Removal of large fragments of the extensor process of the distal phalanx via arthrotomy in horses: 14 cases (1992-1998)

Objective-To evaluate the outcome of horses with large fragments of the ext ensor process of the distal phalanx that were removed by use of arthrotomy. Design-Retrospective study. Animals-14 horses with large fragments of the extensor process of the dista l phalanx. Procedure-Medical records for horses with large fragments of the extensor p rocess that were removed by use of arthrotomy were reviewed. Data retrieved from medical records included signalment, use of horse, affected limb, lam eness history, lameness examination findings, radiographic findings, surgic al technique, and outcome. Follow-up evaluation was obtained by telephone i nterview. Results-Most affected horses were < 5 years old and had a history of chroni c lameness. Lameness grade ranged from 1/5 to 4/5. Fragments involved 20 to 45% of the dorsopalmar articular surface of the distal phalanx. Eight of 1 4 horses had a successful out come. Outcome was not associated with age, du ration or severity of lameness, or fragment size. Conclusions and Clinical Relevance-Despite involvement of a large portion o f the articular surface and use of arthrotomy, joint instability and perman ent soft tissue injury was not a problem in most horses. Outcome may be imp roved by selection of horses with lameness of < 2 years' duration and caref ul management after surgery. A fair prognosis may be anticipated for remova l of large fragments of the extensor process via arthrotomy.