$navicular bone fracture$

$navicular bone fracture$

#NAVICULAR BONE FRACTURE FULL#

Palmar digital neurectomy is an option after the fracture heals to increase the horse’s soundness. 3 Conservative therapy usually entails variable periods of rest with corrective trimming and shoeing to immobilize the hoof. Therefore, most veterinarians use a conservative management approach. Navicular bone fractures may be treated conservatively or by surgery. Distal limb flexion markedly exacerbates the lameness. Marked pain over the navicular area is noted with hoof testers. Generally speaking, the horse is unwilling to place the heels of the affected foot on the ground. They are usually acute and exhibit a grade III-V of V lameness. True fractures have pain referable to the navicular bone. The navicular bone may have more than one center of ossification, resulting in either a bipartite or tripartite bone. In order to diagnosis this condition one first needs to be sure they are dealing with a fracture. The etiology is always traumatic but can be predisposed by either infection or chronic demineralization from navicular disease. 5 These are simple sagittal fractures, comminuted fractures, avulsion fracture of the navicular collateral sesamoidean ligament, and avulsion fractures of the impar ligament. Navicular bone fractures: Navicular bone fractures can be classified into one of four types. Type VI fractures have an excellent prognosis. The prognosis for type V fractures depends on the circumstances of the fracture that is whether it is traumatic or pathological. 2,6 For types III and IV the prognosis is guarded to fair due to the possibility of distal interphalangeal arthritis. The prognosis for fracture types I and II is fair to good. It should not be performed if a palmar digital nerve block does not substantially improve the lameness. This surgery is usually only effective for palmar process fractures but can reduce pain in all the fractures. Neurectomy of the palmar digital nerve may be necessary due to chronic low grade pain. Larger fragments should be stabilized by lag screw fixation or can be removed completely via an arthrotomy. Small fragments are easily removed via arthroscopy. Type IV fractures are best treated by surgical intervention. The bone in the palmar processes of third phalanx is more porous and does not hold screws well. Therefore radiographic or fluoroscopic guidance during surgery is essential for a successful outcome. Lag screw placement may be difficult because the fracture line can not be seen during surgery. Types II, III, and IV are amenable to lag screw fixation.

#NAVICULAR BONE FRACTURE FULL#

2,6 A full bar shoe with quarter clips, full rim shoe, or glu-strider shoes will immobilize the hoof capsule and effectively turn the capsule into a cast. Treatment of types I, II, III, and V can be treated by therapeutic shoeing. In early cases, you must have the x-ray beam centered on the fracture in order to see it. The fracture may not be visible for 5-7 days. Multiple oblique views may be necessary in order to center the beam on the fracture and see the fracture. 6 Usually at least 4-5 views (LM, DP, D60PrPDi, PPrPDi minimally) should be made in order to examine the entire bone from several angles. Radiographs are necessary to confirm the diagnosis. These two techniques usually can aid the practitioner to center the x-ray beam on the fracture. Hoof percussion reveals sensitivity around the entire hoof but especially over the fracture. Hoof tester examination usually reveals marked pain over the entire hoof but especially over the fracture. Extensor process fractures are often accompanied by swelling over the coronary band. 2 The lameness is usually accompanied by an increased digital pulse. The diagnosis is based on several clinical signs, such as the sudden onset of modereate to severe (grade 3 -5 of 5) lameness. 2,6 Improper shoeing, hard surfaces, stone bruises, infectious conditions and nutritional deficiencies are all considered to be contributing factors. The etiology of these fractures are primarily traumatic. Finally, type V fractures are all other fractures not defined in I-IV, except marginal (peripheral distal phalanx) fractures which are considered type VI fractures and small non-articular palmar process fractures in foals. Type IV fractures comprise all extensor process fractures. Type III fractures are sagittal and divides the bone nearly into equal halves. Type II fractures are articular wing fractures. 2,6,7 Type I is a non articular fracture of the palmar process (wing) of the distal phalanx. The radiographic configuration has prognostic implications.Ĭoffin bone fractures: Distal phalangeal fractures can be classified into one of seven types. They can only be differentiated by radiography. Take Home Message: Coffin bone and navicular bone fractures are painful conditions of the hoof.

$navicular bone fracture$