Page 49 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

24 CHAPTER 1

VetBooks.ir Therapeutic laser 1.47
Low-intensity lasers may have an effect on the local
circulation and have biomodulation effects on the
targeted tissue in order to trigger cell proliferation
and provide analgesia, although the exact mecha-
nisms within the tissue are unknown. Lasers have
been used to aid the healing of wounds, superficial
flexor tendonitis and also for OA. They are increas-
ingly used clinically but, at present, there are few
peer reviewed publications on its use, mode of action
or effectiveness.

Magnetic and electromagnetic
therapy
Magnets have been used to assist fracture healing
and treat back problems due to the finding that bone
has piezoelectrical properties. It is suggested that
pulsed electromagnetic fields may stimulate bone
healing and provide analgesia. Although widely used Fig. 1.47 Extracorporeal shock-wave treatment of
in equine practice, there is no objective data as to the left hindlimb of a horse with proximal suspensory
their efficacy. ligament desmitis.

Extracorporeal shock-wave therapy
Shock-wave therapy was developed from the human pastern region and at its insertion onto P3). Recently,
technique of lithotripsy for the treatment of bladder treatment of angular limb deformities with shock-
and kidney stones. It has also been used for various wave therapy to retard growth on the convex side of
human orthopaedic injuries and has more recently the deformity has also been reported. Many of the
been used in horses. High acoustic wave impulses conditions where shock-wave therapy has been used
are generated (either focused, where the waves are have no or minimal scientific evidence basis and as
generated electrohydraulically, piezoelectrically or such it should be prescribed with this in mind.
electromagnetically and converge on a small point
[Fig. 1.47], or radially, where the waves are gener- FIRST-AID TREATMENT OF
ated pneumatically and expose surrounding tis- THE FRACTURE PATIENT
sues) and targeted at the tissue under treatment. It
is suggested that shock-wave treatment may increase Immediate fracture support with first-aid mea-
regional blood flow, have direct cellular effects and sures helps to relieve pain, minimises further bony
activate osteogenic factors; it also has analgesic and soft-tissue damage, stabilises the limb, pre-
properties. Conditions treated with this technique vents further contamination if open and renders
in the horse are sore shins, insertional desmopathies the horse safer to travel. These factors allow the
(particularly proximal suspensory desmitis, suspen- best possibility for appropriate treatment if this is
sory branch insertions and avulsion fractures at the achievable. A brief, but thorough, examination of
proximal attachment of the suspensory ligament) the whole horse is necessary initially to ascertain
and impinging dorsal spinous processes. Other con- that there are no life-threatening injuries present;
ditions reported to be treated include tibial stress these should be attended to first. Horses can (but
fractures, incomplete proximal phalangeal fractures, not always) be extremely distressed and severely
subchondral bone pain, OA of the distal hock joints, lame with fractures of the limb, so physical (e.g. a
superficial digital flexor tendonitis and deep digital twitch) or chemical restraint may be needed before
flexor tendonitis (particularly at the palmar/plantar application of any splint support. Chemical restraint