Page 88 - Manual of Equine Field Surgery

84 LIMB SURGERIES

POSTOPERATIVE CARE is then gradually lowered over the first postoper-
ative week to allow for an adaptation period.

Postoperative Care

Dietary Modification

Bandaging: A sterile dressing is placed over the

incision and a half limb bandage is applied. The Rapid growth should be controlled to the extent

bandage is changed every 3 to 4 days and the possible. Early weaning may be indicated in foals

limb is maintained in a bandage for 3 weeks. of heavy lactating mares. High-energy diets

Exercise Restridions: Handwalking should be should be avoided, and there n1ay be some benefit

introduced 5 days postoperatively and the time to limiting feed intake to grass hay only for 30

period of handwalking gradually increased over days.' More commonly, growing weanlings are fed

the following 3 weeks up to 30 to 45 minutes a grass hay or grass-alfalfa mix hay-based diet

twice daily. When controlled exercise is not possi- with concentrate rations of 0.5°/o body weight for

ble, turnout in a small area is provided. a 60-day period.

Medications: Phenylbutazone is administered at

4.4 mg/kg BID for the initial 24 hours and 2.2

mg/kg BID for an additional 3 days. Continued

phenylbutazone administration at lower doses or EXPECTED OUTCOME

less frequent intervals may be necessary for pain

management. Most horses with DDFT contracture improve dra-

Suture removal: Skin sutures are removed 12 matically with distal check ligament desmotomy,

days postoperatively. corrective trimming or shoeing, and management

of controllable underlying factors. Younger horses

and those with deformities of less than 90 degrees
Corrective Trimming have the best prognosis. 2•5 The results for treat-

If not done preoperatively, the heels should be ment of metacarpophalangeal deformity vary.2•3•6

trimmed or rasped to lower the hoof angle. In In a single report of selected cases of caudal foot

some cases, toe extensions are used in the post- lameness, results were good. 7

operative period to increase tension on the DDFT

during breakover and to protect the toe from
.
excessive wear. COMPLICATIONS

A large change in hoof angle subsequent to

surgery and corrective trimming may cause sig- Complications include excessive scar tissue for-

nificant postoperative pain and subsequent con- mation and recurrent contracture. The amount of
•
tractural reflex. In these cases, the foot can be

trimmed and a temporary heel elevation can be

placed on the foot (Figure 13-11). The elevation

Figure 13-12 No ground contact at the heel in a

Figure 13-11 Temporary heel elevation using acrylic. horse with deep digital flexor tendon contracture.

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