Arthroscopic removal of large extensor process fragments in 18 Friesian horses: long-term clinical outcome and radiological follow-up of the distal interphalangeal joint

Objective: Report long-term clinical and radiological follow-up in horses after removal of large extensor process fragments occupying >25% of the joint surface of the distal interphalangeal joint (DIJ). Study Design: Retrospective case series. Animals: Friesian horses (n=18) that underwent arthroscopic removal of a large extensor process fragment. Methods: Arthroscopic examination of the DIJ was performed in dorsal recumbency with the affected foot in extension using routine portals. Visualization of the fragment was improved using motorized synovial resectors. A dissection plane between the common digital extensor tendon and the extensor process fragment was created using sharp lever instruments, in some cases aided by motorized burrs and radiofrequency ligament dissection. The fragment was removed piecemeal using Ferris-Smith rongeurs. Medical records, preoperative and postoperative radiographs, and owner surveys were reviewed for case details and outcome. Results: The technique described allowed removal of the large fragment in all 18 horses. Of the 17 horses where long-term clinical follow-up was available, 14 were used as intended and 3 kept some degree of lameness. The angle between the remodeled extensor process and the dorsal surface of the distal phalanx was increased and subchondral bone remodeling at the fragment bed was noted on postoperative lateromedial radiographs. Conclusion: Arthroscopic removal is a good treatment option for horses with large extensor process fragmentation with a good long-term outcome. Remodeling of the remaining extensor process and the subchondral new bone formation in the fragment bed can occur with functional recovery

Single-stage reconstruction of third-degree perineal lacerations in horses under general anesthesia : Utrecht repair method

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