Splint Bone & Proximal Sesamoid Bone Fractures Flashcards
What bones are referred to as the splint bones?
MC/MT II and IV
T/F: MT IV has minimal articulation and weight transfer with the 4th tarsal bone
TRUE
What are causes of splint bone fractures?
Hyperextension of fetlock (closed) External trauma (open)
T/F: Many splint bone fractures are treated successfully with rest alone
TRUE
What may lead to persistent lameness post splint bone fracture?
Suspensory desmitis
What is the most common splint bone fracture?
Fractured splint bone(distal 1/3)
What is the surgical treatment for a splint bone fracture?
Segmental ostectomy
What is the rule of fractions when removing a portion of the splint bone during a segmental ostectomy?
Don’t remove more than distal 2/3 of splint bone(except MT IV)
If more than this is removed than you will need internal fixation
If you are providing internal fixation when correcting a splint bone fracture, which bone shouldn’t be involved?
MC III
This will lead to persistent lameness due to micromovement between the bones
If you have to incoorporate MCIII, how many months post-op do you have to go back to surgery to remove the plate?
3-4 months post-op
What is the common age and location of splint exostosis/proliferative periostitis?
Young horses MCII (medial aspect)
What is the most common causeof splint exostosis?
Direct trauma
What are CS of splint exostosis?
Firm swelling at the site (warm and painful)
What is the conservative treatment for splint exostosis?
NSAIDs, local DMSO or corticosteroids
What is deep to the splint bone?
Neurovascular bundle
Where are three places to get the pulse on a horse?
Facial artery
Transverse facial artery
Dorsal metatarsal artery (runs between lateral splint bone MT IV and MTIII)
What type of fracture can be prevented by the gait & speed training?
Dorsal cortical fracture of MCIII
What is the surgical treatment for a dorsal cortical fracture of MCIII?
Osteostixis
Creates holes around site and brings mesenchymal cells to surface
What direction should you drill when performing osteostixis?
Drill towards the medullary canal (this is where your growth factors come from)
What are the six types of proximal sesamoid bone fractures?
Apical (most common) Mid-body Basal Abaxial Sagittal Comminuted
What is a common cause of proximal sesamoid fractures>
Excessive tension from suspensory ligament (commonly seen in racing breeds)
What does treatment of proximal sesamoid fractures depend on?
Size of the fragment
What does a mid-body sesamoid fracture require to treat?
Internal fixation (lag screw or circumferential cerclage wire)
T/F: Screw fixation with arthroscopic guidance is superior to wire fixation
TRUE
