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substance to provide support, even after the removal of the remaining exostosis. While bevelling the distal margin may increase the amount of exposed medullary cavity, it eliminates the sharp osseous margin that could irritate the SLB. We recommend bevelling the splint bone to minimise the irritation and inflammation in the region. The second technique involves a segmental ostectomy of
the affected splint bone. The affected portion of the bone is removed, leaving the proximal and distal portions of the splint bone intact (Jenson et al. 2004). Reported limitations of this surgical approach include regrowth of the transected bone and, in our experience, increase the risk of reformation of exostosis and associated adhesions and impingement of the suspensory ligament. While this technique may be appropriate for management of specific types of splint bone fractures, it is limited in its use for exostosis resolution. Additional techniques should be employed regardless of
surgical procedure to reduce the incidence of adhesion reformation. Periligamentous injection of hyaluronic acid matrix formulations at the surgical site has been reported to decrease incidence of adhesion formation (Gaughan et al. 1991). Using sharp dissection and minimising exposed tissue edges reduces inflammation and potential foci for adhesions and exostosis reformation. Post-surgical therapies include adequate bandaging to
reduce the occurrence of seroma formation, stall confinement, anti-inflammatory and broad-spectrum antibiotic therapy and regular follow-up examinations with imaging.
Conclusion
Splint bone exostosis with associated SL impingement, desmitis and adhesions can cause significant lameness in the equine case. Definitive diagnosis through physical examination, diagnostic anaesthesia and appropriate imaging of these lesions is paramount in guiding appropriate medical and surgical therapies to return the horse to athletic performance.
Authors’ declaration of interests No conflicts of interest have been declared.
Ethical animal research Not applicable.
Source of funding No sources of funding.
Authorship Both authors contributed to this manuscript.
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