Diagnosis, treatment and outcome of cranial nuchal bursitis in 30 horses.

BACKGROUND: No large retrospective case series describing the treatment and outcomes following diagnosis of cranial nuchal bursitis have been published. OBJECTIVE: To describe the clinical presentation, diagnostic techniques, treatment and outcome of horses suffering from cranial nuchal bursitis and to determine their outcome after medical or surgical treatment. STUDY DESIGN: Retrospective case series. METHODS: Medical records (1990-2014) of two referral centres were reviewed for signalment, diagnostic features, method of treatment (medical, surgical or both) and outcome. RESULTS: The median age of horses was 13 years (range 5-22 years) and follow-up time ranged from 12 to 108 months. Fourteen horses were treated medically and 20 horses were treated surgically. Of those horses treated medically, four horses had recurrence of clinical signs requiring subsequent surgical treatment. Overall, 41.7% of horses had recurrence of clinical signs following treatment and 66.7% of horses were able to return to their previous level of exercise. Five horses underwent more than one surgical procedure due to recurrence of clinical signs. Of those horses treated solely surgically, 28.6% of the horses had recurrence of clinical signs and 78.6% returned to their previous level of exercise. Of those horses treated solely medically, 33.3% had recurrence of clinical signs and 66.7% returned to their previous level of exercise. Of those horses treated surgically following failed medical management, 100% had recurrence of clinical signs and 25% returned to their previous level of exercise. MAIN LIMITATIONS: Retrospective design with small sample number. CONCLUSIONS: Nuchal bursitis can be successfully managed with either medical or surgical treatment. Prognosis for return to work tends to be worse in horses requiring surgical intervention following failed medical management.

Surgical treatment of distal tarsal joint luxations in three horses.

The clinical signs, radiographic findings, surgical treatment, and outcome of three horses with luxation of the distal tarsal joints are reported. Two patients showed luxations of the tarsometatarsal joint whereas luxation of the proximal intertarsal joint was found in one case. Open reduction, followed by internal fixation was performed in two horses and closed reduction with a transfixation pin cast was performed in the third. The treatment in all three cases resulted in a satisfactory clinical outcome.

In vitro comparison of cortical bone temperature generation between traditional sequential drilling and a newly designed step drill in the equine third metacarpal bone.

OBJECTIVES: To compare heat generation and time to finish between a new step drill and sequential drilling in order to create a 6.2 mm pilot hole for insertion of a positive profile transfixation pin into the equine third metacarpal bone. METHODS: Nine pairs of equine third metacarpal bones from cadavers of adult horses were used. Maximum temperature rise of the bone was measured continuously at the cis- and trans-cortices 1, 2 and 3 mm from the final pilot hole during creation of a 6.2 mm hole using a step drill and sequential drilling with 4.5, 5.5 and 6.2 mm drill bits. Five holes were drilled into the mid diaphysis of each bone in lateral to medial direction, and drilling forces of 60, 80 and 120 N were used (15 holes in each group). Time from start to finish was measured and cortical thickness was recorded for each hole. RESULTS: The maximum heat generation (mean [95% CI]) with step drilling and sequential drilling was not significantly different at 60 N and 120 N of drilling force. However, at 80 N of drilling force, the 2.13 degrees C difference between the two drilling techniques was significant. The time to finish (seconds) was significantly shorter for the holes created by step drilling (35.1 [32.06 - 37.59]) than by sequential drilling (145.8 [138.52 - 151.67]) (P < 0.001). CLINICAL RELEVANCE: Based on our results, we concluded that the step drill is a viable alternative to traditional sequential drilling of equine third metacarpal bone because it did not result in excessive heat generation that can result in bone necrosis.