Page 626 - Adams and Stashak's Lameness in Horses, 7th Edition

592 Chapter 4

is not considered paramount to supporting the load in ligament of the deep digital flexor tendon in adult horses. Am J
Vet Res 1998;59:347–351.
the working horse. Therefore, treatments may be more 12. Van den Belt AJM, Becker CK, Dik KJ. Desmitis of the accessory
VetBooks.ir has empirically included oral nonsteroidal medication, ligament of the deep digital flexor tendon in the horse: clinical and
geared toward eliminating pain and lameness. Treatment
ultrasonographic features. A report of 24 cases. Zentralbl
intralesional hyaluronan injection to reduce adhesions,
Veterinarmed (A) 1993;40:492–500.
and intralesional injection of steroid to reduce pain and 13. Bertone AL. Management of orthopedic emergencies. Vet Clin N
Am (Equine Pract) 1994;10:603.
inflammation as well as to reduce fibrosis. More recently, 14. Bischofberger AS, Furst A, Auer J, et al. Surgical management of
ALDDFT desmitis has been treated with injections of complete diaphyseal third metacarpal and metatarsal bone frac-
stem cells, BMAC, and PRP. ture: clinical outcome in 10 mature horses and 11 foals. Equine
Desmotomy of the ALDDFT may relieve excessive Vet J 2009;41:465–473.
tension on a fibrotic ALDDFT in chronic cases (greater 15. Bosch G, de Mos M, van Binsbergen R, et al. The effect of focused
than 3 months); in one study, only 14%–18% made a extracorporeal shock wave therapy on collagen matrix and gene
expression in normal tendons and ligaments. Equine Vet J
full recovery. It has been suggested that desmotomy 2009;41:335–341.
12
may prevent re‐injury. Horses that have received a des- 16. Boston RC, Nunamaker DM. Gait and speed as exercise compo-
11
motomy of the ALDDFT as a treatment for chronic nents of risk factors associated with onset of fatigue injury of the
rotation of the third phalanx can have pain at the des- third metacarpal bone in 2‐year‐old Thoroughbred racehorses.
Am J Vet Res 2000;61:602.
motomy site when returned to full work. Similar medi- 17. Bowman KF, Evans LH, Herring ME. Evaluation of surgical
cal treatment as described above can be effective in removal of fractured distal splint bones in the horse. J Vet Surg
eliminating pain. Topical nonsteroidal and steroidal 1982;11:116.
mediations can be effective. 18. Boyde A, Haroon Y, Jones SJ, et al. Three dimensional structure of
the distal condyles of the third metacarpal bone of the horse.
As with all other soft tissue injuries to the flexor Equine Vet J 1999;31:122.
surface of the metacarpus/metatarsus, a controlled con- 19. Bramlage LR. Fetlock arthrodesis. In Equine Fracture Repair.
valescent exercise program should be followed based on Nixon AJ, ed. WB Saunders, Philadelphia, 1996;172–178.
lameness and ultrasound examination at 60‐day 20. Bramlage LR. Surgical management of tendonitis and desmitis. In:
Proceedings of the Dubai Equine International Symposium.
intervals. Rantanen NW and Hauser ML, eds. 1996;375–378.
21. Bramlage LR, Rantanen NW, Genovese RL, et al. Long term
effects of surgical treatment of superficial digital flexor tendinitis
Prognosis by superior check desmotomy. Proc Am Assoc Equine Pract
1988;34:655–656.
The reported prognosis for resolution of pain and 22. Brokken MT, Schneider RK, Sampson SN, et al. Magnetic reso-
return to work is guarded. In one study of 27 horses, 12 nance imaging features of proximal metacarpal and metatarsal
(44%) resumed work within 5 months, and 10 (37%) injuries in the horse. Vet Radiol Ultrasound 2007;48:507–517.
eventually resumed full work. It is strongly recom- 23. Cervantes C, Madison JB, Ackerman N, et al. Surgical treatment
mended that controlled exercise be used, rather than of dorsal cortical fractures of the third metacarpal bone in thor-
oughbred racehorses: 53 cases (1985–1989). J Am Vet Med Assoc
pasture turnout, and that lameness is resolved long 1992;200:1997–2000.
before healing is complete. The horse’s return to work 24. Chesen AB, Dabareiner RM, Chaffin MK, et al. Tendinitis of the
should be based on the results of serial ultrasonographic proximal aspect of the superficial digital flexor tendon in horses: 12
cases (2000–2006) J Am Vet Med Assoc 2009;234: 1432–1436.
appearance. 25. Cornelissen BP, Vanweeren PR, Ederveen AG, et al. Influence of
exercise on bone mineral density of immature cortical and tra-
becular bone of the equine metacarpus and proximal sesamoid
References bone. Equine Vet J (Suppl) 1999;31:79.
26. Cowles RR, Johnson LD, Holloway PM. Proximal suspensory
1. Ahern BJ, Boston RC, Ross MW. Enostosis‐like lesions in equids: desmitis: a retrospective study. Proc Am Assoc Equine Pract
79 cases (1997–2009). JAVMA 2014;245:1042–1047. 1994;4:183–185.
2. Allen AK. Experience with ultrasound‐guided tendon puncture or 27. Dallap BL, Bramlage LR, Embertson RM. Results of screw fixa-
splitting. Proc Am Assoc Equine Pract 1992;38:273–277. tion combined with cortical drilling for treatment of dorsal cortical
3. Allen D, White NA. Management of fractures and exostosis of the stress fractures of the third metacarpal bone in 56 Thoroughbred
metacarpals and metatarsals II and IV in 25 horses. Equine Vet J racehorses. Equine Vet J 1999;31:252.
1987;19:326. 28. Davies HM, McCarthy RN, Jeffcott LB. Surface straining on the
4. Argüelles D, Carmona JU, Climent F, et al. Autologous platelet dorsal metacarpus of thoroughbreds at different speeds and gaits.
concentrates as a treatment for musculoskeletal lesions in five Acta Anat (Basel) 1993;146:148.
horses. Vet Rec 2008;162:208–211. 29. Davies HM, Gale SM, Baker ID. Radiographic measures of bone
5. Barber SM, Caron J, Pharr J. Metatarsal/metacarpal exostosis shape in young thoroughbreds during training for racing. Equine
removal—a prospective study. Vet Surg 1987;16:82. Vet J (Suppl) 1999;30:262.
6. Barclay WP, Foerner JJ, Phillips TN. Axial sesamoid injuries asso- 30. Del Bue M, Ricco S, Ramoni R, et al. Equine adipose‐tissue
ciated with lateral condylar fractures in horses. J Am Vet Med derived mesenchymal stem cells and platelet concentrates: their
Assoc 1985;186:278. association in vitro and in vivo. Vet Res Commun 2008;Suppl
7. Barr ARS, Dyson SJ, Barr FJ, et al. Tendinitis of the deep digital 1:S51.
flexor tendon in the distal metacarpal/metatarsal region associ- 31. Doran R. Management of simple and complicated splint bone
ated with tendinitis of the digital sheath in the horse. Equine Vet J fractures in horses. Equine Pract 1994;16:29.
1995;27:348–355. 32. Doran R. Fractures of the small metacarpal and metatarsal (splint)
8. Bassage LH, Richardson DW. Longitudinal fractures of the con- bones. In Equine Fracture Repair. Nixon AJ, ed. WB Saunders,
dyles of the third metacarpal and metatarsal bones in racehorses: Philadelphia. 1996;200–207.
224 cases (1986–1995). J Am Vet Med Assoc 1998;212:1757. 33. Dowling BA, Dart AJ. Mechanical and functional properties of the
9. Bassage LH, Ross MW. Enostosis‐like lesions in the long bones of equine superficial digital flexor tendon. Vet J 2005;170:184–192.
10 horses: scintigraphic and radiographic features. Equine Vet J 34. Dowling BA, Dart AJ, Hodgson DR, et al. Superficial digital flexor
1998;30:35–42. tendonitis in the horse. Equine Vet J 2000;32:369–378.
10. Baxter GM, Doran RE, Allen D. Complete excision of a fractured 35. Duprezz P. Fractures of the small metacarpal and metatarsal
fourth metatarsal bone in eight horses. Vet Surg 1992;21:273. bones (Splint bones). Equine Vet Ed 1994;6:279.
11. Becker CK, Sabelberg HHCM, Buchner HHF, et al. Long‐term 36. (a)Dyson S. Proximal suspensory desmitis: clinical, ultrasonographic
consequences of experimental desmotomy of the accessory and radiographic features. Equine Vet J 1991;23:25;(b) Dyson SJ.