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Biomedical subjects

G E Fackelman

Publications and source records attributed to G E Fackelman.

At least 19 recordsLinked to original sources

Preliminary studies on the vascular anatomy of the equine superficial digital flexor tendon.

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. No resulting intratendinous lesions could be documented on gross post mortem and histological examination at three, 10, or 35 days post operatively. There was mild paratendinous proliferation in all instances. In one horse, four intratendinous ligatures were placed within the medial and lateral borders of the contralateral tendon to isolate further from its blood supply a 10 cm segment. Gross lesions at 35 days post operatively included a marked paratendinous response involving the entire 10 cm segment, and a darkened, soft focus within the core of the tendon. Histopathology and electron microscopy demonstrated focal degeneration. It was concluded that the blood supply of the normal equine superficial digital flexor tendon is primarily intratendinous, rather than paratendinous as previously thought. The lesions in one horse similar to those in naturally occurring tendinitis supported a vascular aetiology of the disease, and set the groundwork for studies aimed at the development of a clinically relevant tendinitis model.

Angiography↗

Complications during treatment of traumatic disruption of the suspensory apparatus in Thoroughbred horses.

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. In 7 of 9 cases with infection confirmed by microbiologic culture, the horse had received surgical treatment; in 6 of those 7 cases, the infection involved the surgical site. Postoperative wound infection developed in 4 of 7 cases when the surgery was performed within 18 days of injury. In 3 cases, septic metacarpophalangeal arthritis developed, but it was unrelated to surgical procedures. Implant failure or loosening and infection led to euthanasia in 5 of 6 horses treated by internal fixation to stabilize the metacarpophalangeal joint. Three of 6 attempts to perform metacarpophalangeal arthrodesis by application of a bone plate to the dorsal aspect of the joint resulted in implant failure after 45 to 101 days. Major complications did not develop in 2 horses that were treated successfully.

Animals↗

Tendon surgery.

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Animals↗

Decalcified bone grafts in the horse.

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. The most compelling reason for the use of the substance is the elimination of the need of a harvesting operation on a patient already undergoing extensive surgery for the restitution of skeletal integrity.

Animals↗

Effect of exogenous hyaluronic acid on joint function in experimentally induced equine osteoarthritis: dosage titration studies.

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.

Animals↗

Effect of hyaluronic acid in naturally occurring and experimentally induced osteoarthritis.

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. Horses were worked for 2 more weeks and then were evaluated. A highly significant (P less than 0.01) increase in weight bearing on the treated limb was observed. Ten horses with clinical unilateral front limb lameness, involving a single joint, also were treated with 40 mg of hyaluronic acid. The day after the injection, the horses resumed training and were examined 2 weeks later. At that time, the horses were free from observable lameness, and this observation was corroborated by force plate data. According to their trainers, the horses' performance improved markedly after the injection and remained improved. Seemingly hyaluronic acid was beneficial when injected into the arthritic joints of these two groups of horses.

Animals↗