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I. M. Wright - One of the best experts on this subject based on the ideXlab platform.
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Frequency distribution of osteochondral fragmentation of the dorsoProximal articular surface of the Proximal Phalanx in racing Thoroughbreds in the UK
Equine Veterinary Journal, 2018Co-Authors: R. Walsh, M. R. W. Smith, I. M. WrightAbstract:BACKGROUND Osteochondral fragmentation of the dorsoProximal margin of the Proximal Phalanx is commonly recognised in racing Thoroughbreds. Frequency distribution has been documented in racing Thoroughbreds and Quarter Horses in the USA and in European Warmbloods but no data have been published from the UK. Concurrent intra-articular soft tissue lesions and radiographic accuracy of fragment distribution in racing Thoroughbreds have not previously been reported. OBJECTIVES To document frequency distribution of dorsoProximal fragmentation of the Proximal Phalanx in a UK population of racing Thoroughbreds and to compare this with published data. To document concurrent intra-articular lesions identified arthroscopically and radiographic accuracy of fragment distribution. STUDY DESIGN A retrospective single centre-based, observational study. METHODS Surgical reports and radiographs of all racing Thoroughbreds that underwent arthroscopic surgery for removal of fragmentation from the dorsoProximal margin of the Proximal Phalanx at Newmarket Equine Hospital between 2011 and 2015 were reviewed. RESULTS Two hundred and forty-two (85.8%) horses were in or being prepared for flat racing. Osteochondral fragmentation of the dorsoProximal aspect of the Proximal Phalanx was present in 428 fetlock joints of 282 horses, consisting of 194 (45.3%) left and 188 (43.9%) right metacarpophalangeal joints, and 20 (4.7%) left and 26 (6.1%) right metatarsophalangeal joints. Fragmentation was located dorsomedially in 316 (73.8%), dorsolaterally in 32 (7.5%) and biaxially in 80 (18.7%) joints. Concurrent soft tissue lesions were identified in 168 (39.3%) joints. Radiographic evidence of fragmentation was visible in 320 joints (74.8%). MAIN LIMITATIONS Limited numbers preclude conclusions with respect to yearlings and horses in jump race training. CONCLUSION DorsoProximal fragmentation of the Proximal Phalanx occurred most frequently medially and in the forelimbs. Sidedness was not demonstrated. Although similar to previously reported data, variance in limb distribution is evident. Further research is required to determine whether concurrent intra-articular soft tissue lesions are aetiopathogenic or an additional result of the pathological changes leading to fragmentation. Fragmentation site was not always accurately identified radiographically. The Summary is available in Spanish - see Supporting information.
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Short frontal plane fractures involving the dorsoProximal articular surface of the Proximal Phalanx: Description of the injury and a technique for repair
Equine Veterinary Journal, 2017Co-Authors: I. M. Wright, G. J. MinshallAbstract:Background Chip fractures of the dorsoProximal articular margin of the Proximal Phalanx are common injuries in racehorses. Large fractures can extend distal to the joint capsule insertion and have been described as dorsal frontal fractures. Objectives To report the location and morphology of short frontal plane fractures involving the dorsoProximal articular surface of the Proximal Phalanx and to describe a technique for repair under arthroscopic and radiographic guidance. Study design Single centre retrospective case study. Methods Case records of horses with frontal plane fractures restricted to the dorsoProximal epiphysis and metaphysis of the Proximal Phalanx referred to Newmarket Equine Hospital were retrieved, images reviewed and lesion morphology described. A technique for repair and the results obtained are reported. Results Twenty-two fractures in 21 horses commencing at the Proximal articular surface exited the dorsal cortex of the Proximal Phalanx distal to the metacarpophalangeal/metatarsophalangeal joint capsule in 17 hind- and 5 forelimbs. All were in Thoroughbred racehorses. In 16 cases these were acute racing or training injuries. Twenty fractures were medial, one lateral and one was midline. All were repaired with a single lag screw using arthroscopic and radiographically determined landmarks. Sixteen horses raced after surgery with performance data similar to their pre-injury levels Main limitations The study demonstrates substantial morphologic similarities between individual lesions supporting a common pathophysiology but does not identify precise causation. There are no cases managed differently that might permit assessment of the comparative efficacy of the treatment described. Conclusions Short frontal plane fractures involving the dorsoProximal margin of the Proximal Phalanx that exit the bone distal to the metacarpophalangeal/metatarsophalangeal joint capsule have substantial morphologic similarities, are amenable to minimally invasive repair and carry a good prognosis for return to training and racing. This article is protected by copyright. All rights reserved.
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Are there radiologically identifiable prodromal changes in Thoroughbred racehorses with parasagittal fractures of the Proximal Phalanx
Equine Veterinary Journal, 2013Co-Authors: M. R. W. Smith, I. M. WrightAbstract:Summary Reasons for performing study Fractures of the Proximal Phalanx are generally considered to result from monotonic supraphysiological loads, but radiological observations from clinical cases suggest there may be a stress-related aetiology. Objectives To determine whether there are radiologically identifiable prodromal changes in Thoroughbred racehorses with confirmed parasagittal fractures of the Proximal Phalanx. Study design Retrospective cross-sectional study. Methods Case records and radiographs of Thoroughbred racehorses with parasagittal fractures of the Proximal Phalanx were analysed. Thickness of the subchondral bone plate was measured in fractured and contralateral limbs, and additional radiological features consistent with prodromal fracture pathology documented. Results The subchondral bone plate was significantly thicker in affected than in contralateral limbs. Evidence of additional prodromal fracture pathology was observed in 15/110 (14%) limbs with parasagittal fractures, and in 4% of contralateral limbs. Conclusions The results of this study are not consistent with monotonic loading as a cause of fracture in at least a proportion of cases, but suggest a stress-related aetiology. Increased thickness of the subchondral bone plate may reflect (failed) adaptive changes that precede fracture. Potential relevance Better understanding of the aetiology of fractures of the Proximal Phalanx may help develop strategies to reduce the risk of fracture. The Summary is available in Chinese – see Supporting information.
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Radiographic configuration and healing of 121 fractures of the Proximal Phalanx in 120 Thoroughbred racehorses (2007-2011).
Equine Veterinary Journal, 2013Co-Authors: M. R. W. Smith, I. M. WrightAbstract:Summary Reasons for performing study Although fractures of the Proximal Phalanx are one of the most common long bone fractures of Thoroughbred horses in training, limited details on variations in morphology and radiological progression have been published. Objectives To describe in detail the configuration of parasagittal fractures of the Proximal Phalanx in a group of Thoroughbred racehorses, to report fracture distribution within this group of horses and to document radiological progression of fracture healing in cases treated by internal fixation. Study design Restrospective case series. Methods Case records and radiographs of Thoroughbred racehorses with parasagittal fractures of the Proximal Phalanx admitted to Newmarket Equine Hospital between 2007 and 2011 were analysed. Results One hundred and twenty-one fractures were identified in 120 Thoroughbred racehorses. Fractures were frequently more complex than was appreciated immediately following injury; a feature that has not been reported previously. There was seasonality of fractures in 2- and 3-year-old horses, but not in older horses. Conclusions and potential relevance Fractures of the Proximal Phalanx may be more complex than recognised previously, although often their complexity cannot be identified radiographically immediately following injury. The seasonality observed in 2- and 3-year-old horses is most likely to be a consequence of the timing of the turf-racing season in the UK. The Summary is available in Chinese – see Supporting information.
Seiichi Suzuki - One of the best experts on this subject based on the ideXlab platform.
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valgus toe deformity of fourth Proximal Phalanx due to osteochondroma treated with closing wedge osteotomy
Foot and Ankle Surgery, 2014Co-Authors: Toshinori Kurashige, Seiichi SuzukiAbstract:Abstract Osteochondroma is the most common benign tumor of all benign and primary bone tumors. It rarely occurs in the Proximal Phalanx of the lesser toe. The treatment of osteochondroma usually consists of simple resection. However, if other deformities remain, added procedures may be considered. We report a case of a valgus toe deformity of the fourth Proximal Phalanx due to osteochondroma. The patient was a 21-year-old man who noticed a valgus deformity of his fourth toe over 10 years earlier. He began to experience pain in his fifth toe because of crossover of the fourth toe when wearing formal shoes. Although resection of osteochondroma was performed, the valgus deformity was not sufficiently corrected. Therefore, closing wedge osteotomy of the Proximal Phalanx was performed at the same time. A good outcome was achieved for this patient.
Sanjeev Kakar - One of the best experts on this subject based on the ideXlab platform.
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flexor digitorum superficialis tenodesis for traumatic digit amputation at the level of the Proximal Phalanx
Hand, 2017Co-Authors: Maureen A Oshaughnessy, Sanjeev KakarAbstract:Background: Traumatic amputation of the digit requiring revision amputation at the level of the Proximal Phalanx provides the opportunity to improve flexor function via tenodesis of the remaining flexor digitorum superficialis (FDS) tendon. Salvage of the remaining FDS and performing flexor tenodesis to the Proximal Phalanx allows increased flexion at the metacarpophalangeal (MCP) joint. Methods: This series reviews FDS tenodesis, outlining its surgical technique with clinical and functional outcomes. Institutional review board–approved retrospective study was performed. Twelve digits in 8 patients were included. Results: Average flexion-extension arc of affected MCP joint was 82°, and average grip strength was 70% of unaffected extremity. No patients required revision surgery or revision amputation. One patient had a minor wound infection treated successfully with oral antibiotics. Conclusions: FDS tenodesis is a reliable motion-preserving procedure for patients with amputations at the level of the proxi...
Fernando Alvarez - One of the best experts on this subject based on the ideXlab platform.
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the importance of the length of the first metatarsal and the Proximal Phalanx of hallux in the etiopathogeny of the hallux rigidus
Foot and Ankle Surgery, 2009Co-Authors: Alberto Calvo, Ramon Viladot, Josep Gine, Fernando AlvarezAbstract:Abstract The purpose of this study was to determine if the relative length of the first metatarsal and the Proximal Phalanx of the hallux, in respect to the total foot length, were associated with the incidence of hallux rigidus. For this retrospective study, lateral radiographs from 132 cases with hallux rigidus and a control group of 132 normal feet were reviewed. We measured the following parameters: the index between the foot length and first metatarsal length, the Proximal Phalanx of the hallux length, and the sum of the first metatarsal length and the Proximal Phalanx of the hallux length. We found a statistically significant difference ( p : 0.002) between the two groups in the Foot L/1st Mtt L index, and no statistical difference in the Foot L/Phalanx L index. We think that a greater length of first metatarsal is involved in the etiopathogeny of hallux rigidus.
Elzer, Mendeley E Data) - One of the best experts on this subject based on the ideXlab platform.
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Arthroscopic treatment of short frontal plane fractures of the Proximal Phalanx
2019Co-Authors: Elzer, Mendeley E Data)Abstract:Medical and race record information for horses treated arthroscopically for short frontal plane fractures of the Proximal Phalanx
