Wounds of the pastern and foot region managed with phalangeal casts: 50 cases in 49 horses (1995–2006)

Ketzner, K. M.; Stewart, Alban; Byron, Christopher R.; Stewart, MC; Gaughan, E.M.; Vanharreveld, PD; Lillich, J. D.

doi:10.1111/j.1751-0813.2009.00471.x

Cited by 11 publications

(6 citation statements)

References 13 publications

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“…In the small case series from Booth and Knottenbelt (1999), 50 % of the lacerations were sutured, although the reason for this is not stated in the paper. In a similar publication from Ketzner et al (2009), 63.6% of wounds were sutured and the authors found no significant difference in outcome between cases involving or not involving a synovial structure. In a more recent publication on wounds of the lower limb Eggleston (2018), recommends that a wound communicating with a synovial structure be managed with replaceable bandages until it can be confirmed that synovial communication is sealed and the infection resolved.…”

Section: Appraisal Application and Reflectionmentioning

confidence: 90%

“…Of the 61 horses available at follow-up in the Janicek et al (2005) study, 18% developed a hoof wall defect, but the number of horses treated with a foot cast compared to bandaging alone or a combination of the two is not stated. In the study from Ketzner et al (2009), 10.5% of all wounds healed with excessive scarring at the coronary band and hoof. As previously mentioned, all horses in that cases series were treated with casting and the number of wounds involving the coronary band/hoof remains unclear.…”

Section: Appraisal Application and Reflectionmentioning

confidence: 93%

“…We have failed to find evidence to support this assertion in the available literature and believe this should be considered as expert opinion as well. In the case series from Ketzner et al (2009), 68.4% of wounds treated with casting healed with minimal scarring compared to 21.1% which healed without scarring. While this study includes wounds located to the pastern and hoof area, the number involving heel bulbs is not specified and all horses were treated with a casting, none with bandaging.…”

Section: Appraisal Application and Reflectionmentioning

confidence: 95%

See 2 more Smart Citations

Healing of equine heel bulb lacerations: Evidence behind casting compared to bandaging alone

Dubuc

Ruiz

2020

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PICO question In horses with heel bulb lacerations, does casting the distal limb compared to bandaging result in increased speed of healing and functional outcome? Clinical bottom line Category of research question Treatment The number and type of study designs reviewed A single retrospective study was found to be relevant to the topic along with one case report and two case series, including one tutorial article Strength of evidence The majority of the current recommendations come from expert opinions, making the level of evidence low Outcomes reported There are currently insufficient data to compare the effect of foot/slipper casts versus bandaging alone on the rate of healing of equine heel bulb lacerations Conclusion Based on the information from these three publications, it is not possible to recommend the use of a foot cast over a bandage alone at this time How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

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Section: Appraisal Application and Reflectionmentioning

confidence: 90%

Section: Appraisal Application and Reflectionmentioning

confidence: 93%

Section: Appraisal Application and Reflectionmentioning

confidence: 95%

See 1 more Smart Citation

Healing of equine heel bulb lacerations: Evidence behind casting compared to bandaging alone

Dubuc

Ruiz

2020

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“…In this study of 50 wounds in 49 horses, treatment consisted of wound debridement, lavage, wound closure (in 28 wounds), cast application and antibiotics (in 84% of cases). 6 The authors report that applying the cast was easy with the horses either standing or under general anaesthetic and there were minimal complications. At follow-up, the majority of horses were sound, three horses were still lame, one was euthanased because of persistent lameness and another three horses were lost to follow-up.…”

Section: Phalangeal Casts Well-tolerated and Effective For Equine Foomentioning

confidence: 99%

In this issue – September 2009

Jackson

2009

Aust Veterinary J

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“…Alignment and apposition of the coronary band is most important to the outcome (Stashak 1989). In a retrospective study, wounds involving the pastern and foot that were treated with a phalangeal cast carried a good prognosis for soundness and cosmetic healing (Ketzner et al 2009). When the DIP joint is involved, arthrodesis may sometimes be performed to stabilize the joint as a salvage procedure if infection is not present (Reeves et al 1989).…”

Section: Discussionmentioning

confidence: 99%

Treatment of a severe distal forelimb wound presenting with extensive laceration and distal interphalangeal joint luxation in a donkey

Brogniez¹,

Launois²,

Perrin³

et al. 2012

PHK

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SummaryThis report describes the clinical presentation, management and outcome in a donkey with severe distal limb laceration and distal interphalangeal (DIP) luxation. Soft tissue damage was extensive leaving flexor tendons and palmar conjunctive tissue and skin as the only support structures to connect the distal phalanx and hoof to the rest of the distal limb. Arteriography was performed under general anesthesia to assess vascular supply to the foot. The palmar digital artery and its major branches to the foot were identified on the digital angiograms. The arcus terminalis, ramus palmaris arcus terminalis and ramus marginalis solearis which vascularise the sole were visible. Surgical exploration of the wound confirmed the complete transection of the DIP joint capsule, the DIP collateral ligaments and the distal sesamoidean ligament. The perioplic corium and coronary corium were separated from the laminar corium and remained attached to the skin of the pastern. Synovial lavage and regional antibiotherapy were performed. After surgical debridment, the perioplic corium and coronary corium were repositioned in their groove. The skin was sutured to the horn with stainless steel wire, polydioxanone sutures and stainless steel staples. A half limb cast was applied for protection during recovery from anaesthesia and was bivalved after 48 hours to be used as a protective and support device. Complications included an episode of laminitis of the controlateral limb and hyperlipaemia. Twelve months following surgery, the donkey was living normally in pasture, though being lame at walk. This case highlights several simple techniques that can be used in severe pastern wounds.Keywords: donkey / distal interphalangeal joint / luxation / laceration / arteriography / computed tomography / traumatology Behandlung einer schweren Verletzung der distalen Vorderzehe mit Hufgelenksluxation bei einem EselDie Huf-und Fesselregion ist aufgrund ihrer distalen Lage an der Extremität besonders anfällig für Verletzungen. Traumatisch bedingte, partielle Hufwandabrisse können vorkommen, allerdings wurde ein vollständiger Abriss der Hufwand selten beschrieben. Von Hufgelenkssubluxationen nach schweren Verletzungen des gemeinsamen Zehenstreckers und der dorsalen Kapselanlagen des Hufgelenks wurde berichtet. Aufgrund des Auftretens degenerativer Gelenkerkrankungen ist die Prognose restitutio ad integrum vorsichtig zu stellen. Zudem haben traumatische Wunden unter Beteiligung synovialer Strukturen der Gliedmaßen eine sehr schlechte Prognose. Schwere oder chronische Infektionen die diese Verletzungen begleiten sind aufgrund von Gefäßverschlüssen, Ischämien und Gewebsnekrosen schwer zu behandeln. Um das Hufgelenk zu stabilisieren kann bei Abwesenheit von Infektionen eine distale Arthrodese durchgeführt werden. Dieser Bericht beschreibt den klinischen Fall eines Esels mit einer, durch eine Schnittwunde hervorgerufenen, schweren distalen Gliedmaßenverletzung, samt Luxation des Hufgelenks, Beschädigung des Hufs und Abriss der Hufwand, sowie deren Ther...

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Wounds of the pastern and foot region managed with phalangeal casts: 50 cases in 49 horses (1995–2006)

Abstract: In this study, wounds involving the pastern and foot that were treated with a phalangeal cast carried a good prognosis for soundness (89.4%) and cosmetic healing (89.5%). The phalangeal casts were well-tolerated and effective.

Cited by 11 publications

References 13 publications

Healing of equine heel bulb lacerations: Evidence behind casting compared to bandaging alone

Healing of equine heel bulb lacerations: Evidence behind casting compared to bandaging alone

In this issue – September 2009

Treatment of a severe distal forelimb wound presenting with extensive laceration and distal interphalangeal joint luxation in a donkey

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