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  Discussion on Arthroscopy of Sesamoid with a Twist
Author Message
Member:
Pblaw

Posted on Wednesday, Jun 25, 2003 - 8:09 pm:

Hello Dr. O.,
Well, my Arab, Fire, is in trouble again. He fractured his left rear inner sesamoid when he "woke up" in the middle of sedation while having his teeth floated in the equine dentist's stocks - similiar to a cow shoot - he was tied in there about 4 different ways and, well, you can imagine how he reacted to that situation when the sedation (apparently) wore off too soon.
So, upon diagnosis of the fracture about 5 days later, I scheduled surgery for the following week.
During the surgery I become very worried when 1.5 hours of surgery turned into 3.5 hours of surgery... I find out that, while the bone fragment removal was a super sucess, a scalpel blade broke off in Fire's fetlock and "migrated" so much that my vet could not retrieve it and sewed it up in the leg - between the skin and the bone. I am told it is in the best possible position for a scalpel inside a horse's fetlock to be. We are monitoring it for the next 6 weeks with x-rays.
I know that my vet did everything he could do to get it out then and feels horrible about the situation. He is an extremely well respected vet and surgeon. Fire had been under anesthesia a long time and Doc told me that he was nearing the line of causing more damage than he could prevent by getting it out right then. The question is - what happens next? I guess that I am sort of asking you for a second opinion. If this encapsulates in tissues - does it just stay there - and for how long? If he were to kick something would it dislodge? I mean its SHARP. And because of the crazy migration during the surgery - could it migrate around more? If it migrates to a bad place i.e., joint, ligament, tendon - how DO we get it out? I am also faced with my horse having a pre-existing condition (he is insured with major med. right now - but what about next year?) So - if you could - please advise on how I should handle the situation.
Thanks--
Moderator:
DrO

Posted on Thursday, Jun 26, 2003 - 6:57 am:

Jeez...could this get any worse? I can't imagine that it will be OK to leave it in place, but then again I cannot see the size and location. I would have radiographs taken documenting the location and have them sent to another qualified equine surgeon for a second opinion.
DrO
Member:
Pblaw

Posted on Saturday, Aug 2, 2003 - 9:26 am:

Update on Fire - he did undergo a second surgery by the same vet to remove the scalpel and all went well with that. At almost 2 months past his first surgery he is being turned out at night in a 30x30 paddock after 2 weeks of handwalking for 15 min per day. I hyDrOtherapy his leg everyday for 10-20 minutes and he has had 2 Shock Wave Therapy treatments and will have a third in two weeks and at that time we will ultrasound to check on his suspensory branch. I'm praying that he will return to his "awesome show horse self" again. How does this sound to you Dr. O?
Thanks--
Moderator:
DrO

Posted on Sunday, Aug 3, 2003 - 9:30 am:

Getting the scalpel piece out was the critical step. I will keep my fingers crossed.
DrO
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