Executive Editor: Jörg Auer

Authors: Jörg Auer

Phalanges Distal phalanx, Multifragment, Screw fixation and resection

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Glossary

Aftertreatment

Because the non-articular fragments are not repaired, additional external coaptation is needed to facilitate their healing. For that purpose the horse is recovered either in a hoof cast or with a bar shoe and side clips.

The cast is changed at 2 weeks and left in place for another 4 weeks. At that time the hoof is wrapped only with non-elastic tape for 2 weeks.

 

 

Radiographic follow up

Follow-up radiographs are taken at 2 months after initiation of the treatment. Dependent on the result and the findings of a  brief lameness exam treatment is either continued or stopped.
Bar shoes with side clips are changed at 4-6 weeks intervals. At the third application the side clips can usually be removed. It is advisable to take radiographs at the 2nd changing of the shoes to assess healing.

Left a multifragment fracture, treated at the time of admission (Dec 13, 2001 / 2 views): the faint fracture lines can be appreciated.

7.5 week follow up

A 7.5 week follow up after insertion of one cortex screw in lag fashion: The fracture lines are becoming wider and somewhat fuzzy.

10.5 week follow up

The 10.5 week follow up radiograph shows progression of bone healing. A horse shoe with side clips is applied to provide additional external support to the fracture. However the fractures are not completely healed.

 

 

 

 

 

 

Complication

The hoof cast and horse shoes with side clips effectively prevent hoof expansion during weight-bearing, which leads to a contracted foot. Once the cast is removed a special shoe whose heels are taped to the outside is applied to facilitate expansion of the heels. This procedure takes some time.

The same problem occurs with the bar shoe and side clips. The management is identical to the one above.

v1.3 2013-11-20