E2: Digit amputation, Bone spavins, Splints, Proximal sesamoids

Question 1

What is the dose for penicillin?

Answer 1

20,000-22,000 IU/kg BID

Question 2

What are the treatment options for chronic septic arthritis of the DIJ in cattle?

Answer 2

Facilitated ankylosis

Amputation

Culling

Question 3

For how long can a tourniquet be left on?

Answer 3

Up to 2 hours

Question 4

What can you do to prevent neuropraxia when a tourniquet needs to be placed?

Answer 4

Use padding under the touniquet

Question 5

Do you use an open or closed amputation technique if spesis is present?

Answer 5

Open

Question 6

Chronic repetitive compression, torsion and shear strains cause the formation of ______.

Answer 6

Bone spavins

Question 7

What is this needle (in the green circle) for?

Answer 7

Identification / orientation

Question 8

T/F: The bandage after an ampuation should be placed immediately after the touniquet is removed.

Answer 8

False, bandage before removing tourniquet

Question 9

What is the average survival time post digit amputation in cattle?

Answer 9

2 years

Some never recover

Question 10

Why do some cattle never recover from amputation?

Answer 10

Rapid breakdown of supporting structures

Question 11

On the thoracic limb, digit amputation is more successful if it is the _____ digit.

Answer 11

Lateral

Question 12

On the pelvic limb, digit amputation is more successful if it is the _____ digit.

Answer 12

Medial

Question 13

What is the upper limit (kg) for successful amputation?

Answer 13

341 kg

Question 14

What is good antibiotic choice for IA use in a cow with acute septic arthritis of the DIJ?

Answer 14

Florfenicol (FFC)

Question 15

What is used to create arthrotomies during a facilitated ankylosis procedure in the DIJ of cattle?

Answer 15

Trephine

Question 16

What do you submit for culture before removing infected cartilage and bone during an ankylosis?

Answer 16

Subchondral bone

Question 17

Bone spavins are DJD of the ______ and the _____ joints on the ____ aspect of the joint.

Answer 17

Distal intertarsal (DIT)

Tarsometatarsal (TMT)

Medial

Question 18

What is this abnormal conformation called? What is the more severe version of this called?

Answer 18

Sickle hocked

“Camped under”

Question 19

What is this abnormal conformation called? Horses that perform what types of activities are prone to this?

Answer 19

Cow hocked

Western performace horses: Cutting, Reining, Roping, Barrel racing

Question 20

What view is this?

Answer 20

DLPMO

Question 21

What view is this?

Answer 21

DMPLO

Question 22

On which view can you see both ridges of the talus?

Answer 22

DLPMO

Question 23

Which aspects are viewed in a DLPMO

Answer 23

Dorso-medial

Lateral-plantar/palmar

Question 24

For how long do you hold a proximal limb flexion/spavin test?

Answer 24

90 seconds

Question 25

T/F: Medical management for bone spavins has a highly variable success rate.

Answer 25

True ## Footnote *35-70% with IA tx*

Question 26

What is the goal of surgical management of bone spavins?

Answer 26

Ankylosis

Question 27

What surgery can be done to decrease rotational and shearing forces?

Answer 27

Cunean tenectomy

Question 28

T/F: 70% ethanol and MIA (monoiodoacetate) and 2 commonly used agents for chemical ankylosis.

Answer 28

False, MIA is no longer used due to the high morbidity it causes

Question 29

Why are 3 drill tracts at 30deg diverging angles created when ankylosing the TMT or DIJ joints? (i.e. what is the goal)

Answer 29

Spot welding the joint

Question 30

What is the average time to return to soundness after surgical ankylosis?

Answer 30

7.5 months ## Footnote *3.5 - 12 mo*

Question 31

How does laser facilitated ankylosis work?

Answer 31

Destroys cartilage by superheating and vaporizing synovial fluid

Question 32

Which method of facilitated ankylosis results in a return to work the following day in many horses?

Answer 32

Ethyl alcohol

Question 33

A 3 year old TB racehorse presents with an acute grade 5/5 lameness. What is the first step in diagnosis of the problem? a. Nerve block b. Flexion test c. Survey rads

Answer 33

c. Survey rads ## Footnote *Severe lameness is an indication to not do a nerve block*

Question 34

Fractures of P1 occur most commonly in the ________ plane.

Answer 34

Sagittal

Question 35

Where do you place the first screw (in lag fashion) when repairing a sagittal P1 fracture? At what intervals are additonal screws placed?

Answer 35

Proximally within 5mm of the sagittal groove (to align the articular surface) 20-22mm

Question 36

Are fractures of the proximal phalanx more common in the fore or hindlimb?

Answer 36

Forelimb ## Footnote *75%*

Question 37

Which bones are the splint bones?

Answer 37

MC/MT II MC/MT IV

Question 38

In this DP view of the carpus, what is the top arrow pointing to? Bottom arrow?

Answer 38

Top: Carpal bone IV Bottom: Metacarpal bone IV (Lateral splint bone)

Question 39

There is less of an articular relationship between the head of the lateral splint bone and the fourth\_\_\_\_\_ bone in the \_\_\_limb.

Answer 39

Tarsal Hind

Question 40

How much of the distal forelimb splint bone can be surgically removed?

Answer 40

2/3

Question 41

Care must be taken not to engage _______ when plating a splint bone fracture of the forelimb.

Answer 41

Metacarpal bone III | (MC III/ Cannon bone)

Question 42

What surgery is appropriate for this patient who has an old malunion fracture of the lateral splint bone resulting in chronic lameness?

Answer 42

Segmental ostectomy

Question 43

A young horse with a history of splint exostosis whose bone lesion has healed has a painful bump (as seen in the picture) and is lame. What structure is involved?

Answer 43

Suspensory ligament *Desmitis*

Question 44

Which artery/arteries must you look out for when performing surgery on the lateral splint bone of the hindlimb?

Answer 44

Dorsal metatarsal (between splint and cannon) and Digital plantar (plantar to splint) ## Footnote *Also nerves and digital plantar vein*

Question 45

What is the most common fracture of the proximal sesamoid bones?

Answer 45

Apical fracture

Question 46

What are the 3 places to get a pulse on a horse?

Answer 46

Facial artery Transverse facial artery Dorsal metatarsal artery

Question 47

What type of fracture is this? What is the layman's term? In which horses are these common?

Answer 47

Stress fracture of **dorsal cortex** of **MCIII** Bucked shins Young racehorses

Question 48

T/F: Long distance galloping rather than regular short distance breezing is indicated for the prevention of bucked shins.

Answer 48

False, opposite

Question 49

How is the prognosis for bucked shins and saucer fractures for return to racing?

Answer 49

Good

Question 50

What fracture is shown here?

Answer 50

Apical sesamoid fracture

Question 51

How much of the sesamoid bone can be moved arthroscopically?

Answer 51

Up to 1/3

Question 52

You wish to evaluate the suspensory ligament in a horse with an apical sesamoid fracture. How will you do this?

Answer 52

Ultrasound

Question 53

What type of fixation is required for a midbody sesamoid fracture? What is the preferred surgery?

Answer 53

Internal fixation Lag screw with arthroscopic guidance

Question 54

T/F: Abaxial sesamoid fractures are usually displaced.

Answer 54

False, uusally not displaced

Question 55

What view must you take when you have an abaxial sesamoid fracture to see if the fracture is articular?

Answer 55

60degree skyline view

Question 56

What type of fracture is shown here? How is the prognosis for RTR?

Answer 56

Basilar fracture of the proximal sesamoid bone Poor