跛行的原发性胫骨SCL通过保守治疗愈合,但持续性原发性和继发性胫骨SCL需要螺钉固定以减轻跛行。