Céline Mespoulhès-Rivière

Factors affecting outcome of extensor tendon lacerations in the distal limb of horses - A retrospective study of 156 cases (1994–2003)

Distal limb lacerations are common injuries in horses, with a better prognosis reported for extensor tendons lacerations compared to flexor tendons lacerations. The objective of the present study was to determine the influence of type and location of injury, modalities of treatment and post surgical complications on the outcome of extensor tendon lacerations. The medical records of 156 horses surgically treated for extensor tendon lacerations over a 10-year period were analysed retrospectively. Information was obtained for 124 horses with a minimum of 18 months follow-up. Statistical analysis was performed on 129 horses (five horses were euthanatized during hospitalization) in order to determine factors affecting outcome. Seventy-four percent of the horses returned to soundness, 17% had moderate gait impairment and 9% remained lame. Approximately 60% of the sports horses returned to an equal or higher level of performance, and 17.5% returned to a lower level. In the multivariate statistical analysis, the only significant factor that favourably influenced outcome was complete suture of the wound. A significant association could not be detected between outcome and absence of a functional extensor tendon, The most important post-surgical complication was extensive scarring of the wound. The present results report outcome of extensor tendon lacerations in a large number of horses and outline the importance of primary wound healing in order to avoid major scarring with potential functional consequences.

Mechanical comparison of 3 anchoring techniques in the muscular process for laryngoplasty in the equine larynx.

Objective To compare mechanical properties of 2 techniques with a conventional technique for anchoring the muscular process in a laryngoplasty procedure. Study design Experimental ex vivo study. Sample Population Equine larynges (n = 60). Methods A single loop (SL), a screw (SC), and a double loop technique (DL) were compared. Constructs were subjected to cyclic loading, oscillating from 5 to 50 N for 3000 cycles, followed by a single cycle to failure test. Mean distraction, load at failure, stiffness, and failure mode were compared between groups. Results Mean ± SD distraction in cyclic loading was greater for DL (2.1 ± 0.7 mm) than for SL (1.9 ± 1.3 mm) and SC (1.539 ± 0.9 mm); however, there was no significant difference between SL and SC or between SL and DL. Mean ultimate failure load was greater for DL (240 ± 44.56 N) than for SC (189.59 ± 46.16 N) and SL (150.93 ± 44.43 N) and greater for SC compared with SL. Failure occurred by cartilage tearing for DL and SL, and by screw pull out (n = 13) or knot slippage (4) for SC. Conclusion In cyclic loading, SC is more stable than DL and at least as stable as SL. In single cycle to failure, DL is the strongest construct and SC is stronger than SL.OBJECTIVE To compare mechanical properties of 2 techniques with a conventional technique for anchoring the muscular process in a laryngoplasty procedure. STUDY DESIGN Experimental ex vivo study. SAMPLE POPULATION Equine larynges (n = 60). METHODS A single loop (SL), a screw (SC), and a double loop technique (DL) were compared. Constructs were subjected to cyclic loading, oscillating from 5 to 50 N for 3000 cycles, followed by a single cycle to failure test. Mean distraction, load at failure, stiffness, and failure mode were compared between groups. RESULTS Mean ± SD distraction in cyclic loading was greater for DL (2.1 ± 0.7 mm) than for SL (1.9 ± 1.3 mm) and SC (1.539 ± 0.9 mm); however, there was no significant difference between SL and SC or between SL and DL. Mean ultimate failure load was greater for DL (240 ± 44.56 N) than for SC (189.59 ± 46.16 N) and SL (150.93 ± 44.43 N) and greater for SC compared with SL. Failure occurred by cartilage tearing for DL and SL, and by screw pull out (n = 13) or knot slippage (4) for SC. CONCLUSION In cyclic loading, SC is more stable than DL and at least as stable as SL. In single cycle to failure, DL is the strongest construct and SC is stronger than SL.

Internal Fixation of Cervical Fractures in Three Horses

OBJECTIVE To describe the surgical treatment outcome of cervical fractures in 3 horses. STUDY DESIGN Case report. ANIMALS Three client-owned horses with cervical vertebral fractures. METHODS Three horses were refered for neck stiffness, pain, and ataxia after a cervical trauma because of a fall. Radiographic examination showed an oblique displaced fracture of the caudal aspect of the body of the second cervical vertebra (C2) in horse 1, an oblique displaced fracture of the caudal aspect of C4 involving the disc between C4 and C5 in horse 2, and a displaced transverse fracture of the body of the axis (C2) extending to the lateral arches and involving the vertebral canal in horse 3. In horse 1, the fracture was reduced and stabilized using a 14-hole narrow DCP plate, applied ventrally, and fixed with cancellous screws. A cervical fusion was performed. In horses 2 and 3, fracture fixation was performed using a 5-hole narrow LCP and 5 mm locking screws. RESULTS All horses showed improvement and returned to full activity. The fracture healed in all horses. CONCLUSION Internal fixation of cervical fracture in these horses was associated with minimal complications, and was associated with healing and a highly functional outcome in all horses. The LCP was preferred and would be recommended for ventral stabilization of selected cases of vertebral fractures.

Two-step surgery combining standing laparoscopy with recumbent ventral median celiotomy for removal of enlarged pathologic ovaries in 20 mares.

OBJECTIVES To report a combination of standing laparoscopic technique for intra-abdominal dissection of the mesovarial pedicle followed by a limited ventral median celiotomy under general anesthesia for removal of enlarged ovaries in mares. STUDY DESIGN Case series. ANIMALS Mares (n = 20) aged 3-22 years with unilateral enlarged ovaries. METHODS Enlarged ovaries were confirmed by transrectal palpation and ultrasonography. After sedation, 3 laparoscopic portals were made in the paralumbar fossa. The mesovarium was desensitized and dissected using a vessel sealing device, and the ovary was left free in the abdomen. Then under general anesthesia, the mare was positioned in dorsal recumbency and an 8 cm ventral median celiotomy made for ovary retrieval in a specimen bag. RESULTS This 2-step procedure was successfully used for removal enlarged ovaries (12-50 cm) in 17 mares and for management of behavioral problems in 3 mares. No operative or postoperative complications occurred. Owner satisfaction and cosmesis were considered excellent. CONCLUSIONS Standing laparoscopy combined with a limited median celiotomy is a safe technique for ovariectomy in mares. This technique mitigates most of the disadvantages of standing flank ovariectomy and a conventional open ventral median approach.

Two-Step Surgery Combining Standing Laparoscopy With Recumbent Ventral Median Celiotomy for Removal of Enlarged Pathologic Ovaries in 20 Mares: Two-Step Procedure for Ovariectomy in Mares

OBJECTIVES To report a combination of standing laparoscopic technique for intra-abdominal dissection of the mesovarial pedicle followed by a limited ventral median celiotomy under general anesthesia for removal of enlarged ovaries in mares. STUDY DESIGN Case series. ANIMALS Mares (n = 20) aged 3-22 years with unilateral enlarged ovaries. METHODS Enlarged ovaries were confirmed by transrectal palpation and ultrasonography. After sedation, 3 laparoscopic portals were made in the paralumbar fossa. The mesovarium was desensitized and dissected using a vessel sealing device, and the ovary was left free in the abdomen. Then under general anesthesia, the mare was positioned in dorsal recumbency and an 8 cm ventral median celiotomy made for ovary retrieval in a specimen bag. RESULTS This 2-step procedure was successfully used for removal enlarged ovaries (12-50 cm) in 17 mares and for management of behavioral problems in 3 mares. No operative or postoperative complications occurred. Owner satisfaction and cosmesis were considered excellent. CONCLUSIONS Standing laparoscopy combined with a limited median celiotomy is a safe technique for ovariectomy in mares. This technique mitigates most of the disadvantages of standing flank ovariectomy and a conventional open ventral median approach.