Publications by authors named "Fackelman G"

Objective: To assess the effects of a crosslinked, modified hyaluronic acid (xCMHA-S) gel on equine tendon healing using an in vivo surgical model.

Study Design: In vivo experimental study.

Animals: Adult horses (n = 5).

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A 2-year-old alpaca was presented for acute onset right forelimb lameness. Clinical findings included bilateral carpal valgus (more severe in the affected forelimb) and medial instability of the right radio-carpal joint. Surgical treatment consisted of radio-carpal joint arthrodesis, which is presented as a therapeutic option for severe carpal instability secondary to injury to the supporting ligamentous structures of the carpus.

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The intra-articular anatomy of 103 equine tarsi was studied by contrast radiography with image intensification and computerized tomography. There was communication between the tarsometatarsal and distal intertarsal joints in 21 of 55 (38%) interpretable tarsometatarsal arthrograms, and in 11 of 48 (23%) interpretable distal intertarsal arthrograms. The difference was not significant.

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The vascular and microvascular anatomy of normal equine superficial digital flexor tendons was studied by dissection of vinyl-perfused specimens and by microangiography on high detail film. The presence of an extensive intratendinous vascular latticework was confirmed, and a 'nutrient artery' described closely associated with the accessory ligament of the superficial digital flexor tendon (proximal check ligament). Circumferential stripping of the paratenon from the tendon to eliminate afferent vessels was performed bilaterally in three horses and unilaterally in a fourth, followed by a treadmill training regimen.

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Signs of malignant hyperthermia, including progressive increases in PaCO2, skin temperature and heart rate, and elevated serum levels of potassium, inorganic phosphate, and creatine kinase, were identified in a halothane-anesthetized horse. Treatment was discontinuing halothane administration, applying ice and cold fluids, and hyperventilating with 100% oxygen. After an initial recovery, bilateral hindlimb myopathy and pigmenturia developed.

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Four long bone fractures with a short distal fragment were repaired with a cobra head bone plate alone (2 cattle) or in combination with a straight, broad dynamic compression plate (2 horses). Three fractures were of the distal femur (1 horse, 2 cattle) and one was of the distal radius (1 horse). The long-term outcome of the three femoral fractures was soundness in one case and mild lameness in two.

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A total of 19 Thoroughbred horses were treated for traumatic disruption of the suspensory apparatus, using either external support of the injured limb, removal of fractured proximal sesamoid bone fragments, metacarpophalangeal arthrodesis, compression screw fixation of the fractured proximal sesamoid bones, application of a cast-brace attached to a transfixation pin inserted through the third metacarpal bone, or combinations thereof. Major complications during the treatment of traumatic disruption of the suspensory apparatus were infection (9 of 19 horses, 47%), large cast sores (10 of 14 treated horses, 71%), laminitis (7 of 19 horses, 37%), and orthopedic implant failure or loosening (4 of 6 treated horses, 67%), which led to euthanasia in 16 of 18 cases with complete follow-up information. Increased pain and lameness signaled the development of such complications.

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Tendon surgery.

Vet Clin North Am Large Anim Pract

July 1983

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The need for early postoperative weight bearing following fracture repair in the horse has led to investigation of various means of expediting the healing process. Bone grafting represents one means of accomplishing this, and the transplantation of autologous tissues has proven to be most useful in equine orthopedics. Acid-decalcified, frozen, allogeneic bone for grafting is easy to prepare, readily contoured, osteogenic, and elicits no obvious immune or rejection response.

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A single intra-articular injection of 20 or 40 mg of purified hyaluronic acid of rooster comb origin resulted in restoration of normal joint function in horses with experimentally induced osteoarthritis. The functional improvement, measured by pressure sensitive force plate techniques, was detectable within one week after treatment and persisted throughout a four week experimental period despite continued use of the joints. The response was dose dependent in that injection of 0 (saline), 5 or 10 mg hyaluronic acid per joint space resulted in no significant change in joint function while dosages of 20 or 40 mg produced maximum improvement.

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Effect of intraarticular injections of hyaluronic acid was evaluated in two groups of horses, using force plates to assess quantitatively the degree of lameness observed. In six horses, chip fractures were created surgically on the dorsomedial aspects of both radial carpal bones. After the horses were trained for 30 days, 40 mg of hyaluronic acid was injected intraarticularly into the limb showing the greater degree of lameness.

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