CASE STUDY – OCTOBER 2013
A 9-year-old WB Jumper gelding presenting with Grade 2/5 right forelimb lameness noted after jumping.
- Physical exam was initially unrevealing.
- Diagnostic nerve blocks localized the lameness to the sub-carpal area.
- Ultrasound exam was negative.
- Radiographs of the upper cannon bone area showed a mild lucency in the upper metacarpal cortex (see Fig 1 – left).
- Diagnostic Treatment: Anti-inflammatories, ice; referred for standing MRI.
Note: Two days post-examination, horse became non-weight bearing; right forelimb swollen in sub-carpal area.
- There was focal fiber disruption and/or severe degenerative injury in the medial lobe of the suspensory ligament (fig 2).
- There was an incomplete non-displaced avulsion fracture in the palmar medial cortex of the third metacarpal bone at the level of the suspensory ligament injury (fig 3).
- Horse remained non-weight bearing.
- Placed in a heavy Robert Jones bandage reinforced by a PVC splint.
- Treated with broad-spectrum antibiotics and by regional limb perfusion.
Radiographs taken six months post onset showed the fracture was healing. Horse jogged sound in hand and is beginning slow return to work.