OBJECTIVE To evaluate histologic changes and gene expression patterns in body and limb wounds in horses in response to bacterial inoculation. SAMPLE Wound biopsy specimens from 6 horses collected on days 7, 14, 21, and 27 after excisional wounds (20 wounds/horse) were created over the metacarpal and metatarsal region and lateral thoracic region (body) and then inoculated or not inoculated on day 4 with Staphylococcus aureus and Pseudomonas aeruginosa. PROCEDURES Specimens were histologically scored for the amount of inflammation, edema, angiogenesis, fibrosis organization, and epithelialization. Quantitative PCR assays were performed to quantify gene expression of 10 inflammatory, proteolytic, fibrotic, and hypoxia-related markers involved in wound healing. RESULTS Except for gene expression of interleukin-6 on day 27 and tumor necrosis factor-α on day 14, bacterial inoculation had no significant effect on histologic scores and gene expression. Gene expression of interleukin-1β and -6, serum amyloid A, and matrix metalloproteinase-9 was higher in limb wounds versus body wounds by day 27. Gene expression of cellular communication network factor 1 was higher in limb wounds versus body wounds throughout the observation period. CONCLUSIONS AND CLINICAL RELEVANCE The lack of clear markers of wound infection in this study reflected well-known difficulties in detecting wound infections in horses. Changes consistent with protracted inflammation were evident in limb wounds, and gene expression patterns of limb wounds shared similarities with those of chronic wounds in humans. Cellular communication network factor warrants further investigation and may be useful in elucidating the mechanisms underlying poor limb wound healing in horses.

OBJECTIVE To compare heat generation and mechanical bone damage for tapered and cylindrical transfixation pins during drilling, tapping, and pin insertion in equine third metacarpal bones. SAMPLE 16 pairs of cadaveric equine third metacarpal bones. PROCEDURES For cylindrical pin insertion, a 6.2-mm hole was drilled and tapped with a cylindrical tap, and then a standard 6.3-mm pin was inserted. For tapered pin insertion, a 6.0-mm hole was drilled, reamed with a tapered reamer, and tapped with a tapered tap, and then a 6.3-mm tapered pin was inserted. Paired t tests and 1-way ANOVAs were used to compare heat generation (measured by use of thermocouples and thermography), macrodamage (assessed by use of stereomicroscopy), and microdamage (assessed by examination of basic fuchsin–stained histologic specimens) between cylindrical and tapered pins and between tapered pins inserted to various insertion torques. RESULTS Tapered pin insertion generated less heat but resulted in more bone damage than did cylindrical pin insertion when pins were inserted to the same insertion torque. Insertion of tapered pins to increasing insertion torques up to 16 N•m resulted in increased heat generation and bone damage. CONCLUSIONS AND CLINICAL RELEVANCE Tapered pin insertion resulted in lower heat production than did cylindrical pin insertion. However, tapered pin insertion resulted in greater bone damage, which likely was attributable to differences in the tapered and cylindrical taps. A tapered pin may be preferable to a cylindrical pin for insertion in equine cortical bone provided that improvements in tap design can reduce bone damage during insertion.

OBJECTIVE To compare regional proportions and spatial distributions of volumetric bone mineral density (BMDv) of the palmar aspect of the distal epiphysis of the third metacarpal bone (McIII) in limbs with or without a condylar fracture from Thoroughbred racehorses. SAMPLE McIIIs from cadavers of Thoroughbred racehorses with (n = 6 bones) and without (8) a condylar fracture. PROCEDURES BMDv and spatial distributions of BMDv in peripheral quantitative CT images of the distal epiphysis of McIIIs were quantitatively assessed with spatial analysis software. Relative proportions of voxels within 9 threshold categories of BMDv and spatial statistics for BMDv distribution were compared between fractured and nonfractured limbs. RESULTS No significant differences in BMDv characteristics were identified between fractured and nonfractured limbs, although fractured limbs had a lower proportion of voxels in the BMDv thresholds 700 to < 800 mg/cm3 and 800 to < 900 mg/cm3 but a higher proportion of voxels in the BMDv threshold 1,000 to < 1,100 mg/cm3 for the central condylar region of the medial condyle. Results of spatial analysis reflected the response of bone to race training rather than differences between fractured and nonfractured limbs. In both limb groups, uniform clusters of low BMDv with areas of high BMDv were identified. CONCLUSIONS AND CLINICAL RELEVANCE BMDv characteristics of the distal epiphysis of McIII reflected training load, and fracture characteristics were subtle. Serial imaging techniques in conjunction with detailed training data are required to elucidate the onset of the pathological response to load in horses.

Objective-To compare variables for screw insertion, pushout strength, and failure modes for a headless tapered compression screw inserted in standard and oversize holes in a simulated lateral condylar fracture model. Sample Population-6 pairs of third metacarpal bones from horse cadavers. Procedure-Simulated lateral condylar fractures were created, reduced, and stabilized with a headless tapered compression screw by use of a standard or oversize hole. Torque, work, and time for drilling, tapping, and screw insertion were measured during site preparation and screw implantation. Axial load and displacement were measured during screw pushout. Effects of drill hole size on variables for screw insertion and screw pushout were assessed by use of Wilcoxon tests. Results-Drill time was 59% greater for oversize holes than for standard holes. Variables for tapping (mean maximum torque, total work, positive work, and time) were 42%, 70%, 73%, and 58% less, respectively, for oversize holes, compared with standard holes. Variables for screw pushout testing (mean yield load, failure load, failure displacement, and failure energy) were 40%, 40%, 47%, and 71% less, respectively, for oversize holes, compared with standard holes. Screws could not be completely inserted in 1 standard and 2 oversize holes. Conclusions and Clinical Relevance-Enlarging the diameter of the drill hole facilitated tapping but decreased overall holding strength of screws. Therefore, holes with a standard diameter are recommended for implantation of variable pitch screws whenever possible. During implantation, care should be taken to ensure that screw threads follow tapped bone threads.

Eleven pairs of canine metacarpal bones, 10 pairs of metatarsal bones, and 7 pairs of ribs were harvested cleanly and prepared for banking at -20 C for 1 year. One bone of each pair was randomly assigned to 1 type of storage: plastic pack vs immersion in a normal solution of sodium chloride. The contralateral bone was assigned to the opposite treatment. Six pairs of metacarpal bones and 5 pairs of metatarsal bones were tested in torsion to failure. No significant difference was found within pairs. All ribs, 5 pairs of metacarpal bones, and 5 pairs of metatarsal bones were loaded in 4-point bending to failure. The energy absorbed at failure and the ultimate displacement of ribs and metacarpal and metatarsal bones were increased by 25 to 30% and 18 to 24%, respectively, when the bones were frozen in isotonic saline solution. Corticocancellous grafts frozen in normal saline solution are biomechanically less fragile and brittle than grafts stored in plastic without saline solution.

Sonographic observations were made of the image mean gray scale (MGS) of the flexor tendons and ligaments in the left and right metacarpal regions of each of 10 clinically normal horses. In images made in the dorsal and sagittal planes, the MGS was measured at multiple sites in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament (AL), and suspensory ligament (SL), and at single sites in the medial and lateral limbs of the SL, and the palmar ligament. Relative sonographic brightness of each tendon and ligament was calculated by dividing the value of its MGS by the mean value for the MGS of images of 3 soft tissue equivalent phantoms. When a multivariate repeated-measures of ANOVA of the relative brightness values was statistically significant (P < 0.05), Tukey's method of multiple comparisons was used to determine which values were significantly different from each other. In the dorsal plane, the SL was significantly brighter than the DDFT, SDFT, and AL; relative brightnesses of the DDFT and SDFT were similar, as were those of the SDFT and AL. In the sagittal plane, the SL again was the significantly brightest structure, followed by the Al, and similar brightnesses of the DDFT and SDFT. In dorsal images made 25 cm distal to the accessory carpal bone, relative brightnesses of the SDFT, DDFT, and the medial and lateral limbs of the SL were similar. In images made 30 cm distal to the accessory carpal bone, relative brightness of the palmar ligament was significantly (P < 0.05) less than that of the SDFT and DDFT in the dorsal plane, but not in the sagittal plane, where it was significantly greater. Relative brightness values represented a unique sonographic characteristic of each structure and, in the future, may provide further insights into tendon and ligament structure and function.

Observations were made in dorsal and sagittal planes of the ultrasonographic mean gray scale of the flexor tendons and ligaments of the metacarpal regions of 5 Thoroughbred geldings, during weight bearing and nonweight bearing. In images made when the horses were nonweight bearing, the mean gray scale of the superficial and deep digital flexor tendons and accessory ligament was significantly reduced, but that of the interosseous medius muscle (suspensory ligament) was not. When relaxed, collagen fiber bundles in the tendons and ligaments acted as diffuse, rather than specular, reflectors of ultrasonic waves leading to localized regions of hypoechogenicity and a consequent reduction in mean gray scale. The suspensory ligament, however, remained under tension during nonweight bearing and so mean gray scale was not reduced. Analyses of the ultrasonographic mean gray scale have the potential to provide quantitative data relating to the changes in echogenicity that develop in injured equine tendons and ligaments.

To study communications and boundaries of the middle carpal and carpometacarpal joints of the horse, 50 forelimbs were obtained from fresh cadaver specimens. Blue latex solution (20 +/- 2.5 ml) was injected into the middle carpal joint, and the specimens were frozen in extension. Frozen specimens were cut into 1-cm sagittal sections from the middle of the radius to the middle of the metacarpus. The communications between the middle carpal and carpometacarpal joints and the presence, length, and position of the distopalmar outpouchings of the carpometacarpal joint were recorded. The middle carpal and carpometacarpal joints always communicated between os carpale III (C3) and os carpale IV (C4). An additional communication between the joints existed in 17 (34%) of the specimens, 10 on the palmar aspect of C4, and 3 on the palmar aspect of os carpale II (C2). When os carpale 1 (C1) was present (n = 5), communication between C1 and C2 was observed in 4 of the 5 specimens. In all specimens, medial and lateral distopalmar outpouchings of the carpometacarpal joint were observed and were located between the axial surface of os metacarpale II (MC2) and os metacarpale IV (MC4) and the abaxial surface of the suspensory ligament. There was no significant difference between the lengths of the lateral (2.3 +/- 0.54 cm) or medial (2.6 +/- 0.75 cm) distopalmar outpouchings. Small extensions from the distopalmar outpouchings were seen and extended axially into the fibers of the suspensory ligament or between the suspensory ligament and the distal accessory ligament of the deep digital flexor tendon. In one carpus, the middle carpal joint communicated with the antebrachiocarpal joint between the articulation of the os carpi intermedium (Ci) and the os carpi ulnare (Cu).

OBJECTIVE To measure penetration efficiencies of low-level laser light energy through equine skin and to determine the fraction of laser energy absorbed by equine digital flexor tendons (superficial [SDFT] and deep [DDFT]). SAMPLE Samples of skin, SDFTs, and DDFTs from 1 metacarpal area of each of 19 equine cadavers. PROCEDURES A therapeutic laser with wavelength capabilities of 800 and 970 nm was used. The percentage of energy penetration for each wavelength was determined through skin before and after clipping and then shaving of hair, through shaved skin over SDFTs, and through shaved skin, SDFTs, and DDFTs (positioned in anatomically correct orientation). Influence of hair color; skin preparation, color, and thickness; and wavelength on energy penetration were assessed. RESULTS For haired skin, energy penetration was greatest for light-colored hair and least for dark-colored hair. Clipping or shaving of skin improved energy penetration. Light-colored skin allowed greatest energy penetration, followed by medium-colored skin and dark-colored skin. Greatest penetration of light-colored skin occurred with the 800-nm wavelength, whereas greatest penetration of medium- and dark-colored skin occurred with the 970-nm wavelength. As skin thickness increased, energy penetration of samples decreased. Only 1% to 20% and 0.1% to 4% of energy were absorbed by SDFTs and DDFTs, respectively, depending on skin color, skin thickness, and applied wavelength. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated that most laser energy directed through equine skin was absorbed or scattered by the skin. To achieve delivery of energy doses known to positively affect cells in vitro to equine SDFTs and DDFTs, skin preparation, color, and thickness and applied wavelength must be considered.