International survey of equine orthopaedic specialists reveals diverse treatment strategies for horses with overriding spinous processes

Background Overriding spinous processes, also known as ‘kissing spines’, are one of the most common causes of back pain in horses. The aim of this study was to investigate which options for diagnosis and treatment are preferred by equine orthopaedic specialists and assess which techniques are used for local injection. Methods An online survey was distributed among members of the European/American College of Veterinary Surgeons, the European/American College of Veterinary Sports Medicine and Rehabilitation, the International Society of Equine Locomotor Pathology and nationally recognised advanced equine orthopaedic practitioners. Results The survey was completed by 353 respondents. The injection techniques most commonly used involve placing two needles abaxial to the interspinous space (42%) under ultrasonographic guidance (32%) or one needle in the midline (35%) between two spinous processes. The most popular combination for overriding dorsal spinous process therapy was local injection (26.7%) combined with controlled exercise (25.5%). Manual therapy was considered by 42% of European and 25% of American specialists (p = 0.01). Surgical intervention as a first-line treatment was recommended mainly by specialists working in the United States, the UK or Ireland (p = 0.001). Overall, most equine orthopaedic veterinarians (71%; n = 201) preferred conservative management and recommended surgery only for horses that did not respond to conservative therapy. Limitations Respondents’ personal bias may have skewed the findings. Conclusions Despite a growing body of evidence, the therapeutic approach to ‘kissing spines’ in horses is influenced by professional specialisation and regional preferences. Variations in injection techniques and differing criteria for surgical intervention warrant further investigation

Structure and Innervation of the Equine Supraspinous and Interspinous Ligaments

Pain related to the osseous thoracolumbar spine is common in the equine athlete, with minimal information available regarding soft tissue pathology. The aims of this study were to describe the anatomy of the equine SSL and ISL (supraspinous and interspinous ligaments) in detail and to assess the innervation of the ligaments and their myofascial attachments including the thoracolumbar fascia. Ten equine thoracolumbar spines (T15‐L1) were dissected to define structure and anatomy of the SSL , ISL and adjacent myofascial attachments. Morphological evaluation included histology, electron microscopy and immunohistochemistry (S100 and Substance P) of the SSL , ISL , adjacent fascial attachments, connective tissue and musculature. The anatomical study demonstrated that the SSL and ISL tissues merge with the adjacent myofascia. The ISL has a crossing fibre arrangement consisting of four ligamentous layers with adipose tissue axially. A high proportion of single nerve fibres were detected in the SSL (mean = 2.08 fibres/mm2) and ISL (mean = 0.75 fibres/mm2), with the larger nerves located between the ligamentous and muscular tissue. The oblique crossing arrangement of the fibres of the ISL likely functions to resist distractive and rotational forces, therefore stabilizing the equine thoracolumbar spine. The dense sensory innervation within the SSL and ISL could explain the severe pain experienced by some horses with impinging dorsal spinous processes. Documentation of the nervous supply of the soft tissues associated with the dorsal spinous processes is a key step towards improving our understanding of equine back pain

Alternative approach for fracture fixation following implant infection in a Salter-Harris type-II fracture of the proximal phalanx in a Warmblood foal

A 2-day-old female Warmblood foal (70 kg) presented with a closed, displaced Salter-Harris type-II fracture of the proximal physis of the left hind first phalanx. The fracture was repaired with four 4.5 mm cortical screws and a wire in a figure-of-8 pattern applied on the lateral and medial aspect of the phalanx, respectively. A 4.5 mm cortical screw was additionally inserted in lag-fashion to engage the lateral metaphyseal spike. Three days postoperatively, medial and proximal displacement of the distal fracture fragment and implant infection were apparent and revision surgery was performed. Previous implants were removed and two 4.5 mm transphyseal cortical lag-screws were placed in proximolateral–distomedial and dorsoproximal–plantarodistal direction across the physis and the fracture line. Postoperatively, the fracture healed rapidly and the implants were removed 6 weeks later. Nineteen months after implant removal, the horse did not show any sign of lameness, despite a shortening of the proximal phalanx compared to the contralateral limb. In cases of postoperative implant instability and infection, implant removal often becomes necessary. However, new implants cannot be placed safely in the previous location. To avoid this problem, this report describes an alternative approach for screw positioning in case of previous implant infection in a Salter-Harris type-II fracture of the proximal physis of the first phalanx

Arthroscopic removal of osteochondral fragments of the cervical articular process joints in three horses

Objective To report arthroscopic osteochondral fragment removal from the equine cervical spine articular process joints (APJs) including long-term follow-up. Study Design Case series. Animals Three Warmblood horses with forelimb lameness and/or reduced range of motion of the cervical spine with osteochondral fragments between the cervical vertebrae C5/C6 or C6/C7. Method Arthroscopy of the APJs of C5/C6 and C6/C7 was performed under general anesthesia. Following endoscopic evaluation of the joints, osteochondral fragments were removed using a rongeur. Results All horses recovered from anesthesia with no anesthetic or minor postanesthetic complications. One horse needed a second procedure for fragment removal. Fourteen to 31 months post-surgery the horses were sound for their intended use and neurological examination revealed no abnormalities. Conclusion Arthroscopic removal of osteochondral fragments can be performed safely in the equine cervical APJs of C5/C6 and C6/C7 resulting in a favorable long-term outcome. Clinical Significance Arthroscopic removal is a valid option for horses showing clinical signs that can be attributed to osteochondral fragments in the APJs of the neck

Wo ist der Fuß des Fjordes? : kommunikationsstörende Fehler in deutschen Übersetzungen norwegischer Touristenbroschüren

Die Arbeit zeigt, in wie fern sich deutsche Übersetzungsfehler in norwegischen Touristenbroschüren kommunikationsstörend auswirken können. Zudem wird aufgezeigt, welche Fehlertypen sich besonders häufig als kommunikationsstörend erweisen. Der Arbeit liegt ein Korpus von 126 Broschüren aus ganz Norwegen zugrunde, die in Bezug auf verschiedene Fehlertypen untersucht wurden. Die Untersuchung ergab, dass Touristenbroschüren eine beträchtliche Anzahl von kommunikationsstörenden Fehlern enthalten. Mehr als die Hälfte der Broschüren weisen mehr als zwei solcher Fehler pro A4 Seite auf. Die Fehler liegen vor allem im Bereich der Lexik und der Kultureme. Ein Zusammenhang zwischen der Anzahl der Fehler und dem Thema oder Sprachenumfang der einzelnen Broschüren konnte nicht nachgewiesen werden. Die Untersuchung zeigt zudem, dass es in Touristenbroschüren nicht nur bestimmte Fehlertypen gibt, die häufig zu finden sind, sondern dass es auch ganz konkrete Wörter bzw. Phrasen gibt, die beim Übersetzen offenbar problematisch sind und oft zu Fehlern führen

Application of locking compression plates as type 1 external fixators to treat unilateral mandibular fractures in four equids and one dromedary

Objectives To describe a novel fixation of open, unstable, unilateral mandibular fractures applying a locking compression plate as an external skeletal fixator (ESF-LCP). Animals Four horses and one dromedary. Study design Short case series. Methods Animals presented with unstable, open, unilateral fractures of the mandible. Fracture fixation was performed under general anesthesia. A 4.5/5.5 narrow LCP was applied externally above the level of the skin and combined with intraoral tension band wiring. Results Fracture fixation was achieved successfully using an ESF-LCP. Minimal tissue manipulation was required during application and removal of the construct. The ESF-LCPs provided adequate access to the wounds at the fracture site, were well tolerated, and did not interfere with any objects in the animals’ environment. Mild drainage at the screw-skin interface developed in all cases, requiring early implant removal due to surgical site infection in one case. The use of longer plates was associated with superficial pressure necrosis of the skin in the masseter area in two cases. Implants were removed after 3 to 12 weeks, and the long-term functional outcome after 11 to 41 (median 13) months was good in all cases. Conclusion Stabilization of mandibular fractures with ESF-LCP led to good outcomes in this case series. The use of longer plates positioned more caudally and in a ventrolateral position seemed associated with surgical site infection and pressure necrosis of the skin. Clinical significance Use of a locking compression plate as an external skeletal fixator seems to offer a viable alternative to treat unilateral mandibular fractures, especially when these are open and/or infected

Computed tomographic imaging and surgical management of distal insertional avulsion fragments of the caudal cruciate ligament in four horses

Objective To describe cases with caudal cruciate ligament (CdCL) avulsion fragments diagnosed based on computed tomography (CT) examination and report on arthroscopic fragment removal. Animals Four Warmblood horses with hindlimb lameness and osseous fragments located in the caudal medial femorotibial joint (mFTJ). Study design Short case series. Methods CT and arthroscopic evaluation of the caudal mFTJ were performed. The caudal mFTJ and the insertion of the CdCL on the tibia were assessed and removal of the avulsion fragments was attempted in three horses using a cranial intercondylar approach. Results The fragment was not accessible via caudomedial approaches in one horse. A cranial intercondylar approach was used in three horses, allowing removal of the intra-articular fragment in two horses, and removal of two-thirds of the proximal fragment in the last horse. Acute, profuse, arterial bleeding occurred in this horse during surgery with transient postoperative soft tissue swelling. Comorbidities included medial femoral condyle cartilage defects (3), cranial cruciate ligament lesions (2), and medial collateral ligament lesions (2). Horses were followed up for 16 months (median, range 11–28 months), at which point all were back in ridden exercise; owners' satisfaction was good. Conclusion CT examination confirmed the diagnosis and allowed evaluation of the stifle joint for comorbidities. A cranial intercondylar arthroscopic approach facilitated the removal of CdCL insertional avulsion fragments, although not always complete. Clinical significance A cranial intercondylar approach can allow access to CdCL avulsion fragments, but complications and incomplete removal remain possible

Basic layouts for modular assembly systems – a simulation-based comparison

The article discusses the challenges posed by increased individualization of products, shorter product life cycles, and external factors on the flexibility of modern production systems. In particular, flexible workshop-oriented manufacturing principles are being implemented to replace or supplement traditional assembly lines, with various terms such as "modular assembly" and "matrix production" etc. used to describe similar concepts. The article presents these concepts under the umbrella term of modular production or assembly systems, which utilize adaptable workstations and autonomous vehicles to transport production orders between stations. The design of such systems is crucial to their performance, with considerations such as task allocation, material supply, and fleet sizing requiring complex interplay. The article compares traditional matrix layouts with alternative options, such as single-lane pathways and non-matrix layouts like honeycomb or star shapes, using simulationbased analysis to evaluate their potential impact on system performance