Lecture 4 Shoulder slip (sweeny)^J bicipital bursitis^J omarthritis^J capped elbow^J radial paralysis^J carpitis. bent knee^J and knock knee. Hygroma of knee^J open k.pptx

Veterinary surgery unit 6

1. lecture 4

2. Shoulder slip ( sweeny ) Omarthritis Radial paralysis Carpitis Contracted Tendons in Horses /Equine Angular Limb Deformities Blemished knee Bursitis/ hygroma ( Bicipital bursitis,Capped elbow, Hygroma of knee)

3. 1. SHOULDER SLIP (SWEENY) Suprascapular nerve injury Instability of shoulder joint due to atrophy of infraspinatous and supraspinatous muscles Cause: Trauma or overstretching of limb Chronic nerve compression Fracture of supraglenoid tubercle Prominent scapular spine with atrophied muscles

4. Signs: Prominent scapular spine Acute condition:- pain, no weight bearing Chronic condition:- lateral instability of shoulder joint during weight bearing Treatment: NSAIDs, DMSO in the region of suprascapular nerve Stall rest Surgical decompression of nerve

5. 2. OMARTHRITIS Arthritis of scapulo -humeral joint Common in performance horses Cause: Articular fracture due to trauma Displacement or Osteochondrosis of shoulder joint

6. Signs: Mild swelling at shoulder joint Painful joint movement Lameness varies with severity Treatment: Rest Intrasynovial administration of corticosteroid and sodium- hyaluronate

7. 3. RADIAL NERVE PARALYSIS Paralysis of the radial nerve results in the inability of the horse to extend the elbow, carpus and foot

8. Dropped elbow Lengthening of limb

9. 3. RADIAL NERVE PARALYSIS Etiology Humeral fractures. Collisions with objects. Post-recumbency anesthesia → especially if the limb is malpositioned and stretched. Trauma to shoulder region or humerus Prolonged lateral recumbency Neoplasm around radial nerve Enlargement of axillary lymph node

10. Equine Physitis Physitis means an inflammation of the growth plate (physis = growth plate, itis = inflammation)

11. Physistis can have several causes: Nutrition is the most important cause, either excess or deficiency of nutrients. Trauma or excessive weight-bearing on a certain growth plate. Genetic predisposition Infectious cause . A growth plate can also become inflamed due to a bacterial infection.

12. The treatment of physitis consists mainly in two components: Rest will limit exercise and, therefore, the compression of the physis when the foal is moving. Restriction of diet , so the foal reduces body weight and delays the excessive growth speed limiting it to a normal rate.

13. 4. CARPITIS (popped knee) Acute or chronic inflammation of carpal joint Involves synovial membrane, fibrous joint capsule and ligaments of carpus Common in race horse Concussion and trauma are main causes.

14. Signs: Lameness with shortening of cranial stride Swelling on anterior surface POSITIVE CARPAL FLEXION TEST Radiography : enthesiophytes formation Treatment : Immobilization by pressure bandage Stall rest

15. CARPAL FLEXION TEST

16. 5 . Contracted Tendons in Horses / Leg is excessively straight, usually at the fetlock or coronary band, i.e., corono -pedal joint, but it occasionally also affects the knees There are two general forms of contracted tendon, i.e., congenital and acquired. In the congenital condition ,

17. Treatment Diet Restrication injection of a specific large dose of oxytetracyline antibiotics. This appears to work by the alteration of calcium metabolism or calcium availability in the tendons. Surgical approach: Tenotomy of flexor tendon

18. 6 . Equine Angular Limb Deformities (ALD) Angular limb deformities are seen in young foals and are defined as  lateral or medial deviations of the limb in the frontal plane distal to a particular joint

19. Carpal Valgus  commonly named “knock-kneed.” The limb deviates outwards below the knee. This is the most common form of angular deformity.

20. Carpal Varus commonly named “bow legs.” The limb deviates inwards below the knee.

21. Non-surgical treatments (considered for those foals that are very young and/or have a mild deviation). Non-surgical treatment options include: Stall rest Splints and/or cast placement on the affected leg Corrective hoof trimming and glue-on shoes with outside or inside extensions

22. Surgical treatments: Periosteal Stripping:  Transphyseal Bridging: Transphyseal Screw Placement

23. 8. BLEMISHED KNEE

24. Operation for blemished knee in equine other wise known as Cherry’s Operation. Site: Anterior surface of the knee where the scar (blemish) is situated. Technique: The scar or cicatrix is removed by including it in an elliptical skin incision vertically on the anterior aspect of the knee. This wound is closed by interrupted apposition sutures after relaxing the skin by placing additional vertical skin incisions on either side of it. After healing, the three wounds will only appear as three narrow streaks of scar covered by hair.

25. 9. Bursitis/ Hygroma Anatomy of bursae Natural bursae eg Bicipital bursa, Trochateric bursa etc Acquired bursae-At the joints eg bursa of knee, hock, elbow etc Bursae facilitate movement of tendon, joint Bursae contain synovial fluid Bursitis –, Constant trauma, inflammation, excessive synovial fluid accumulation and swelling

26. Examples of bursitis Subcutaneous Capped hock/ hygroma of hock Capped elbow/shoe boil/ hygroma of elbow Capped knee/ hygroma of knee etc Subligamentous Atlantal bursa (ligament nuchae & rectus capitus dorsalis major M) Pole evil Supraspinous bursa (between supraspinous lig & 2-5 thoracic vertebrae) Fistulous wither Subtendinous Bicipital bursa Trochanteric bursa Cuneal bursa Navicular bursa etc etc

27. BICIPITAL BURSITIS Inflammation of intertubercular bursa Cause: Trauma Infection from open wound Septic bursitis :- hematogenous spread (Brucellosis) Signs: Acute onset of lameness Swelling and pain over the cranial aspect of shoulder region Chronic case: atrophy of shoulder and pectoral muscle Treatment : Topical application of DMSO, intrasynovial injection with corticosteroids and hyauronate Incisional and arthroscopic approach Synovectomy

28. CAPPED ELBOW ( Olecranon bursitis, Shoe boil) Cause: Trauma by the shoe on affected limb hitting the point of olecranon tuberosity Signs: Freely moveable swelling over the point of elbow No evident lameness Treatment: Bursal drainage followed by administration of iodine solution Chemical debridement with magnesium and Copper sulphate powder En bloc resection of bursa

29. CARPAL HYGROMA/ CAPPED KNEE Synovial swelling on the dorsal surface of carpus Acquired bursa Synovial fistula No lameness Dx (History, palpation, FNA, radiography)

30. Hygroma cattle/ Capped knee

31. Equine Wobbler Syndrome

32. Dynamic compression of the spinal cord by the vertebrae when the neck is flexed.

33. Static narrowing of the cervical canal. Signs manifest regardless of the neck’s position

34. THANKS