Objective To describe perioperative management, surgical procedure, and outcome in mares with third‐degree perineal lacerations (TDPL) treated with a single‐stage repair, the Utrecht repair method (URM). Study design Retrospective study. Animals Twenty mares with TDPL. Methods Medical records of mares with TDPL reconstructed with a URM were reviewed for perioperative management; surgical outcome; and postoperative fertility, athletic performance, and complications. Results Mares ranged in age from 3.5 to 11 years. Long‐term follow‐up was available for 13 mares. Mean duration of follow‐up was 9 years (median, 9.5; range, 2–215 months (17.9 years)). Standardized perioperative fasting and postoperative refeeding protocols were used. Only five mares received supportive gastric medication. Reconstruction of the rectovestibular shelf was successful in 18 of 20 mares. Two of 20 mares developed a small rectovestibular fistula after the initial repair, which was successfully repaired with a second surgery. Other postoperative complications were observed in 13 mares and consisted of mild postanesthetic myositis, facial nerve paralysis, esophageal obstruction, rectal obstipation, partial perineal dehiscence, and rectal or vestibular wind‐sucking. Six of seven mares that were subsequently bred became pregnant. One mare was successfully used for embryo recovery, and five of six mares foaled without recurrence of a TDPL. Nine of 13 mares were used for riding at various levels. Conclusion The alternative single‐stage reconstruction for TDPL was successful in 18 of 20 mares after a single surgery. No major complications related directly to the technique were noted. Clinical significance The URM is a valid alternative surgical technique for repairing TDPL in mares.
Summary Background Equine veterinarians frequently obtain lateromedial radiographs of the feet. During assessment, one infrequently encounters a triangular‐shaped articular indentation of the articular surface of the distal phalanx (P3). To the authors’ knowledge, there are no detailed radiographic or MRI descriptions of this specific articular indentation in the literature so far. Objectives The main purpose of this study was to give a detailed morphological description of this radiographical identified articular indentation. Study design Descriptive study. Methods All LM and DP radiographs of the feet of horses presented at our hospital between August 2016 and August 2019 were retrospectively reviewed for presence of an articular indentation. Following selection, patient information, patient history, clinical findings, MRI‐finding and surgical details were retrieved. In total, 30 horses were included of which 12 underwent magnetic resonance imaging. Radiographs and MRI results were evaluated for the precise location, shape and extent of the articular indentation and for signs of degenerative joint disease of the DIPJ. Results Four different indentation types were identified radiographically. Concomitant low field MRI proved to be a useful and excellent imaging modality for evaluation of this rare articular indentation and its surrounding subchondral bone. MRI findings were various and ranged from slight subchondral contour deviations to obvious OCLL (Osseous Cyst Like Lesions). Furthermore, MRI identified some additional indentation related OCLLs that were not noted on plain radiographs. Main limitations The limited number of horses that were included and the absence of complementary histopathology. Conclusions Articular indentations are typically identified in the third quarter of the articular margin of P3 and may have underlying OCLLs. Since OCLLs are known to be a potential cause of future unsoundness, careful radiographic assessment is advised if an indentation is encountered. If needed, Standing Low‐Field MRI can give additional and detailed information.
The purpose of this study was to provide a detailed radiographic description of the nutrient foramen (NF) of the dorsal cortex of the proximal phalanx (Pl) which may aid the veterinary practitioner in identification of the NF and subsequently prevents misinterpretation of this radiographic finding. Medical records of 190 horses (116 Standardbreds, 64 Warmbloods and 10 Friesians) presented for standard radiographic screening were retrospectively reviewed. All four lateromedial radiographs of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints were evaluated for presence, localisation and trajectory of a dorsal NF by a registered radiologist and a surgical resident. In 27.5% (209/ 760) radiographs, a full-cortex NF was identified. The Standardbred-group represented the majority with 30% (138/ 464) diagnosed NF, followed by the Warmblood-group with 26% (66/256) NF and the Friesian-group with 13% (5/40) NF. Most NF had a unilateral distribution (62%). Fifty per cent of the NF entered the dorsal cortex at 47.4-59.2% of the total dorsal length of Pl. Four different trajectory types were noted; a sigmoid-shaped course (44%), a straight course (33%), a palmar/plantar-curved course (14%) and a dorsal-curved course (9%). The consistent entrance location of the NF into the dorsal cortex and medullary cavity, together with its typical trajectory aids the veterinary practitioner in distinguishing an NF from a pathologic fissure or fracture. Comparison with radiographs of the contralateral limb is unreliable as most NF are identified unilaterally.
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