Arthroscopic Removal of Large Extensor Process Fragments in 18 Friesian Horses: Long-Term Clinical Outcome and Radiological Follow-Up of the Distal Interphalangeal Joint.
Authors: Compagnie Ellen, Ter Braake Frerik, de Heer Natascha, Back Willem
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Arthroscopic Management of Large Extensor Process Fragments in Friesians Large extensor process fragments occupying more than a quarter of the distal interphalangeal joint surface represent a significant orthopaedic challenge; this retrospective review of 18 Friesian horses examined the long-term outcomes of arthroscopic removal using a technique that creates a dissection plane between the common digital extensor tendon and the bony fragment, with piecemeal extraction via rongeurs and support from motorised synovial resection and radiofrequency instrumentation. Successful fragment removal was achieved in all 18 cases, with 14 of the 17 horses available for follow-up returning to intended use and only three retaining some degree of lameness. Postoperative radiographs demonstrated remodelling of the remaining extensor process and new subchondral bone formation at the fragment bed, indicating that functional reintegration of damaged joint tissues can occur even after extensive fragmentation. For practitioners managing DIJ pathology in heavy breeds, these findings suggest that arthroscopic fragmentation removal—despite the technical demands of accessing and mobilising large fragments—offers a realistic prospect of return to work, particularly when radiological evidence of bone remodelling is evident. The increased angle between the remodelled extensor process and the dorsal phalanx warrants further investigation as a potential prognostic indicator of functional recovery.
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Practical Takeaways
- •Arthroscopic removal of large extensor process fragments is a viable surgical option for Friesian horses with good functional recovery rates (82% return to work)
- •Motorized instruments and sharp dissection technique allow safe separation of the common digital extensor tendon from large fragments for complete removal
- •Expect radiographic evidence of remodeling and new bone formation post-operatively, which correlates with functional improvement even in larger defects
Key Findings
- •Arthroscopic removal of large extensor process fragments (>25% joint surface) was successfully completed in all 18 Friesian horses using motorized synovial resection and piecemeal extraction
- •14 of 17 horses with long-term follow-up (82%) returned to intended use, while 3 retained some degree of lameness
- •Postoperative radiographs showed increased angle of remodeled extensor process and subchondral bone remodeling at the fragment bed site