Degloving injury of the distal aspect of the limb in a horse and preventing bone sequestrum formation using multiple, partial depth cortical fenestration

Abstract

Exposed or denuded bone is a common complication of wounds of the distal aspect of the limb. This clinical report describes the treatment of an extensive laceration of the right hindlimb of a 12-year-old Hungarian Warmblood Horse gelding, which was managed initially by application of hydrogel dressings to enhance autolytic debridement, subsequently, by cortical fenestration of the denuded cortical bone and by stimulating the production of granulation tissue to cover the exposed bone. An early radiographic sign of sequestrum formation (discrete changes in the outer cortex) was not seen after the injury. Six weeks later, the wound was completely covered with vascularized, healthy-appearing bed of granulation tissue, which was prepared for grafting using the punch technique. A reinforced bandage was applied for the following 7 weeks; the grafts were accepted by granulation tissue. The horse was discharged 20 weeks after admission and the owners were advised to maintain stall rest with hand walking for two weeks. Four years later the owner reported that the wound had completely healed with a good cosmetic outcome and the horse was being used in a carriage.