Page 359 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

334 CHAPTER 1

VetBooks.ir including the distal carpus or tarsus. This is to rule ends is filled with heterogeneous haemorrhagic tis-
sue. The lesion may affect the SL body and/or both
out concurrent phalangeal, metacarpal/tarsal or PSB
fractures, and fragmentation/avulsion at the SL or
sesamoidean ligament insertions (see Chapter 1.4, branches (Fig. 1.656).
Figs. 1.238, 1.239). Management
Treatment may only be instituted for salvage, aim-
Ultrasonography ing for pasture soundness. Even then, multiple com-
The whole suspensory apparatus should be evalu- plications make any treatment a costly, prolonged
ated, along with the flexor tendons. Acute rupture and painful experience. Conservative treatment with
is characterised by complete loss of definition of fibreplast casting, followed by Robert Jones bandag-
the SL in both transverse and longitudinal views ing and splints for several months, has been success-
(Figs. 1.654, 1.655). The space between the frayed ful in some horses, although severe pressure sores,

1.654 1.655 Figs. 1.654, 1.655
Transverse (1.654) (from a
palmaromedial approach) and
longitudinal (1.655) (sagittal)
sonograms of the palmar
metacarpus in zone II. The SL
is very enlarged, hypoechogenic
and with complete loss of
visible fibres. The margins are
ill defined (dotted lines and
double yellow arrow). There is
a mixture of slightly echogenic
but homogeneous fibrinous
tissue and anechogenic fluid.
The periligamentous tissues
are thickened due to oedema
(red arrows).
1.656

Fig. 1.656 Longitudinal sonogram from the medial
aspect of the metacarpus (frontal plane zone IIB/
IIIA) at the level of the SL bifurcation. There is
partial rupture of the SL body and branch. Part of
the SL remains intact with regular fibre alignment
(white double arrow). The ruptured distal end
(yellow arrow) floats in amorphous, hypoechogenic
tissue (haematoma) (red arrows). Note the marked,
hypoechogenic periligamentous and subcutaneous
tissue thickening.