Page 151 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

126 CHAPTER 1

VetBooks.ir 1.219 Fig. 1.219 Dorsolateral/palmaromedial oblique
radiograph of the right forelimb showing a P2 fracture
involving the proximal interphalangeal joint. Note
the separated palmarolateral eminence of P2 (arrow).
(Photo courtesy Graham Munroe)

incident and can be associated with subluxation or
other severe soft-tissue trauma. Osteochondral frag-
mentation may be traumatic and related to avulsion
fragments within associated soft tissues following
hyperextension of the joint. Axial fragments may
be within the straight sesamoidean ligament and/
or the axial palmar/plantar ligament of the pastern
joint. Abaxial fragments may be located within the
insertion of the superficial flexor tendon or associ-
ated with the abaxial palmar/plantar ligament of the
pastern joint. Ultrasonography may be of assistance
to determine soft-tissue involvement.

Clinical presentation
P1 fractures may present as acute-onset severe lame-
ness or mild intermittent lameness depending on the
length and degree of comminution. In mild, incom-
plete fractures a pain response may be present on

1.220 1.221

Figs. 1.220, 1.221 A comminuted biarticular P2 fracture shown in lateromedial (1.220) and oblique (1.221)
radiographs of the distal limb.