| Abstrakt: |
Reasons for performing study Blackthorn ( Prunus spinosus) is recognised as causing infections and tissue reactions. Objectives To describe the presentation, diagnosis, treatment and outcome of blackthorn plant thorn synovitis in the horse. Study design Case series. Methods All cases in this prospective study presented with acute onset synovitis within 24 h of thorn penetration, had a standardised clinical assessment, surgical treatment and aftercare. Surgical treatment was performed within 24 h of presentation under general anaesthesia, using a 2-stage procedure: Stage 1: perisynovial technique. Ultrasound guided placement of a 20 gauge 35 mm needle marker that is used as a guide for electrosurgical dissection onto perisynovial thorn fragments. Stage 2: endoscopic technique. Using standard and novel portals to locate and remove thorn fragments and debris from synovial structures. Results Thirty-five cases met the study inclusion criteria over a 24 month period. Mean lameness score on presentation was 4/5 (range 1-5). The most commonly affected structures were fetlock joints (11/35) and tendon sheaths (10/35). Mean synovial fluid total protein was 50.5 g/l (range 18-116), and TNCC was 158 x 109 (range 21-412) on presentation and 12 x 109 (range 1-46) at 48 h post operatively. All synovial fluid cultures were negative. All horses were sound ( grade 0) at 5 days post operatively and all returned to full work. Conclusions There are a limited number of case series of blackthorn injury in humans; however, the consensus is that surgical treatment is required for a successful outcome. The 2-stage surgical procedure described, achieved accurate identification and removal of thorn material in all cases. In contrast to previous studies on synovial sepsis, these cases had a positive outcome despite high pre- and post operative synovial fluid total protein and TNCC. These findings suggest that thorn synovitis cases have a different aetiology from synovitis originating from sepsis or contamination. Ethical animal research: The study was reviewed and approved by the Ethics Committee, School of Veterinary Medicine and Science, University of Nottingham. Owners gave informed consent for their horses' inclusion in the study. Source of funding: None. Competing interests: None declared. [ABSTRACT FROM AUTHOR] |
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