Download PDF
Vet Comp Orthop Traumatol 2014; 27(02): 102-106
DOI: 10.3415/VCOT-13-08-0105
Original Research
Schattauer GmbH

The microvasculature in the equine distal phalanx: Implications for fracture healing

S. M. Schade
1   Michigan State University, College of Veterinary Medicine, Laboratory for Comparative Orthopaedic Research, East Lansing, Michigan, United States
,
S. P. Arnoczky
1   Michigan State University, College of Veterinary Medicine, Laboratory for Comparative Orthopaedic Research, East Lansing, Michigan, United States
,
R. M. Bowker
1   Michigan State University, College of Veterinary Medicine, Laboratory for Comparative Orthopaedic Research, East Lansing, Michigan, United States
› Author AffiliationsThe authors thank Drs. John A. Stick and Frank Nickels for their assistance in this study. Funding was provided by The Laboratory for Comparative Orthopaedic Research and the Wade O. Brinker Endowment, College of Veterinary Medicine, Michigan State University; and the American Quarter Horse Association and the United States Equestrian Federation.
Further Information

Publication History

Received: 22 August 2013

Accepted: 17 February 2013

Publication Date:
20 December 2017 (online)

    Permissions and Reprints

Summary

Objectives

To describe the intra-osseous microvasculature of the distal phalanx of the equine forelimb with regard to its potential clinical relevance.

Methods

Eleven clinically normal equine forelimbs were used from six adult horses (range: 4 to 18 years old) euthanatized for reasons unrelated to lameness. In each limb the median artery was catheterized at the level of the carpus and India ink was injected under constant manual pressure. The limbs were frozen and 5 mm thick sections of the foot were cut in the sagittal, coronal, or transverse planes on a band saw. The sections were fixed in 10% formalin and cleared using a modified Spalteholz technique. Once cleared, the sections were photographed and the microvascular anatomy identified.

Results

The vascular injections revealed a rich intra-osseous microvascular supply of the distal phalanx originating from the medial and lateral palmar digital arteries. In addition, numerous smaller vessels from the terminal arch, formed by anastomosis of the medial and lateral palmar digital arteries, could be seen branching into the distal aspects of the distal phalanx. This distal portion of the distal phalanx appeared more densely vascularized than the proximal part in all specimens examined.

Clinical significance

The increased vascularity demonstrated in the distal portion of the distal phalanx appears to correlate with improved fracture healing reported in this area. This may also explain why healing fractures which involve both the distal and proximal portions of the distal phalanx have been described as progressing from distal-to-proximal.

Keywords

Equine - distal phalanx - microvasculature - forelimb - fracture healing
 

  • References

  • 1 Yovich JV, Hilbert BJ, McGill CA. Fractures of the distal phalanx in horses. J Am Vet Med Assoc 1982; 189: 550-554.
    PubMedGoogle Scholar
  • 2 Scott EA, McDole M, Shires MH. A review of third phalanx fractures in the horse: sixty-five cases. J Am Vet Med Assoc 1979; 174: 1337-1343.
    PubMedGoogle Scholar
  • 3 Rijkenhuizen AB, de Graaf K, Hak A. et al. Management and outcome of fractures of the distal phalanx: a retrospective study of 285 horses with a long term outcome in 223 cases. Vet J 2012; 192: 176-182.
    CrossrefPubMedGoogle Scholar
  • 4 Honnas CM, O’Brien TR, Linford RL. Distal phalanx fractures in horses: a survey of 274 horses with radiographic assessment of healing in 36 horses. Vet Radiol 1988; 29: 98-107.
    CrossrefPubMedGoogle Scholar
  • 5 Stashak TS. Lameness. In: Adams’ Lameness in Horses. Philadelphia: Lippincott Williams & Wilkins; 2001
    Google Scholar
  • 6 Kaneps AJ, Turner TA. Diseases of the Foot. In: Hinchcliff KW, Kaneps AJ, Geor RJ. editors. Equine Sports Medicine and Surgery: Basic and Clinical Sciences of the Equine Athlete. New York: Saunders; 2004. pg. 2004-260.
    Google Scholar
  • 7 Honnas CM, O’Brien TR, Linford RL. Solar margin fractures of the equine distal phalanx. Proceedings of the 33rd Annual Convention of the American Association of Equine Practitioners. 1987. November 29-December 2 New Orleans, Louisiana, USA: pg. 399-410.
    Google Scholar
  • 8 Scott EA, Sandler GA, Shires MH. Angiography as a diagnostic technique in the equine. J Equine Med Surg 1978; 37: 869-873.
    PubMedGoogle Scholar
  • 9 Collins JN, Galuppo LD, Thomas HL. et al. Use of computed tomography angiography to evaluate the vascular anatomy of the distal portion of the forelimb of horses. Am J Vet Res 2004; 65: 1409-1420.
    CrossrefPubMedGoogle Scholar
  • 10 Rosenstein DS, Bowker RM, Bartlett PC. Digital angiography of the feet of horses. Am J Vet Res 2000; 61: 255-259.
    CrossrefPubMedGoogle Scholar
  • 11 Hoffmann KL, Wood AK, McCarthy PH. et al. Sonographic observations of the peripheral vasculature of the equine thoracic limb. Anat Histol Embryol 1999; 28: 281-289.
    CrossrefPubMedGoogle Scholar
  • 12 Pollitt CC. Clinical anatomy and physiology of the normal equine foot. Equine Vet Educ 1992; 4: 219-224.
    CrossrefPubMedGoogle Scholar
  • 13 Crock HV. The blood supply of the lower limb bones in man. E&S Livingstone LTD; London: 1967
    Google Scholar
  • 14 Rhinelander FW, Wilson JW. Blood supply to developing, mature, and healing bone. In: Sumner-Smith G.. editor. Bone in Clinical Orthopaedics: A study in comparative osteology. Toronto: W.B. Saunders; 1982. pg. 1982-81.
    Google Scholar
  • 15 Von Horst C, Henry RW. User-oriented plastination. Proceedings of American Association of Veterinary Anatomists Meeting. 2011 August 6-8 Ithaca, NY, USA: pg. 8.
    PubMedGoogle Scholar
  • 16 Dugat D, Rochat M, Ritchey J. et al. Quantitative analysis of the intramedullary arterial blood supply of the feline tibia. Vet Comp Orthop Traumatol 2011; 24: 313-319.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 17 Franch J, Garcia F, Dela Fuente J. et al. Microangiographic pattern of bone healing in canine tibial osteotomies treated with type II external fixators. Vet Comp Orthop Traumatol 1998; 11: 118-124.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 18 Torok A. Physical properties of India Ink. Product Bulletin. Newark, NJ: Sanford Faber Corporation; 1995
    Google Scholar
  • 19 Trumble TN, Arnoczky SP, Stick JA. et al. Clinical relevance of the microvasculature of the equine proximal sesamoid bone. Am J Vet Res 1995; 56: 720-724.
    PubMedGoogle Scholar
  • 20 Pettersson H. Conservative and surgical treatment of fractures of the third phalanx. Proc Am Assoc Equine Pract 1972; 18: 183-188.
    PubMedGoogle Scholar
  • 21 Fürst AE, Lischer CJ. Foot. In: Auer J, Stick J. editors. Equine Surgery. St. Louis: Saunders; 2012. pg. 2012-1264.
    Google Scholar
  • 22 Smith JW, Arnoczky SP, Hersh A. The intraosseous blood supply of the fifth metatarsal: implications for proximal fracture healing. Foot Ankle 1992; 13: 143-152.
    CrossrefPubMedGoogle Scholar
  • 23 O’Sullivan CB, Dart AJ, Malikides N. et al. Nonsurgical management of type II fractures of the distal phalanx in 48 Standardbred horses. Aust Vet J 1999; 77: 501-503.
    CrossrefPubMedGoogle Scholar
  • 24 Pettersson H. Fractures of the pedal bone in the horse. Equine Vet J 1976; 8: 104-109.
    CrossrefPubMedGoogle Scholar
  • 25 Prosby RD, Ramsey MW, Behnke BJ. et al. Aging reduces skeletal blood flow, endothelium-dependent vasodilation, and NO bioavailability in rats. J Bone Miner Res 2007; 22: 1280-1288.
    CrossrefPubMedGoogle Scholar
  • 26 Lahtinen T, Alhava EM, Karjalainen P. et al. The effect of age on blood flow in the proximal femur in man. J Nucl Med 1981; 22: 966-972.
    PubMedGoogle Scholar
  • 27 Bloomfield S, Hogan HA, Delp MD. Decreases in bone blood flow and bone material properties in aging Fischer-344 rats. Clin Orthop 2002; 396: 248-257.
    CrossrefPubMedGoogle Scholar
  • 28 Kita K, Kawai K, Hirohata K. Changes in bone marrow blood flow with aging. J Orthop Res 1987; 5: 569-575.
    CrossrefPubMedGoogle Scholar
  • 29 MacPherson JN, Tothill P. Bone blood flow and age in the rat. Clin Sci Mol Med 1978; 54: 111-113.
    PubMedGoogle Scholar
  • 30 Roche B, Vanden-Bossche A, Normand M. et al. Validated laser Doppler protocol for measurement of mouse bone perfusion - response to age or ovariectomy with genetic background. Bone 2013; 55: 418-426.
    CrossrefPubMedGoogle Scholar
  • 31 Hodson E, Clayton HM, Lanovaz JL. The forelimb in walking horses 1. Kinematics and ground reaction forces. Equine Vet J 2000; 32: 287-294.
    CrossrefPubMedGoogle Scholar
  • 32 Dejardin LM, Arnoczky SP, Cloud GL. Determination of strain patterns in the normal equine hoof using photoelasticity: an in vitro study. Equine Vet J 1999; 31: 232-237.
    CrossrefPubMedGoogle Scholar
  • 33 Newlyn HA, Collins SN, Cope BC. et al. Finite element analysis of static loading in donkey hoof wall. Equine Vet J suppl 1998; 26: 103-110.
    PubMedGoogle Scholar