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).


METHODS
Retrospective case series.


METHODS
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.


CONCLUSIONS
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.
Equine Department of Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
Ellen
E
Compagnie
Equine Department of Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
Frerik
F
Ter Braake
Equine Department of Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
Natascha
N
de Heer
Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.|Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
Willem
W
Back
D000818:Animals; D001182:Arthroscopy / Q000662:veterinary; D005260:Female; D006734:Horse Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D006736:Horses / Q000293:injuries*; D007592:Joint Diseases / Q000601:surgery / Q000662:veterinary*; D007794:Lameness, Animal / Q000601:surgery; D008297:Male; D010375:Pedigree; D015641:Radiography, Interventional / Q000662:veterinary; D012189:Retrospective Studies; D014033:Toe Joint / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome