EQUINE VETERINARY EDUCATION / AE / JANUARY 2017
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TABLE 1: Frequencies of exposure variables in horses (n = 138) treated for coronation injury
% of horses or
Exposure variable Sex
Age Breed
Category Female
mean (n) s.d. (range)
50.7
Male castrated 44.2 Male Years
Warmblood 5.1
10.75 5.2 (0.5–27) 57.2
Arabian horse 15.9 Thoroughbred 9.4 Franches Montagnes
5.1
Spanish horse Quarter Horse Standardbred
Fig 1: Horse which sustained a bilateral coronation injury whilst falling when trail riding.
Coronation type
Emergency management prior to admission
Time from injury to admission
Extensor tendon involvement
Coldblood Unilateral Bilateral No Yes
Days
Carpal joint involvement No Yes No Yes No Yes No Yes
Acute radiographic bone changes
Intra-articular antimicrobial treatment Wound healing type
Duration of implanted drain
Complication: exuberant granulation tissue
Complication: local infection
Complication: suture dehiscence
Fig 2: Latero-medial radiograph of the right carpus showing radiopaque foreign material present in the wound area following a coronation injury. In this horse the middle carpal joint was also involved.
hypothesised that carpal joint involvement, extensor tendon involvement and time from injury to admission would decrease the survival to discharge rate, increase the hospitalisation time, increase the long-term coronation specific mortality rate and decrease soundness and return to intended use. We hypothesised that carpal joint involvement and time from injury to admission would increase the rate of increased post-injury stumbling and increase coronation injury recurrence rate.
Materials and methods
Medical records of horses incurring unilateral or bilateral coronation injuries admitted to the Equine Hospital from 1992 to 2014 were retrospectively reviewed by one of the authors (N.B.). The case definition for coronation injury in this study
Complication: skin necrosis
Primary
Secondary Days
No Yes No Yes No Yes No Yes
2.9 2.9 2.2
Icelandic horse 2.2 Pony
1.5 0.7
43.5 56.5 39.9 60.1
1.9 8.4 (0.08–69)
82.6 17.4 84.1 15.9 98.4 1.6
58 42
75.4 24.6
3.46 1.75 (1–14)
88.4 11.6 70.3 29.7 89.1 10.9 97.1 2.9
was a horse that had sustained an injury to the dorsal aspect of at least one of its carpi after stumbling and falling on hard ground. Horses with missing information in their medical
records on clinical examination findings, radiographical findings, treatment or clinical progression were excluded from the study. In horses incurring bilateral coronation injury, the data of the clinically worse affected limb were used in the analysis. Data retrieved from the medical records and compiled in
an Excel data sheet included: subject details, activity at the time of injury, duration from injury to admission and emergency management prior to admission (antimicrobial agents, anti-inflammatory agents, wound management, bandaging). The injury was categorised according to the uni- or bilateral nature, presence of extensor tendon involvement, and carpal joint involvement. Radiographic findings on presentation (presence of radiopaque foreign bodies [Fig 2]
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