Lee, Sang-Kyu
(Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
,
Kim, Jinyoung
(KRA Veterinary Center, Korea Racing Authority)
,
Seo, Jong-pil
(College of Veterinary Medicine, Jeju National University)
,
Lee, Inhyung
(Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
,
Kang, Byung-Jae
(Department of Veterinary Clinical Sciences, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
A 6-year-old Thoroughbred mare presented to the Korea Racing Authority Equine Hospital with dropping of the left front fetlock due to an injury sustained while racing. Radiographic examination revealed a comminuted fracture of both proximal sesamoid bones of the affected fetlock. Arthrodesis of the ...
A 6-year-old Thoroughbred mare presented to the Korea Racing Authority Equine Hospital with dropping of the left front fetlock due to an injury sustained while racing. Radiographic examination revealed a comminuted fracture of both proximal sesamoid bones of the affected fetlock. Arthrodesis of the fetlock joint using a broad dynamic compression plate with a tension band wire was performed as a salvage procedure for the future use as a broodmare. After surgery, however, a delayed union of the bones and surgical site infection was present for a prolonged period. Staphylococcus aureus was persistently identified from the surgical site, and antimicrobial therapies were based on antibiotic sensitivity tests, including regional perfusions. The removal and replacement of surgical implants associated with seropurulent discharge was based on coordinating the development of fetlock ankylosis and infection control over 13 months. Firstly, seven screws associated with surgical drainage were replaced and bone morphogenetic protein-2 (BMP-2) and local antibiotics were placed into the surgical site to accelerate bone fusion at postoperative month 7. Further six screws, along with drainage, were removed at postoperative month 10. The plate and screws were removed from the limb due to the progression of bone fusion at postoperative month 13; BMP-2 and local antibiotics were also used. Delayed healing of arthrodesis due to surgical site infection and implant instability were treated by implant removals and antibiotic therapies, and the horse eventually showed improved weight-bearing ability of the affected limb.
A 6-year-old Thoroughbred mare presented to the Korea Racing Authority Equine Hospital with dropping of the left front fetlock due to an injury sustained while racing. Radiographic examination revealed a comminuted fracture of both proximal sesamoid bones of the affected fetlock. Arthrodesis of the fetlock joint using a broad dynamic compression plate with a tension band wire was performed as a salvage procedure for the future use as a broodmare. After surgery, however, a delayed union of the bones and surgical site infection was present for a prolonged period. Staphylococcus aureus was persistently identified from the surgical site, and antimicrobial therapies were based on antibiotic sensitivity tests, including regional perfusions. The removal and replacement of surgical implants associated with seropurulent discharge was based on coordinating the development of fetlock ankylosis and infection control over 13 months. Firstly, seven screws associated with surgical drainage were replaced and bone morphogenetic protein-2 (BMP-2) and local antibiotics were placed into the surgical site to accelerate bone fusion at postoperative month 7. Further six screws, along with drainage, were removed at postoperative month 10. The plate and screws were removed from the limb due to the progression of bone fusion at postoperative month 13; BMP-2 and local antibiotics were also used. Delayed healing of arthrodesis due to surgical site infection and implant instability were treated by implant removals and antibiotic therapies, and the horse eventually showed improved weight-bearing ability of the affected limb.
* AI 자동 식별 결과로 적합하지 않은 문장이 있을 수 있으니, 이용에 유의하시기 바랍니다.
문제 정의
No previous fetlock arthrodesis case has been reported in South Korea. The objective of this report was to describe the management of postoperative complications after one of the first surgical attempts of traumatic suspensory apparatus in the left front limb of a 6-year-old Thoroughbred mare, injured during a race.
제안 방법
The regional antibiotic perfusion was performed at postoperative months 9 and 11, in the standing position, with an Esmarch bandage (Avocor X-Mark latex-free esmarch bandage, Avcor health care products Inc., Texas, USA) tourniquet over the carpus, and under sedation with detomidine (0.02 mg/kg IV; Domosedan, Orion pharma, Espoo, Finland) and butorphanol (0.05 mg/kg IV; Butophan injection, Myungmoon pharm, Hwaseong, South Korea).
The limb condition, including heat, digital pulse, and swelling, was assessed daily. Antibiotics and nonsteroidal anti-inflammatory drugs were administered for 4 weeks as follows: up to postoperative week 2; flunixin meglumin (1.1 mg/kg IV; Finadyne injection, MSD, France), potassium penicillin G (22,000-44,000 IU/kg IV; Alvogen penicillin G potassium, Alvogen Korea, Seoul, South Korea), and gentamycin (6.6 mg/kg IV; Eagle gentamycin injection, Eaglevet, Seoul, South Korea), and from postoperative week 3 to 4; meloxicam (0.6 mg/kg IV; Metacam injection, Boehringer Ingelheim, Germany) and ceftiofur (3.3 mg/kg IV; New cencure, CTCBIO, Hongcheon, South Korea).
대상 데이터
A 6-year-old Thoroughbred mare was brought to Seoul Korea Racing Authority Equine Hospital with severe gait pain in the left front limb occurring immediately after a sudden breakdown during a race. The horse presented with a left front lameness score of 5/5 on the American Association of Equine Practitioners scale (https://aaep.
이론/모형
A 6-year-old Thoroughbred mare was brought to Seoul Korea Racing Authority Equine Hospital with severe gait pain in the left front limb occurring immediately after a sudden breakdown during a race. The horse presented with a left front lameness score of 5/5 on the American Association of Equine Practitioners scale (https://aaep.org/horsehealth/lameness-exams-evaluating-lame-horse). The affected fetlock was swollen, the horse bearing its entire weight on the paired limb.
참고문헌 (19)
Ahern BJ, Richardson DW, Boston RC, Schaer TP. Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006). Vet Surg 2010; 39: 588-593.
Bertone AL. The fetlock. In: Adams and Stashak's Lameness in Horses, 6th ed. Chichester: Wiley. 2011: 611-613.
Bettschart R, Johnston M. Confidential enquiry into perioperative equine fatalities: CEPEF 4 - a chance to gain new evidence about the risks of equine general anaesthesia. Equine Vet J 2012; 44: 7.
Bhattacharya M, Wozniak DJ, Stoodley P, Hall-Stoodley L. Prevention and treatment of Staphylococcus aureus biofilms. Expert Rev Anti Infect Ther 2015; 13: 1499-1516.
Bramlage LR. First aid and transportation of fracture patients. In: Equine Fracture Repair, 1st ed. Philadelphia: Saunders. 1996: 36-39.
Bramlage LR. In: Proceedings of the 55th Annual Convention of the American Association of Equine Practitioners. Lexington: American Association of Equine Practitioners (AAEP). 2009: 144-149.
Curtiss AL, Stefanovski D, Richardson DW. Surgical site infection associated with equine orthopedic internal fixation: 155 cases (2008-2016). Vet Surg 2019; 48: 685-693.
Perrier M, Lu Y, Nemke B, Kobayashi H, Peterson A, Markel M. Acceleration of second and fourth metatarsal fracture healing with recombinant human bone morphogenetic protein-2/calcium phosphate cement in horses. Vet Surg 2008; 37: 648-655.
Taylor EL, Galuppo LD, Steffey EP, Scarlett CC, Madigan JE. Use of the Anderson Sling suspension system for recovery of horses from general anesthesia. Vet Surg 2005; 34: 559-564.
AI-Helper
※ AI-Helper는 부적절한 답변을 할 수 있습니다.