Can Online Teaching of Radiographic Anatomy Replace Conventional On-Site Teaching? A Randomized Controlled Study.

Different modalities such as lectures, dissections, 3D models, and online learning are used for teaching anatomy. To date, online learning has been considered a useful additional didactic tool. This study aimed to compare veterinary students' performance in radiographic anatomy (radio-anatomy) after online or classroom-based teaching to assess the extent to which the two methods were interchangeable. Three strategies were compared in a cohort of 83 learners. Students were committed to online learning only, online learning with the use of specimen equine bones, or learning on conventional radiographs with specimen equine bones. At baseline (pre-test), scores from a mental rotation test and radio-anatomy knowledge test were similar between groups. After training (post-test), scores in mental rotation and radio-anatomy significantly increased by 6.7/40 units (95% CI: 5.2-8.2; p < .001) and 5.1/20 units (95% CI: 4.3-5.9; p < .001), respectively. There was no difference in scores for mental rotation and radio-anatomy knowledge between groups at post-test. Gender influenced the mental rotation, with men scoring significantly higher than women at pre-test (M = 23.0, SD = 8.8 vs. M = 16.5, SD = 6.9; p = .001) and post-test (M = 32.1, SD = 5.5 vs. M = 22.7, SD = 8.6; p < .001). However, radio-anatomy knowledge was not influenced by gender. These results suggest radio-anatomy teaching can be safely achieved with either conventional radiographs or online resources. This is of interest since, due to the COVID-19 outbreak, rapidly changing from on-site to online methods for teaching veterinary medical education proved necessary.

Apprendre l'anatomie radiographique en présentiel ou en ligne ? Une étude randomisée contrôlée.

Résumé L'enseignement de l'anatomie repose sur diverses techniques: les cours, les dissections, les modèles 3D ou encore les supports en ligne. Ces derniers sont généralement considérés comme des moyens d'apprentissage complémentaires. Cette étude vise à comparer les performances des étudiants vétérinaires (N=83) en anatomie radiographique (radioanatomie) après un apprentissage en ligne ou conventionnel, et de voir dans quelle mesure ces méthodes sont interchangeables. Trois stratégies sont comparées : apprentissage en ligne exclusif, apprentissage en ligne avec des os de chevaux, apprentissage sur radiographies conventionnelles avec des os de chevaux. Les performances au test de rotation mentale et au test de connaissance en radioanatomie sont similaires entre les 3 groupes à la base, lors du test préliminaire. Après l'apprentissage (test final), les scores de rotation mentale et de radioanatomie augment significativement de 6.7/40 points (CI : 5.2­8.2; p < .001) et de 5.1/20 points (CI: 4.3­5.9; p< .001). Il n'y a pas de différence entre les groupes pour les scores de rotation mentale et de radioanatomie après l'apprentissage. Le score de rotation mentale est influencé par le genre, et significativement plus élevé chez les hommes que chez les femmes au test préliminaire (M= 23.0, SD = 8.8 vs. M= 16.5, SD= 6.9; p= .001) et au test final (M= 32.1, SD= 5.5 vs. M= 22.7, SD= 8.6; p< .001). Les performances en radioanatomie ne sont pas influencées par le genre. Ces résultats suggèrent que l'enseignement de la radioanatomie peut être réalisé en présentiel avec des radiographies conventionnelles ou en ligne. Cette interchangeabilité entre apprentissage en présentiel et en distanciel est intéressante au regard des impératifs liés aux crises sanitaires, et des besoins d'adaptation rapide en distanciel. This translation was provided by the authors. To view the original article visit: https://doi.org/10.3138/jvme-2021-0153.

Accuracy of computed tomographic arthrography for assessment of articular cartilage defects in the ovine stifle.

Articular cartilage defects are one of the features of osteoarthritis in animals and humans. Early detection of cartilage defects is a challenge in clinical veterinary practice and also in translational research studies. An accurate, diagnostic imaging method would be desirable for detecting and following up lesions in specific anatomical regions of the articular surface. The current prospective experimental study aimed to describe the accuracy of computed tomographic arthrography (CTA) for detecting cartilage defects in a common animal model used for osteoarthritis research, the ovine stifle (knee, femoropatellar/femorotibial) joint. Joints in cadaver limbs (n = 42) and in living animals under anesthesia (n = 13) were injected with a contrast medium and imaged using a standardized CT protocol. Gross anatomy and histological assessment of specific anatomic regions were used as a gold standard for the evaluation of sensitivity, specificity, negative predictive value, and positive predictive value for CTA identification of articular cartilage defects in those regions. Pooled estimated sensitivity and specificity were 90.32% and 97.30%, respectively, in cadaver limbs, and 81.82% and 95.24%, respectively, in living animals. Pooled estimated positive predictive value and negative predictive values were 98.25% and 85.71%, respectively, in cadaver limbs, and 81.82% and 95.24%, respectively, in living animals. The delineation of cartilage surface was good for anatomical regions most frequently affected by cartilage defects in the ovine stifle: medial femoral condyle, medial tibial condyle, and patella. This study supported the use of CTA as an imaging technique for detecting and monitoring articular cartilage defects in the ovine stifle joint.

Cardiorespiratory parameters in the awake pigeon and during anaesthesia with isoflurane.

OBJECTIVE: To determine baseline cardiovascular and respiratory variables in the awake pigeon, and to assess those variables during anaesthesia at the individual minimal anaesthetic concentration (MAC) of isoflurane during spontaneous breathing. STUDY DESIGN: Prospective, experimental trial. ANIMALS: Seven healthy adult pigeons weighing a mean ± standard deviation (SD) of 438 ± 38 g. METHODS: Heart rate (HR), heart rhythm, respiratory rate (fR), end-expired carbon dioxide tension (Pe'CO2), indirect systolic arterial pressure (SAP) and cloacal temperature (T) were measured in birds in the awake state (after acclimatization to handling). Two weeks later, the pigeons were anaesthetized with isoflurane in order to determine their MAC and evaluate the same cardiovascular and respiratory variables during a further 40 minutes of isoflurane anaesthesia. RESULTS: In the awake pigeon, mean ± SD HR, SAP, fR, Pe'CO2 and T were, respectively, 155 ± 28 beats minute(-1), 155 ± 21 mmHg, 34 ± 6 breaths minute(-1), 38 ± 8 mmHg (5.1 ± 1.1 kPa) and 41.8 ± 0.5 °C. Mean isoflurane MAC was 1.8 ± 0.4%. During maintenance of anaesthesia at MAC, although no significant decreases between values obtained in the awake and anaesthetized states emerged in HR or respiratory rate, significant decreases in SAP and cloacal temperature and an increase in Pe'CO2 were observed. No arrhythmia was identified in awake pigeons, whereas second- and third-degree atrioventricular blocks occurred under isoflurane. CONCLUSIONS AND CLINICAL RELEVANCE: Isoflurane MAC in pigeons appeared to be higher than in other avian species. Isoflurane anaesthesia in pigeons resulted in hypercapnia, hypotension, mild hypothermia and second- and third-degree atrioventricular blocks.

Validation of a psychometric instrument to assess motivation in veterinary bachelor students.

There are indications that motivation correlates with better performance for those studying veterinary medicine. To assess objectively whether motivation profiles influence both veterinary students' attitudes towards educational interventions and their academic success and whether changes in curriculum can affect students' motivation, there is need for an instrument that can provide a valid measurement of the strength of motivation for the study of veterinary medicine. Our objectives were to design and validate a questionnaire that can be used as a psychometric scale to capture the motivation profiles of veterinary students. Question items were obtained from semi-structured interviews with students and from a review of the relevant literature. Each item was scored on a 5-point scale. The preliminary instrument was trialed on a cohort of 450 students. Responses were subjected to reliability and principal component analysis. A 14-item scale was designed, within which two factors explained 53.4% of the variance among the items. The scale had good face, content, and construct validities as well as a good internal consistency (Cronbach's alpha=.88).

Competency frameworks: which format for which target?

In veterinary medical education, it is now necessary to design competency frameworks (CFs) that list expected competencies at graduation. Three different CFs with different formats and contents have been published in Europe, such as the Day One Skills (DOS), the recommendations of the World Organization for Animal Health(OIE), and the Veterinary Professional (VetPro). In the current study, on the basis of a survey among Belgian veterinarians, a fourth document was designed that lists the necessary knowledge, skills, and attitudes grouped into families according to professional situations. The objectives of this study were to assess the perception of CFs by various categories of stakeholders, identify the possible uses of CFs, and determine whether one format should be preferred to another. We used a qualitative approach based on semi-structured face-to-face interviews with different stakeholders after they had reviewed the four different documents (CFs). This study showed that an obligation to design CFs was clearly perceived by academic and professional authorities. Teachers and veterinarians may be either enthusiastic or apprehensive about CFs, while students perceive the usefulness of the documents to plan and assess their learning objectives. Three main roles of CFs were identified: they can be used as communication tools, regulatory tools, or educational tools. However, not one of the documents used in this study was perceived to fulfill all roles. It is therefore likely that no one ideal document yet exists and a combination of formats is necessary.

CT-guided injection technique into intervertebral discs in the ovine lumbar spine.

PURPOSE: Disc injection to create intervertebral (IVD) disc degeneration (IVDD) has been reported in ovine models, but the techniques have not been thoroughly described. The current ex vivo study aimed to evaluate a computed tomography (CT)-guided injection technique into IVDs in the ovine lumbar spine. METHODS: Insertion of needles into the nucleus pulposus was assessed by gross anatomic dissection in two lumbar segments (group A), and injection of liquid within the disc was assessed by discography in six segments (group B). RESULTS: The pathway of the needle was simulated on computer after an initial CT scan, followed by control of the insertion process via a laser beam and monitoring scans. In group A, 20 insertions were assessed and 17 needles (85 %) were successfully positioned in the nucleus pulposus. In group B of 30 injections, the rate of success was 90 %. CONCLUSIONS: The current study provides useful clinical information that will help surgeons working with an ovine model for research on IVDD. This model could also be useful to train less experienced surgeons or radiologists to disc injection. This CT-guided injection seems to offer several advantages such as ease of use, good success rate and safety to important nervous and vascular structures.

Magnetic resonance imaging (MRI) anatomy of the ovine stifle.

OBJECTIVE: To describe magnetic resonance imaging (MRI) anatomy of the ovine stifle and investigate meniscotibial and cruciate ligaments anatomy. STUDY DESIGN: Descriptive ex vivo study. ANIMALS: Pelvic limbs (n = 44) from 22 adult Texel ewes. METHODS: Forty limbs (n = 40) were scanned using 3 Tesla MRI before gross anatomic dissection. Two other limb pairs were frozen and transected to obtain sections that were compared with MRI images for identification of anatomic structures. RESULTS: In all stifles, the craniomedial bundle of the cranial cruciate ligament inserted caudally to the cranial attachment of the medial meniscus. No transverse intermeniscal ligament was identified in 80% of stifles, whereas a few small ligamentous fibers were seen crossing from 1 cranial horn to the other in 20% of stifles. There was good differentiation of menisci, ligaments, and synovial cavities on MRI images. Two bundles were identified in all cranial cruciate ligaments on MRI. Sensitivity and specificity of 3T MRI for detection of transverse intermeniscal ligament were 42% and 84%, respectively. CONCLUSION: 3T MRI provided well defined reference images for menisci, synovial cavities, and most ligaments.

An Ex Vivo Pilot Study to Assess the Feasibility of 3D Printing of Orbital Implants in Horses.

Severe ophthalmic conditions such as trauma, uveitis, corneal damage, or neoplasia can lead to eye removal surgery. Poor cosmetic appearance resulting from the sunken orbit ensues. The aim of this study was to demonstrate the feasibility of manufacturing a custom-made 3D-printed orbital implant made of biocompatible material for the enucleated horse and usable in conjunction to a corneoscleral shell. Blender, a 3D-image software, was used for prototype design. Twelve cadaver heads of adult Warmbloods were collected from the slaughterhouse. On each head, one eye was removed via a modified transconjunctival enucleation while the contralateral eye was kept intact as control. Ocular measurements were collected on each enucleated eye with the help of a caliper and used for prototype sizing. Twelve custom-made biocompatible porous prototypes were 3D-printed in BioMed Clear resin using the stereolithography technique. Each implant was fixated into the corresponding orbit, within the Tenon capsule and conjunctiva. Heads were frozen and thin slices were then cut in the transverse plane. A scoring system based on four criteria (space for ocular prosthesis, soft-tissue-coverage, symmetry to the septum, and horizontal symmetry), ranging from A (proper fixation) to C (poor fixation), was developed to evaluate implantation. The prototypes reached our expectations: 75% of the heads received an A score, and 25% a B score. Each implant cost approximately 7.30€ and took 5 hours for 3D-printing. The production of an economically accessible orbital implant made of biocompatible porous material was successful. Further studies will help determine if the present prototype is usable in vivo.

Effect of Volumes of Solutions on Intraocular Pressure During Intravitreal Injection of Low Dose Gentamicin in Horses With Recurrent Uveitis: A Randomized Controlled Study.

Horses with recurrent uveitis can be treated by intravitreal injection of low dose gentamicin under sedation and after local anesthetic techniques including the retrobulbar nerve block. Since it is reported that retinal degeneration can be secondary to an acute increase of intraocular pressure (IOP), the current randomized controlled study was carried out in order to investigate the changes in IOP following retrobulbar anesthesia, with two different volumes of local anesthetic (lidocaine) solution (10 and 5 mL), and intravitreal injection of 6 mg gentamicin in two different volumes of solution (0.3 and 0.15 mL). Multivariate regression showed that IOP was significantly lower in the pathologic eye at baseline (estimated effect size -6.1 mmHg; P = .0001) and after sedation (estimated effect size -9.4 mmHg; P < .0001). The IOP was significantly higher after a 10 mL block (P .0002) but this effect was very small (+0.5 mmHg). There was no significant difference in IOP after the injection of 0.15 or 0.3 mL solution of gentamicin. There was no significant combined effect of the volume of local anesthetic used for the block and the volume of the gentamicin solution. Since the expected anesthetic effects (desensitization and akinesia) were met in all cases, the smaller volume of 5 mL of lidocaine solution would be preferable for retrobulbar block for intravitreal injections, while intravitreal injections volumes of 0.15 and 0.30 mL can be used indifferently.

Volumetry of ovine incisors dental pulp for further regenerative therapy.

Mesenchymal stem cells (MSCs) are used for regenerative therapy. Dental pulp MSCs make extracted wisdom teeth a useful resource in humans. Preclinical validation of regenerative therapies requires large animal models such as the sheep. Since stem cells can be retrieved from the dental pulp of ovine incisors, the best age to extract a maximal volume of dental pulp needs to be defined. The objective of this ex vivo study was to quantify incisors dental pulp volume, in sheep of various age. Three jaws were dedicated to histology (one per age group); the others were imaged with a computed tomography scanner [3 years-old (n = 9), 4 (n = 3) and 6 (n = 5)]. The incisors dental pulp volume was measured after 3D reconstruction. Multiple linear regression showed that dental pulp volume of ovine incisors decreases with age (ß-estimate = -3.3; p < 0.0001) and teeth position from the more central to the more lateral (ß-estimate = -4.9; p = 0.0009). Weight was not a relevant variable in the regression model. The dental pulp volume ranged from 36.7 to 19.6 mm3 in 3-year-old sheep, from 23.6 to 11.3 in 4-year-old sheep, and from 19.4 to 11.5 in 6-year-old sheep. The pulp volume of the most central teeth (first intermediate) was significantly higher than the most lateral teeth (corner). Haematoxylin-Eosin-Safran of the whole incisors, and of isolated dental pulps demonstrated a similar morphology to that in humans. The first intermediate incisor of 3-year-old sheep should be selected preferentially in preclinical research to retrieve the highest volume of dental pulp.

Lesion Extension and Neuronal Loss after Spinal Cord Injury Using X-Ray Phase-Contrast Tomography in Mice.

Following spinal cord injury (SCI) the degree of functional (motor, autonomous, or sensory) loss correlates with the severity of nervous tissue damage. An imaging technique able to capture non-invasively and simultaneously the complex mechanisms of neuronal loss, vascular damage, and peri-lesional tissue reorganization is currently lacking in experimental SCI studies. Synchrotron X-ray phase-contrast tomography (SXPCT) has emerged as a non-destructive three-dimensional (3D) neuroimaging technique with high contrast and spatial resolution. In this framework, we developed a multi-modal approach combining SXPCT, histology and correlative methods to study neurovascular architecture in normal and spinal level C4-contused mouse spinal cords (C57BL/6J mice, age 2-3 months). The evolution of SCI lesion was imaged at the cell resolution level during the acute (30 min) and subacute (7 day) phases. Spared motor neurons (MNs) were segmented and quantified in different volumes localized at and away from the epicenter. SXPCT was able to capture neuronal loss and blood-brain barrier breakdown following SCI. Three-dimensional quantification based on SXPCT acquisitions showed no additional MN loss between 30 min and 7 days post-SCI. In addition, the analysis of hemorrhagic (at 30 min) and lesion (at 7 days) volumes revealed a high similarity in size, suggesting no extension of tissue degeneration between early and later time-points. Moreover, glial scar borders were unevenly distributed, with rostral edges being the most extended. In conclusion, SXPCT capability to image at high resolution cellular changes in 3D enables the understanding of the relationship between hemorrhagic events and nervous structure damage in SCI.

A controlled study evaluating a novel surgical treatment for kissing spines in standing sedated horses.

OBJECTIVE: To compare the results of a novel minimally invasive surgical technique with intralesional corticosteroid medication, as treatment for overriding dorsal spinous processes (ORDSP) in horses. STUDY DESIGN: Retrospective controlled clinical case series. ANIMALS: Horses (n = 68) with ORDSP. METHODS: ORDSP was diagnosed based on history, clinical, and radiographic examination. All narrowed spaces were treated. Horses undergoing medical treatment had methylprednisolone acetate injected directly in the affected space under radiographic control. Surgical cases had interspinous ligament desmotomy (ISLD) using Mayo scissors; supraspinous ligaments were left intact. All horses had the same controlled exercise plan and returned to work 3-6 weeks after treatment. RESULTS: Methylprednisolone was administered in 1-7 spaces in 38 cases, compared with ISLD in 3-8 spaces in 37 cases. Thirty-four horses (89%) treated medically initially resolved signs of back compared with 35 horses (95%) treated surgically. From these, back pain recurred in 19 medical cases and in none of the surgical cases. Horses having ISLD were 24 times more likely to experience long-term resolution of signs of back pain (OR 24; 95%CI: 5-115; P = < .0001). Repeat radiographs in 19 surgical cases indicated that interspinous spaces widened significantly postoperatively (P = < .0001). CONCLUSIONS: This surgical technique allowed horses with back pain and radiographic ORDSP to return to work without further clinical signs of back pain and to show radiographic evidence of improvement.

Understanding veterinary practitioners' decision-making process: implications for veterinary medical education.

Understanding how veterinary practitioners make clinical decisions, and how they use scientific information to inform their decisions, is important to optimize animal care, client satisfaction, and veterinary education. We aimed to develop an understanding of private practitioners' process of decision making. On the basis of a grounded-theory qualitative approach, we conducted a telephone survey and semi-structured face-to-face interviews. We identified a decision-making framework consisting of two possible processes to make decisions, five steps in the management of a clinical case, and three influencing factors. To inform their decision, veterinary surgeons rarely take the evidence-based medicine (EBM) approach. They consult first-opinion colleagues, specialists, laboratories, and the Internet rather than scientific databases and peer-reviewed literature, mainly because of limited time. Most interviewees suggested the development of educational interventions to better develop decision-making skills in veterinary schools. Adequate information and EBM tools are needed to optimize the time spent in query and assessment of scientific information, and practitioners need to be trained in their use.

Hyaluronidase 1 deficiency decreases bone mineral density in mice.

Mucopolysaccharidosis IX is a lysosomal storage disorder caused by a deficiency in HYAL1, an enzyme that degrades hyaluronic acid at acidic pH. This disease causes juvenile arthritis in humans and osteoarthritis in the Hyal1 knockout mouse model. Our past research revealed that HYAL1 is strikingly upregulated (~ 25x) upon differentiation of bone marrow monocytes into osteoclasts. To investigate whether HYAL1 is involved in the differentiation and/or resorption activity of osteoclasts, and in bone remodeling in general, we analyzed several bone parameters in Hyal1 -/- mice and studied the differentiation and activity of their osteoclasts and osteoblasts when differentiated in vitro. These experiments revealed that, upon aging, HYAL1 deficient mice exhibit reduced femur length and a ~ 15% decrease in bone mineral density compared to wild-type mice. We found elevated osteoclast numbers in the femurs of these mice as well as an increase of the bone resorbing activity of Hyal1 -/- osteoclasts. Moreover, we detected decreased mineralization by Hyal1 -/- osteoblasts. Taken together with the observed accumulation of hyaluronic acid in Hyal1 -/- bones, these results support the premise that the catabolism of hyaluronic acid by osteoclasts and osteoblasts is an intrinsic part of bone remodeling.

Ex vivo study correlating the stiffness of the ovine patellar tendon to age and weight.

Tendons play a crucial role in the musculoskeletal system. In humans, tendon injuries, especially chronic tendinopathy, are very common and the patellar tendon is a frequent location for tendinopathy or injuries. The biomechanical characteristics of the patellar tendon, such as elasticity and stiffness, are of paramount importance and constitute major outcome measures in research studies. We aimed to assess whether the stiffness of the healthy ovine patellar tendon changes with age and weight in a population of normal animals. Sixty-eight 'patella-patellar tendon-tibial tuberosity' units from thirty-four Ile-de-France ewes of body mass 65 to 95 kg, euthanized for reasons other than musculoskeletal diseases, underwent a tensile test providing a measure of the tendon stiffness. Animals were sorted into three categories of age (1-2 yo, 3-5 yo, 6-10 yo). We found a positive but not significant correlation between age category and stiffness (r = 0.22, p = 0.27). There was a significantly positive correlation between weight and stiffness (r = 0.39, p = 0.04). In conclusion, the study characterized biomechanical properties of healthy tendons, provided useful reference values, and established the basis for future biomechanical tests on healing tendons in sheep. The most appropriate sheep population for those future studies would be non-overweight young adults presenting with no lameness.

Non-clinical assessment of lubrication and free radical scavenging of an innovative non-animal carboxymethyl chitosan biomaterial for viscosupplementation: An in-vitro and ex-vivo study.

OBJECTIVE: Lubrication and free radical scavenging are key features of biomaterials used for viscosupplementation (VS) of joints affected by osteoarthritis (OA). The objective of this study was to describe the non-clinical performance characterization of KiOmedine® CM-Chitosan, a non-animal carboxymethyl chitosan, in order to assess its intended action in VS and to compare it to existing viscosupplements based on crosslinked hyaluronan (HA) formulations. METHOD: The lubrication capacity of the tested viscosupplements (VS) was evaluated in-vitro and ex-vivo. In-vitro, the coefficient of friction (COF) was measured using a novel tribological system. Meanwhile, an ex-vivo biomechanical model in ovine hindlimbs was developed to assess the recovery of join mobility after an intra-articular (IA) injection. Free radical scavenging capacity of HA and KiOmedine® CM-Chitosan formulations was evaluated using the Trolox Equivalent Antioxidant Capacity (TEAC) assay. RESULTS: In the in-vitro tribological model, KiOmedine® CM-Chitosan showed high lubrication capacity with a significant COF reduction than crosslinked HA formulations. In the ex-vivo model, the lubrication effect of KiOmedine® CM-Chitosan following an IA injection in the injured knee was proven again by a COF reduction. The recovery of joint motion was optimal with an IA injection of 3 ml of KiOmedine® CM-Chitosan, which was significantly better than the crosslinked HA formulation at the same volume. In the in-vitro TEAC assay, KiOmedine® CM-Chitosan showed a significantly higher free radical scavenging capacity than HA formulations. CONCLUSION: Overall, the results provide a first insight into the mechanism of action in terms of lubrication and free radical scavenging for the use of KiOmedine® CM-Chitosan as a VS treatment of OA. KiOmedine® CM-Chitosan demonstrated a higher capacity to scavenge free radicals, and it showed a higher recovery of mobility after a knee lesion than crosslinked HA formulations. This difference could be explained by the difference in chemical structure between KiOmedine® CM-Chitosan and HA and their formulations.

Use of Negative Pressure Wound Therapy in the Treatment of Limb Wounds: A Case Series of 42 Horses.

Traumatic limb injuries are common in horses. Negative pressure wound therapy (NPWT) has been proven to promote wound healing in human medicine. It has also been described for the treatment of wounds in horses. In this retrospective study, clinical records of 42 (n = 42) animals were assessed. Categories of wounds, duration of NPWT application, frequency of resetting the NPWT device, technical complications, and tolerance to the procedure were recorded. 42 wounds were classified as bony (n = 15; 36 %), articular (n = 14; 33 %), tenosynovial (n = 9; 21%), muscular (n = 2; 5%) and cutaneous (n = 2; 5 %). NPWT was used to help (1) first intention healing by preoperative (n = 3; 7 %) or postoperative (n = 7; 17%) application, (2) second intention healing (n = 31; 74%), and (3) delayed primary closure (n = 1; 2%). Duration of NPWT application ranged from 2 to 36 days (mean 11.5), with the system staying in place for periods ranging from 1 to 7 days (mean 4.5). In 69% (n = 29) of the cases, healing was considered satisfactory at discharge. 26 % (n = 11) of horses were discharged whilst ideally NPWT should have been continued. 2 animals (n = 2; 5%) were euthanized after surgery due to unrelenting pain. The procedure was well tolerated except in 1 horse who showed signs of discomfort at the first application. This study demonstrated that NPWT with long periods of application can be used successfully to manage various types of limb wounds.

Computed tomography to identify preoperative guidelines for internal fixation of the distal sesamoid bone in horses: an in vitro study.

OBJECTIVE: To assess the reliability of computed tomography (CT) to identify the direction of implant insertion for cortical screws along the longitudinal axis of intact (nonfractured) distal sesamoid bones. STUDY DESIGN: In vitro study. SAMPLE POPULATION: Cadaveric paired equine forelimbs (n=16). METHODS: Insertion of a cortical screw in lag fashion along the longitudinal axis of intact (nonfractured) distal sesamoid bones was evaluated in 2 groups (3.5 and 4.5 mm) of 8 paired limbs. In each group, the direction of the distal sesamoid bone was determined by CT (Equine XTC 3000 pQCT scanner). Screw placement was verified by specimen dissection. Implant direction was considered satisfactory if the entire screw length was within the distal sesamoid bone and not damaging the articular or flexural surfaces. RESULTS: In our sample and according to our criteria, the proportion of satisfactory direction of screws was 0.63 (5/8) for 4.5 mm implants, and 0.87 (7/8) for 3.5 mm implants. CONCLUSIONS: CT is a useful imaging modality to identify anatomic landmarks for insertion of a 3.5 mm cortical screw in the distal sesamoid bone.

Anatomy and Ultrasound-Guided Injection of the Medial Branch of the Dorsal Ramus of the Cervical Spinal Nerves in the Horse: A Cadaveric Study.

OBJECTIVE: The aim of this study was to describe the anatomy of the nerves supplying the cervical articular process joint and to identify relevant anatomical landmarks that could aid in the ultrasound-guided location and injection of these nerves for diagnostic and therapeutic purposes. STUDY DESIGN: Twelve cadaveric equine necks were used. Five necks were dissected to study the anatomy of the medial branch of the dorsal ramus of the cervical spinal nerves 3 to 7. Relevant anatomical findings detected during dissections were combined with ultrasonographic images obtained in one other neck. Six additional necks were used to assess the accuracy of ultrasound-guided injections of the medial branch with blue dye. RESULTS: Each examined cervical articular process joint, except for C2 to C3, presented a dual nerve supply. The articular process joints were found to be in close anatomical relationship with the medial branch of the dorsal ramus of the cervical spinal nerve exiting from the intervertebral foramen at the same level, and with the medial branch of the dorsal ramus of the cervical spinal nerve exiting from the intervertebral foramen one level cranial to the articular process joint of interest. A total of 55 nerves were injected under ultrasonographic guidance, 51 of which were successfully stained. CONCLUSION: The current study provided new detailed information regarding the innervation of the cervical articular process joint. The medial branches of the dorsal rami of the cervical spinal nerves were injected with an accuracy that would be of clinical value. Our study offers the foundations to develop new diagnostic and therapeutic techniques for pain management in cervical articular process joint arthropathy in horses.