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Distal limb cast sores in horses : risk factors and early detection using thermography

Tamara Levet (UGent) , Ann Martens (UGent) , Lindsey Devisscher (UGent) , Luc Duchateau (UGent) , Lies Bogaert (UGent) and Lieven Vlaminck (UGent)
(2009) EQUINE VETERINARY JOURNAL. 41(1). p.18-23
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Abstract
Reasons for performing stud-v: There is a lack of evidence-based data on the prevalence, outcome and risk factors of distal limb cast sores, and no objective tool has been described for the early detection of cast sores. Objectives: To investigate the prevalence, location, outcome and risk factors of cast sores after application of a distal limb cast and to determine whether static thermography of the cast is a valuable tool for the assessment of sores. Methods: A prospective study was conducted on horses treated with a distal limb cast. At each cast removal, cast sores were graded as superficial sores (SS), deep dermal sores (DS) or full thickness skin ulcerations (FS). In several cases, a thermographic evaluation of the cast was performed immediately prior to removal and differences in temperature (Delta T) between the coolest point of the cast and 2 cast regions predisposed for sore development (dorsoproximal mc/mtIII and palmar/plantar fetlock) were calculated. Results: Mean +/- s.d. total casting time of 70 horses was 31 +/- 18 days. Overall, 57 legs (81%) developed at least SS. Twenty-four legs (34%) ultimately developed DS and one horse had an FS. Multivariable analysis showed that the severity of sores was positively associated with increasing age (OR: 1.111, P = 0.028), a normal (vs. swollen) limb (OR: 3.387, P = 0.023) and an increase in total casting time (OR per week: 1.363, P = 0.002). The thermographic evaluation (35 casts) revealed that the severity of sores was positively associated with increasing Delta T (OR: 2.100, P = 0.000-5). The optimal cut-off values for the presence of SS and DS were set at, respectively, Delta T = 2.3 and 4.3 degrees C. Conclusion and potential relevance: Distal limb cast is a safe coaptation technique with increasing risk of developing sores with time. Thermography is a valuable and rapid clinical tool to monitor the development of cast sores.
Keywords
IN-VITRO, BONE, IMMOBILIZATION, INTERPHALANGEAL JOINT ARTHRODESIS, thermographic detection, risk factors, cast sores, distal limb, horse

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MLA
Levet, Tamara, et al. “Distal Limb Cast Sores in Horses : Risk Factors and Early Detection Using Thermography.” EQUINE VETERINARY JOURNAL, vol. 41, no. 1, 2009, pp. 18–23, doi:10.2746/042516408X343046.
APA
Levet, T., Martens, A., Devisscher, L., Duchateau, L., Bogaert, L., & Vlaminck, L. (2009). Distal limb cast sores in horses : risk factors and early detection using thermography. EQUINE VETERINARY JOURNAL, 41(1), 18–23. https://doi.org/10.2746/042516408X343046
Chicago author-date
Levet, Tamara, Ann Martens, Lindsey Devisscher, Luc Duchateau, Lies Bogaert, and Lieven Vlaminck. 2009. “Distal Limb Cast Sores in Horses : Risk Factors and Early Detection Using Thermography.” EQUINE VETERINARY JOURNAL 41 (1): 18–23. https://doi.org/10.2746/042516408X343046.
Chicago author-date (all authors)
Levet, Tamara, Ann Martens, Lindsey Devisscher, Luc Duchateau, Lies Bogaert, and Lieven Vlaminck. 2009. “Distal Limb Cast Sores in Horses : Risk Factors and Early Detection Using Thermography.” EQUINE VETERINARY JOURNAL 41 (1): 18–23. doi:10.2746/042516408X343046.
Vancouver
1.
Levet T, Martens A, Devisscher L, Duchateau L, Bogaert L, Vlaminck L. Distal limb cast sores in horses : risk factors and early detection using thermography. EQUINE VETERINARY JOURNAL. 2009;41(1):18–23.
IEEE
[1]
T. Levet, A. Martens, L. Devisscher, L. Duchateau, L. Bogaert, and L. Vlaminck, “Distal limb cast sores in horses : risk factors and early detection using thermography,” EQUINE VETERINARY JOURNAL, vol. 41, no. 1, pp. 18–23, 2009.
@article{671415,
  abstract     = {{Reasons for performing stud-v: There is a lack of evidence-based data on the prevalence, outcome and risk factors of distal limb cast sores, and no objective tool has been described for the early detection of cast sores.
Objectives: To investigate the prevalence, location, outcome and risk factors of cast sores after application of a distal limb cast and to determine whether static thermography of the cast is a valuable tool for the assessment of sores.
Methods: A prospective study was conducted on horses treated with a distal limb cast. At each cast removal, cast sores were graded as superficial sores (SS), deep dermal sores (DS) or full thickness skin ulcerations (FS). In several cases, a thermographic evaluation of the cast was performed immediately prior to removal and differences in temperature (Delta T) between the coolest point of the cast and 2 cast regions predisposed for sore development (dorsoproximal mc/mtIII and palmar/plantar fetlock) were calculated.
Results: Mean +/- s.d. total casting time of 70 horses was 31 +/- 18 days. Overall, 57 legs (81%) developed at least SS. Twenty-four legs (34%) ultimately developed DS and one horse had an FS. Multivariable analysis showed that the severity of sores was positively associated with increasing age (OR: 1.111, P = 0.028), a normal (vs. swollen) limb (OR: 3.387, P = 0.023) and an increase in total casting time (OR per week: 1.363, P = 0.002). The thermographic evaluation (35 casts) revealed that the severity of sores was positively associated with increasing Delta T (OR: 2.100, P = 0.000-5). The optimal cut-off values for the presence of SS and DS were set at, respectively, Delta T = 2.3 and 4.3 degrees C.
Conclusion and potential relevance: Distal limb cast is a safe coaptation technique with increasing risk of developing sores with time. Thermography is a valuable and rapid clinical tool to monitor the development of cast sores.}},
  author       = {{Levet, Tamara and Martens, Ann and Devisscher, Lindsey and Duchateau, Luc and Bogaert, Lies and Vlaminck, Lieven}},
  issn         = {{0425-1644}},
  journal      = {{EQUINE VETERINARY JOURNAL}},
  keywords     = {{IN-VITRO,BONE,IMMOBILIZATION,INTERPHALANGEAL JOINT ARTHRODESIS,thermographic detection,risk factors,cast sores,distal limb,horse}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{18--23}},
  title        = {{Distal limb cast sores in horses : risk factors and early detection using thermography}},
  url          = {{http://dx.doi.org/10.2746/042516408X343046}},
  volume       = {{41}},
  year         = {{2009}},
}

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