title: Osseous abnormalities associated with collateral desmopathy of the distal interphalangeal joint. Part 2: treatment and outcome.
abstract: BACKGROUND
  There are currently few long-term follow-up data relating to recovery from injury of a collateral ligament (CL) of the distal interphalangeal (DIP) joint and limited information about the effect of associated osseous injury on prognosis.
  
  
  OBJECTIVE
  To describe long-term follow-up results for horses with CL injury, with and without associated osseous injury; and to determine the effect of extracorporeal shock wave therapy (ECSWT) or radial pressure wave therapy (RPWT) on outcome.
  
  
  OBJECTIVE
  Prognosis for return to performance for horses with CL-related osseous injury would be worse than for horses with CL injury alone.
  
  
  METHODS
  Magnetic resonance images from 313 feet of 289 horses with foot pain and a definitive diagnosis of collateral desmopathy of the DIP joint were analysed retrospectively for presence of osseous abnormality associated with the ligament origin or insertion and the middle and distal phalanges. Horses were assigned to groups according to the combination of their injuries. Type of treatment was recorded and follow-up information obtained. Thirty-two horses with additional sources of lameness were excluded from analysis of outcome.
  
  
  RESULTS
  Follow-up data were available for 182 horses, 55 of which had follow-up information for up to 2 years after presentation. Twenty-seven percent of horses with CL injury alone and 34% of horses with CL related osseous injury returned to their previous performance level. Prognosis for a combination of injuries to multiple soft tissue and osseous structures within the hoof capsule was substantially worse. There was no effect of ECSWT or RPWT on outcome.
  
  
  CONCLUSIONS
  The presence of mild to moderate CL related osseous injury does not appear to influence prognosis compared with CL injury alone.
  
  
  CONCLUSIONS
  Further studies of a larger number of horses are necessary in order to ascertain if specific types of osseous pathology influence return to performance levels.
authors.affiliation: Centre for Equine Studies, Animal Health Trust, Lanwades Park, Kentford, Newmarket, Suffolk CB8 7UU, UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Dakin
authors.forename: S J
authors.initials: SJ
authors.lastname: Dyson
authors.forename: R C
authors.initials: RC
authors.lastname: Murray
authors.forename: R
authors.initials: R
authors.lastname: Newton
mesh_terms: D000818:Animals; D005534:Foot Diseases / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D005552:Forelimb; D006614:Hindlimb; D006734:Horse Diseases / Q000473:pathology* / Q000628:therapy; D006736:Horses; D007592:Joint Diseases / Q000473:pathology / Q000628:therapy / Q000662:veterinary*; D007794:Lameness, Animal / Q000473:pathology / Q000628:therapy; D008022:Ligaments / Q000293:injuries