Page 523 - Adams and Stashak's Lameness in Horses, 7th Edition
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Lameness of the Distal Limb  489


             hemorrhage and permit repeated lavage and debride-  6.  Cauvin ER, Munroe GA. Septic osteitis of the distal phalanx: find-
             ment of the wound. However, immobilization with a      ings and surgical treatment in 18 cases. Equine  Vet J 1998;
  VetBooks.ir  agement of these injuries. Casts are usually left in place   7.  Chaffin MK. Pedal osteitis. In Current  Techniques in Equine
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             foot cast is often very beneficial in the long‐term man-
                                                                    Medicine and Surgery, 2nd ed. White NA, Moore JN, eds. WB
             for 3–4 weeks and may need to be reapplied depending
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             on the size and location of the avulsion. Wound stability   8.  Christman C. Multiple keratomas in an equine foot. Can Vet J 2008;
                                                                    49:904–906.
             is thought to improve the chances of complete reforma-  9.  DeBowes RM, Yovich JV. Penetrating wounds, abscesses, gravel
             tion of the hoof wall. 31                              and bruising. Vet Clin North Am Equine Pract 1989;5:179–194.
               Hoof avulsions heal by similar processes to other   10.  Findley JA, Pinchbeck GL, Milner PI, et al. Outcome of horses
             open wounds, but healing is often protracted because   with synovial structure involvement following solar foot penetra-
             wound contraction is limited in the foot. Wounds must   tions in four UK veterinary hospitals: 95 cases. Equine  Vet J
                                                                    2014;46:352–357.
             heal be epithelialization and reformation of the corium,   11.  Gaughan EM, Rendano VT, Ducharme NG. Surgical treatment of
             which often requires 3–5 months, depending on the size   septic pedal osteitis in horses: nine cases (1980–1987). J Am Vet
                         28
             of the defect.   There are several types of germinal   Med Assoc 1989;195:1131–1134.
               epithelial tissues in the foot (skin, limbic, coronary, pari-  12.  Getman LM, Davidson EJ, Ross MW, et al. Computed tomogra-
             etal, and solar), and all can contribute to epithelialization   phy or magnetic resonance imaging‐assisted partial hoof wall
                                                                    resection for keratoma removal. Vet Surg 2011;40:708–714.
             of the defect. 26,27  The structure and quality of the hoof   13.  Hamir AN, Kunz C, Evans LH. Equine keratoma. J Vet Diagn
             that forms is related to the type of epidermis that migrates   Invest 1992;4:99–100.
             over the surface of the wound.  Epithelial cells that   14.  Honnas CM,  Trotter GW.  The distal interphalangeal joint. In
                                         26
             migrate aberrantly can lead to hoof deformities. 26,27  Current  Techniques in Equine Surgery and Lameness, 2nd ed.
                                                                    White NA, Moore JN, eds.  WB Saunders Co., Philadelphia,
               For instance, if epidermis from the parietal integu-  1998;389–397.
             ment grows into the space formerly occupied by the   15.  Honnas CM, Ragle CA, Meagher DM. Necrosis of the collateral
             coronary band, the wall generated in that location will   cartilage of the distal phalanx in horses: 16 cases (1970–1985).
                                                                    J Am Vet Med Assoc 1988;193:1303–1307.
             not resemble wall generated from the coronary integu-  16.  Honnas CM, Dabareiner RM, McCauley BH. Hoof wall surgery
             ment. If epidermis from the hoof migrates proximally to   in the horse: approaches to and underlying disorders. Vet Clin
             the coronary band, a horny spur will form in the pastern   North Am Equine Pract 2003;19:479–499.
             region.  One of the goals of treating complete hoof   17.  Katzman SA, Spriet M, Galuppo LD. Outcome following com-
                   26
               avulsion injuries is to prevent aberrant migration of epi-  puted tomographic imaging and subsequent surgical removal of
                                                                    keratomas in equids: 32 cases (2005–2016). J Am Vet Med Assoc
             thelial cells and hoof wall deformities (Figure 4.60).  2019;254:266–274.
                                                                 18.  Kilcoyne I, Dechant JE, Kass PH, et al. Penetrating injuries to the
                                                                    frog (cuneus ungulae) and collateral sulci of the foot in equids: 63
             Prognosis                                              cases (1998–2008). J Am Vet Med Assoc 2011;239:1104–1109.
                                                                 19.  Lindford S, Embertson R, Bramlage L. Septic osteitis of the third
               Generally, incomplete avulsion injuries of the hoof   phalanx: a review of 63 cases. Proc  Am  Assoc Equine Pract
             wall alone and/or including the coronary band have a   1994;40:103.
             very good functional and cosmetic outcome if they are   20.  Lloyd KCK, Peterson PR, Wheat JD, et  al. Keratomas in horses:
             sutured. 21,28,31  The prognosis for deeper avulsion injuries   Seven cases (1975–1986). J Am Vet Med Assoc 1988;193:967–970.
             is often difficult to predict until complete healing has   21.  Markel MD, Richardson GL, Peterson PR, et al. Surgical recon-
                                                                    struction of chronic coronary band avulsion in three horses. J Am
             occurred. Complications such as fracture of the distal   Vet Med Assoc 1987;190:687–688.
             phalanx,  osteomyelitis,  septic  arthritis,  and  OA  of  a   22.  Meagher DM. Ascending infection under the hoof wall (Gravel).
             damaged DIP or PIP joint obviously reduce the progno-  In Large  Animal Internal Medicine. Smith BP, ed. CV Mosby,
                                                                    Philadelphia, 1990;1178.
             sis for a sound horse. Chronic hoof deformities are one   23.  Neil KM, Axon JE, Todhunter PG, et al. Septic osteitis of the distal
             of the most common sequelae of hoof avulsion injuries   phalanx in foals: 22 cases (1995–2002). J Am Vet Med Assoc
             but do not always cause a clinical problem. 27         2007;230:1683–1690.
                                                                 24.  Neil KM, Axon JE, Begg AP, et al. Retrospective study of 108 foals
                                                                    with septic osteomyelitis. Aust Vet J 2010;88:4–12.
                                                                 25.  Parks  A. Foot bruises: diagnosis and treatment. In Current
             ACKNOWLEDGMENTS                                        Techniques in Equine Surgery and Lameness, 2nd ed. White NA,
                                                                    Moore JN, eds. WB Saunders, Philadelphia, 1998;528–529.
               The authors thank Dr. Ted S. Stashak for his contri-  26.  Parks AH. Hoof avulsions. Equine Vet Educ 2008;August:411–413.
             butions to this chapter in the previous edition.    27.  Parks  AH. Chronic foot injury and deformity. In Current
                                                                    Techniques in Equine Surgery and Lameness, 2nd ed. White NA,
                                                                    Moore JN, eds. WB Saunders. Philadelphia, 1998;534–537.
                                                                 28.  Schumacher J, Stashak TS. Management of wounds of the distal
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