Page 198 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Musculoskeletal system: 1.4 The forelimb 173

VetBooks.ir injuries often occur at high speed/impact but have 1.331
been reported following recovery from general
anaesthesia. Elbow luxations often have associated
fractures.

Clinical presentation
Horses present with acute severe non-weight- bearing
lameness with marked soft-tissue swelling and ana-
tomical deformity.

Differential diagnosis
Ulna fracture; humeral fracture.

Diagnosis
Clinical examination will suggest severe elbow
injury. Radiography is usually sufficient to provide
a diagnosis of luxation, but it can be difficult to
achieve good radiographs in the acutely distressed
horse (Fig. 1.331). Evaluation of the radiographs for
concurrent fractures is important.

Management Fig. 1.331 Craniocaudal radiograph of the proximal
Horses with fracture/luxations of the elbow usually radius of a 4-year-old colt showing a comminuted
require euthanasia. Closed repair of elbow luxation proximal radial and ulna fracture with concurrent
is possible under general anaesthesia in ponies and subluxation of the radiohumeral joint.
small horses.
1.332
Prognosis
Prognosis is poor and marked elbow OA usually
develops.

ELBOW HYGROMA

Definition/overview
Hygroma of the elbow or ‘capped elbow’ refers to
a non-painful swelling over the point of the elbow
(Fig. 1.332).

Aetiology/pathophysiology
Hygromas are fluid-filled, acquired subcutaneous
bursae caused by repetitive trauma and inflam-
mation. With chronicity, they may become more
fibrous than fluid like. Horses with a high action
may catch themselves with the shoe of the ipsilat-
eral forelimb. Hygromas can also occur in horses Fig. 1.332 Chronic subcutaneous bursa in the left
that lie down regularly, particularly where bedding fore leg over the point of the elbow. (Photo courtesy
is inadequate. Graham Munroe)