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Smith M.R.W.,Newmarket Equine Hospital | Wright I.M.,Newmarket Equine Hospital
Equine Veterinary Journal | Year: 2014

Reasons for performing study: Fractures of the proximal phalanx are generally considered to result from monotonic supraphysiological loads, but radiological observations from clinical cases suggest there may be a stress-related aetiology. Objectives: To determine whether there are radiologically identifiable prodromal changes in Thoroughbred racehorses with confirmed parasagittal fractures of the proximal phalanx. Study design: Retrospective cross-sectional study. Methods: Case records and radiographs of Thoroughbred racehorses with parasagittal fractures of the proximal phalanx were analysed. Thickness of the subchondral bone plate was measured in fractured and contralateral limbs, and additional radiological features consistent with prodromal fracture pathology documented. Results: The subchondral bone plate was significantly thicker in affected than in contralateral limbs. Evidence of additional prodromal fracture pathology was observed in 15/110 (14%) limbs with parasagittal fractures, and in 4% of contralateral limbs. Conclusions: The results of this study are not consistent with monotonic loading as a cause of fracture in at least a proportion of cases, but suggest a stress-related aetiology. Increased thickness of the subchondral bone plate may reflect (failed) adaptive changes that precede fracture. Potential relevance: Better understanding of the aetiology of fractures of the proximal phalanx may help develop strategies to reduce the risk of fracture. The Summary is available in Chinese - see Supporting information. © 2013 EVJ Ltd.


Smith M.R.W.,Newmarket Equine Hospital | Wright I.M.,Newmarket Equine Hospital
Equine Veterinary Journal | Year: 2014

Reasons for performing study: Although fractures of the proximal phalanx are one of the most common long bone fractures of Thoroughbred horses in training, limited details on variations in morphology and radiological progression have been published. Objectives: To describe in detail the configuration of parasagittal fractures of the proximal phalanx in a group of Thoroughbred racehorses, to report fracture distribution within this group of horses and to document radiological progression of fracture healing in cases treated by internal fixation. Study design: Restrospective case series. Methods: Case records and radiographs of Thoroughbred racehorses with parasagittal fractures of the proximal phalanx admitted to Newmarket Equine Hospital between 2007 and 2011 were analysed. Results: One hundred and twenty-one fractures were identified in 120 Thoroughbred racehorses. Fractures were frequently more complex than was appreciated immediately following injury; a feature that has not been reported previously. There was seasonality of fractures in 2- and 3-year-old horses, but not in older horses. Conclusions and potential relevance: Fractures of the proximal phalanx may be more complex than recognised previously, although often their complexity cannot be identified radiographically immediately following injury. The seasonality observed in 2- and 3-year-old horses is most likely to be a consequence of the timing of the turf-racing season in the UK. The Summary is available in Chinese - see Supporting information. © 2014 EVJ Ltd 46 1 January 2014 10.1111/evj.12094 DESCRIPTIVE CLINICAL REPORTS DESCRIPTIVE CLINICAL REPORTS © 2013 EVJ Ltd.


Minshall G.J.,Newmarket Equine Hospital | Wright I.M.,Newmarket Equine Hospital
Equine Veterinary Journal | Year: 2014

Reasons for performing study: Accurate radiological and ultrasonographic descriptions of frontal plane fractures of the accessory carpal bone (ACB) are lacking, and implications of these fractures for the carpal sheath and its contents have not previously been reported. Objectives: Aims were as follows: 1) to describe the location and radiological features of frontal plane fractures of the ACB; 2) to document communication of displaced fractures with the carpal sheath and consequent injury to the deep digital flexor tendon (DDFT); 3) to describe ultrasonographic identification of lesions; and 4) to report tenoscopic evaluation and treatment. Study design: Retrospective case series. Methods: Analysis of frontal plane fractures of the ACB referred to a single hospital between 2006 and 2012, including review of radiographic, ultrasonographic and tenoscopic images. Results: Nine fractures were identified, of which 8 displaced fractures all communicated with the carpal sheath. Comminuted fragments and/or protruding fracture margins lacerated the lateral margin of the enclosed DDFT. This was identifiable ultrasonographically and confirmed at tenoscopy in 7 cases. Treatment in these horses consisted of removal of torn tendon tissue together with fragmentation and protuberant fracture edges, and 7 of 7 cases returned to work. One horse with a nondisplaced fracture was managed with immobilisation; the fracture healed, and the horse returned to work. One horse with a displaced fracture was retired to stud. Conclusions: Frontal plane fractures of the ACB occur palmar to the groove in its lateral margin for the tendon of insertion of ulnaris lateralis. Comminuted fragments can displace distally within the carpal sheath to a mid-metacarpal level or abaxially to lie extrathecally, lateral to the parent bone. Displaced fractures communicate with the carpal sheath and traumatise the DDFT. © 2013 EVJ Ltd.


Wright I.M.,Newmarket Equine Hospital | Minshall G.J.,Newmarket Equine Hospital
Equine Veterinary Journal | Year: 2014

Reasons for performing study: Osteochondritis dissecans (OCD) of the distal sagittal ridge of the third metacarpal bone (McIII) has not previously been described in the literature. Objectives: To describe the clinical, radiological and arthroscopic features of OCD of the distal sagittal ridge of the McIII and to report outcome in a series of cases. Study design: Retrospective case series. Methods: Case records and images of horses with OCD of the distal sagittal ridge of the McIII admitted to a single referral centre between February 2006 and February 2013 were reviewed. Follow-up information was obtained by telephone questionnaire and/or racing performance. Results: Osteochondritis dissecans of the distal sagittal ridge of the McIII was found in 16 lame horses; 9 unilaterally and 7 bilaterally. Lesions were consistently identified with flexed lateromedial radiographs and in 21 joints in dorsopalmar projections also. These were arthroscopically accessible from the dorsal compartment with metacarpophalangeal joints maximally flexed. This permitted fragment removal and lesion debridement. Thirteen of 14 horses with follow-up of ≥12 months post surgery performed athletically including 11 of 12 Thoroughbreds that raced. Conclusions: Unlike more proximal lesions, OCD of the distal sagittal ridge appears to affect the McIII preferentially. Lesions were identified on dorsopalmar and flexed lateromedial radiographs only and are amenable to arthroscopic surgery. Clinicians should be aware of the potential for OCD to affect the distal sagittal ridge of the McIII together with the radiographic projections needed to identify its presence. A modified arthroscopic approach to the dorsal metacarpophalangeal joint is necessary in order to access lesions. © 2013 EVJ Ltd.


Jacklin B.D.,Newmarket Equine Hospital | Jacklin B.D.,Lane College | Minshall G.J.,Newmarket Equine Hospital | Wright I.M.,Newmarket Equine Hospital
Equine Veterinary Journal | Year: 2014

Reasons for performing study: Surgical management for overriding spinous processes of the thoracolumbar vertebrae (SPs) is often favoured when conservative therapies have failed, pathology is severe, or in competition horses constrained by drug withdrawal periods. Objectives: To evaluate whether subtotal (cranial wedge) ostectomy represents an effective treatment for overriding SPs, with short surgery time and low complication rates, maintains the contour of the spine and produces a functionally and cosmetically better outcome than previously reported surgical techniques for management of overriding/impinging SPs. Study design: Retrospective study. Methods: A new technique is described and records were retrieved for 25 cases that had undergone the procedure at Newmarket Equine Hospital between 2009 and 2011. Case records were evaluated for anamnesis, clinical findings and details of surgical and post operative management. Outcome of surgery was assessed by telephone questionnaire with owners, relating to both functional and cosmetic results. Results: Of cases treated using the described technique, 78.9% had resolution of clinical signs and returned to full work and a further 18.2% were improved. Outcome was unrelated to number of SPs resected or mean radiographic grade of impingement. Cosmetic outcome was described as excellent in 81.8% and good in the remainder. Surgery time ranged from 20 to 70 (median 30) min and there were no intra- or post operative complications. Conclusions: In contrast to previously described amputation techniques, subtotal (cranial wedge) ostectomy removes only impinging portions of SPs. General anaesthesia and lateral recumbency facilitate access and enable a short surgery time. The procedure maintains the contour of the back and has fewer complications, but produces functional outcomes similar to more invasive procedures. © 2013 EVJ Ltd.


Barker W.H.J.,Newmarket Equine Hospital | Wright I.M.,Newmarket Equine Hospital
Veterinary and Comparative Orthopaedics and Traumatology | Year: 2014

Introduction: Accurate description of the calcaneal insertions of the superficial digital flexor tendon (SDFT) is lacking and inconsistent. The aim of this study was to undertake morphologic and morphometic evaluations of these structures to assist in elucidating their functional and pathogenic roles in displacement of the SDFT from the calcaneal tuber.Method: Dissections were performed on 10 normal cadaveric hindlimbs. The anatomy was photographed to allow measurements at repeatable locations and differences in SDFT dimensions at the various locations were compared using a paired student t-test.Results: This study demonstrated that the calcaneal insertions of the SDFT are independent from the overlying tarsal insertions of the biceps femoris and semitendinosus, which blend into the plantar surface of the fibrocartilaginous cap (FCC) of the SDFT before inserting dorsal to the insertion of the SDFT on the calcaneal tuber. The lateral insertion of the SDFT is larger in cross-sectional area (median: 219 mm2) at its origin from the FCC than its medial counterpart (median: 159 mm2, p = 0.004) and has a more complex fibre alignment. The lateral site of attachment of the SDFT on the calcaneal tuber is dorsolateral to the insertion of the gastroc-nemius tendon and is larger (median: 525 mm2) than the medial insertion (median: 428 mm2, p = 0.036), which inserts distal to the insertion of the gastrocnemius tendon.Conclusion: The features identified in this study suggest that the calcaneal insertions of the SDFT are complex and their morphological and morphometric differences are likely to contribute to clinical lesions identified at this site. © Schattauer 2014.


PubMed | Newmarket Equine Hospital and Lane College
Type: | Journal: Equine veterinary journal | Year: 2015

Injury to the superficial digital flexor tendon (SDFT) is common in equids, with a high risk of re-injury associated with changes in tendon stiffness. In vivo measurement of limb stiffness has been shown to correlate with tendon stiffness after injury [1] but requires kinematic analysis which is impractical in a clinical setting. We have developed a simple system for measuring limb stiffness statically, which could be used as a tool for monitoring SDFT healing.To validate a goniometric measurement of limb stiffness.Cross sectional study.Initially, forelimb stiffness indices were determined at the walk for 6 equids using a validated kinematic analysis [1]. Limb stiffness indices were then calculated using portable floor scales to record ground reaction force (GRF), and an electrogoniometer to record metacarpophalangeal joint angle. Goniometric limb stiffness indices were subsequently measured in 11 horses ranging from 2 to 20 years of age, with no clinical evidence of SDFT injury. Strength and significance of correlation and agreement between the measurement methods was assessed and association between limb stiffness, limb (left vs. right), weight and age of horse and were calculated.There were strong positive correlations between GRF and joint angle (R(2)=0.98) and between the static and kinematic methods (R=0.78, P<0.01). There was a positive correlation between limb stiffness and weight (R(2)=0.85, P<0.01), but no association with age or limb.This study validated the measurement of limb stiffness in a clinical setting. The positive correlation of limb stiffness and weight supports the theory of an optimised limb spring [2] for energy-efficient cursorial locomotion which may, in turn, provide a clinically-relevant measure of running efficiency and therefore the quality of tendon healing post injury. Ethical animal research:Owner consent was obtained.None. Competing interests:None declared.


PubMed | Forenaghts Stud, Newmarket Equine Hospital and University College Dublin
Type: Journal Article | Journal: Reproduction in domestic animals = Zuchthygiene | Year: 2016

To evaluate factors contributing to fertility of thoroughbred mares, data from 3743 oestrous periods of 2385 mares were collected on a large thoroughbred farm in Ireland. Fourteen stallions (mean age 8.3 years; range 4-15 years) had bred 2385 mares (mean age 9.4 years; range 3-24 years). Maiden mares accounted for 12%, mares with a foal at foot for 64%, and barren, slipped or rested mares for 24% of the total. The mean pregnancy rate per cycle was 67.8% (68.6% in year 1 and 66.9% in year 2). Backward stepwise multivariable logistic regression analysis was utilized to develop two models to evaluate mare factors, including mare age, reproductive status, month of foaling, dystocia, month of cover, foal heat, cycle number, treatments, walk-in status and stallion factors including stallion identity, stallion age, shuttle status, time elapsed between covers and high stallion usage on the per cycle pregnancy rate and pregnancy loss. Old age (p < 0.001) and cover within 20 days post-partum (p < 0.003) were associated with lowered pregnancy rates. High mare age (p < 0.05) and barren, slipped or rested reproductive status (p = 0.05) increased the likelihood of pregnancy loss. Uterine inflammation or infection, if appropriately treated, did not affect fertility. Only high usage of stallions (used more than 21 times in previous week) was associated with lowered (p = 0.009) pregnancy rates. However, shuttle stallions were more likely to have increased (p = 0.035) pregnancy survival, perhaps reflecting a bias in stallion selection. In conclusion, mare age exerted the greatest influence on fertility; nonetheless, thoroughbreds can be effectively managed to achieve high reproductive performance in a commercial setting.


(i) A technique for minimally invasive repair of slab fractures of the third tarsal bone has not previously been reported. (ii) Results of third tarsal bone slab fracture repair in Thoroughbred racehorses are lacking.To report the outcomes of repair of uniplanar frontal slab factures of the third tarsal bone using a single 3.5 mm cortex screw in lag fashion.Retrospective case series.Case records of horses that had undergone this procedure were reviewed.Seventeen horses underwent surgery. Eighteen percent of cases had wedge shaped third tarsal bones. A point midway between the long and lateral digital extensor tendons and centrodistal and tarsometatarsal joints created a suitable entry site for implants. The fracture location, configuration and curvature of the third tarsal bone and associated joints requires a dorsolateral proximal-plantaromedial distal trajectory for the screw which was determined by preplaced needles. There were no complications and fractures healed in all cases between 4-6 months post surgery. Seventy-nine percent of horses returned to racing and at the time of reporting 3 are in postoperative rehabilitation programs.The technique reported provides a safe, appropriate and repeatable means of repairing slab fractures of the third tarsal bone. Surgical repair is a viable alternative to conservative management. This article is protected by copyright. All rights reserved.


PubMed | Newmarket Equine Hospital, Lane College, Equine Reproductive Services UK Ltd. and Rossdales Equine Practice
Type: | Journal: Placenta | Year: 2016

Early pregnancy loss occurs in 6-10% of equine pregnancies making it the main cause of reproductive wastage. Despite this, reasons for the losses are known in only 16% of cases. Lack of viable conceptus material has inhibited investigations of many potential genetic and pathological causes. We present a method for isolating and culturing placental cells from failed early equine pregnancies. Trophoblast cells from 18/30 (60%) failed equine pregnancies of gestational ages 14-65 days were successfully cultured in three different media, with the greatest growth achieved for cells cultured in AmnioChrome Plus. Genomic DNA of a suitable quality for molecular assays was also isolated from 29/30 of these cases. This method will enable future investigations determining pathologies causing EPL.

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