New Information about

AFJ, PO Box 624 Brookfield, Wl 53008-0624 Ph 414-782-4480

25th Surgical Forum Lake Buena Vista, FL October 16-19, 1997

"Horses treated with appropriate surgical debridement within four days after the injury have a better chance at a successful outcome than horses not receiving appropri- ate treatment prior to this time. Horses that have a hind leg affected are more likely to return to their previous activities. When the deep flexor tendon is punctured or the structures surrounding the navicular bursa are involved, the prognosis is more guarded."

Dr. G. Lynn Richardson Rancho Santa Fe, CA

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Laminitis Q&A for horse owners

American Farriers Journal (AFJ) Special Management Report No. 8, entitled "The 25 most frequently asked questions about laminitis, founder," is available for $8.95. AFJ brought together a panel of five professionals to answer the 25 most commonly asked questions from farriers, veterinarians, horse owners and trainers who encounter this disease in the treatment of horses.

Five viewpoints on each question are presented in this 16-page report that costs $8.95. The report offers advice on when to suspect laminitis, when to contact a veterinarian, if a hoof resection should be performed, when abscesses might occur, how to deal with osteomyelitis and more. The professionals who answer the questions are: Dr. William Moyer, Dr. Ric Redden, Dr. George Platt, Burney Chapman, and Gene Ovnicek.

Penetrating Foot Wounds

Careful inspection for a foreign body is the first step in good surgical management of a penetrating foot wound, according to Dr. Lynn Richardson, speaking at the 25th Surgical Forum. At first, the puncture tract may not be evident, and careful inspection is necessary. The long hair around the coronary band may hide the puncture hole. Sometimes trimming of the bottom of the foot and paring away superfi- cial layers of horny tissue is necessary to discover the puncture tract.

Confirmation of the physical findings is provided with radiology, although a radiograph may not reveal a foreign body if it is wood or glass. Sometimes injection of a contrast agent is necessary to clearly delineate the tract.

Deep puncture wounds that penetrate the corium require "surgical" debridement. In the toe and quarter regions, a hoof knife is necessary to remove tissue around the puncture opening. A puncture wound into the frog must be debrided energetically, removing a tapered core of tissue. If the wound penetrates to the digital flexor tendon, surgical debride- ment of the frog is especially important, with removal of all necrotic or devitalized tissue.

After 12 hours it may be difficult to establish good drainage of a punctured navicular bursae because of fibrin clots which have walled off exudate. For the best outcome, a puncture wound should be treated within four days of injury.

In some chronic cases, the amount of deep digital flexor tendon involved is enough to cause concern over removing too much of the affected tendon and predisposing it to rupture. However, if necrotic tendon tissue is not debrided, it will continue to act as a nidus for ongoing infection and result in a wound that will not heal. The same concerns are valid for the distal ligament of the navicular bone.

"The most common mistake made in the management of this type of injury is a conservative approach," Dr. Richardson said. "Deep puncture wounds should be handled on an emergency basis with appropriate diagnostic imaging to confirm the extent of the injury, followed by surgical debridement of affected tissues."

JOURNAL OF EQUINE VETERINARY SCIENCE