Discussion on Point of Hock Laceration
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Susan Lemer
New Member
Username: slemer
Post Number: 1
Registered: 5-2008
| | Posted on Tuesday, Jun 3, 2008 - 3:50 am: |   |
On May 3rd, my son’s 15 year old thoroughbred horse, Gus, inexplicably sliced open the skin over his left calcaneus while in his stall. The full skin thickness laceration is approximately 7” long and extends from the inside all the way around to the outside of his hock joint. Naturally, no sutures will hold this “active” area of skin, so treatments now consist of daily antibiotics (Tucaprim), 1gm of Bute per day 5 days a week, and twice a week the wound is cleansed and the bandaging changed. The bandage is a long padded soft cast - a Robert-Jones Bandage. So far, Gus has needed to be tranquilized for the procedure.
This bandage is applied with some tension beginning below his fetlock to just below his stifle to reduce movement of his hock and compress the now rapidly forming proud flesh. Our vet trimmed off the excess proud flesh today and reapplied the soft cast. He has suggested we consider skin grafts and a hard cast to “freeze” the motion of his hock, or face many months of this regime and confinement.
Gus is high strung and we are very concerned he would not tolerate the immobility of a hard cast and would do himself more harm. Gus consistently rests on his left side and would be unable to arise with his left hind leg immobilized. He would undoubtedly get cast in a cast. What do you suggest? I have attached pictures of the progress so far.
(The pictures, in order from left-to-right, top-to-bottom, are: May 3rd, day of injury; May 6th, Surgical Serum Drain; May 29th, proud fresh with hock flexed; May 29th, another angle of the injury; May 29th, yet another angle of the injury.)
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Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 20771
Registered: 1-1997
| | Posted on Tuesday, Jun 3, 2008 - 8:55 am: | |
I think the wound is healing fairly well under this regimen. Has the granulation bed closed completely over the wound or does that fissure go all the way through to the subcutaneous tissues? You still have a contraction to go through which will greatly reduce the size of the wound but it will not happen till the granulation bed covers the wound.
I agree with your veterinarian that immobilization will greatly aid healing in this location but if you feel the horse will not tolerate it you are stuck with continuing with what you have. There are some long term tranquilizers available that may help. For more on these see the articles on Prolixin and reserpine at Treatments and Medications for Horses » Sedatives & Anesthetics.
DrO |
Susan Lemer
New Member
Username: slemer
Post Number: 2
Registered: 5-2008
| | Posted on Tuesday, Jun 3, 2008 - 12:51 pm: | |
The granulation bed has not yet closed completely over the wound and the joint capsule is exposed - the fissure goes all of the way through to the subcutaneous tissues. Currently there are two islands of granulation tissue separated by the fissure which our vet said would remain that way until it was sutured (and cast) or managed to heal together on its own. |
Robert N. Oglesby DVM
Moderator
Username: dro
Post Number: 20780
Registered: 1-1997
| | Posted on Wednesday, Jun 4, 2008 - 9:04 am: | |
There are no joint capsules at this location perhaps the tendon sheath would be the synovial structure seen at this level. Good splinting should allow it to heal together on its own. I too would consider casting in such a manner as to leave the wound open through a hole in the cast or possibly consider an "oyster" type cast which is built around the leg then cut in half along the lateral and medial edge so it can be removed wound treated and then put back together using tape.
DrO |
