Metacarpophalangeal joint luxation with joint capsule rupture and bone exposure in a horse

A 300 kg, 11-month-old quarter horse filly was presented with a joint dislocation in the right anterior limb. The animal was attended at the Federal University of Pará (UFPA) Veterinary Hospital in September 2016, where it was reported that the horse was injured on a fence. On clinical examination, the dislocation of the metacarpophalangeal joint with a rupture of the joint capsule and exposure of bone surfaces was observed, however, with no rupture of the extensor and flexor tendons. Surgery was recommended and the patient was anaesthetised with detomidine (Dormiun V; Agener União, São Paulo, Brazil; 0.04 mg/kg), ketamine (Cetamin; Syntec, São Paulo, Brazil; 0.03 mg/kg/h) and guaiacol glyceryl ether (JA Saúde Animal, São Paulo, Brasil, 0.5 ml/kg/h) i.v. The reconstitution of the joint capsule, lateral collateral ligament (LCL) and the other soft tissues around the injury was performed. A chemical arthrodesis was performed, then the tissue approximation and finally the skin suture. Bandages were applied on the wound with hydrophobic cotton and a Robert-Jones dressing. Systemic treatment was performed with enrofloxacin (Zelotril 10%; Agener União, São Paulo, Brazil; 5 mg/kg) i.m., meloxicam (Maxicam 2%; São Paulo, Brasil; 0.6 mg/kg) i.v. during 10 and 20 days, respectively, then replacing the antibiotic with ceftiofur (Cef 50; Agener União, São Paulo, Brasil; 2.2 mg/kg) i.m. for another 22 days. An iodine solution was applied to the joint optimising arthrodesis. After three and a half months, the lesion was entirely healed and with good movement, so the patient was discharged. This case demonstrates that, with adequate treatment and attention, it is possible to recover the patient's quality of life.