Authors of section

Author

Anton Fürst

Executive Editor

Jörg Auer

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Resection

1. Principles/General considerations

There are few reports describing surgical treatment of coccygeal fractures in horses.

In most horses the fractures are closed, but open fractures can occur.

Special cause of coccygeal injury may be improperly placed tail wraps.

Lateral or oblique lateral radiographs confirm the presence of a vertebral fracture.

Symptoms may include:

  • Neuropraxia of the motor nerves
  • Inability to move the tail
  • Inability to defecate properly
  • Muscle atrophy over the tail

Most horses with coccygeal fractures are managed conservatively. In some cases the fractures can be stabilized with plates, pins, and bone cement.

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2. Preparation and approach

This procedure is performed with the patient standing through the dorsal midline approach to the coccygeal region.

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3. Resection

Bone fragments are identified by visualization and palpation. They are removed by freeing them from muscle and ligamentous attachments.

Wound debridement is very important as well as the establishment of a drainage system.

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Sometimes the amputation of the tail distal to the injury is necessary.

Two flaps are created from the superior and inferior ending of the skin and sutured together.

Muscles are also dissected (see case example).

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4. Closure

The subcutaneous tissues, and skin are closed.

A stent bandage is applied and covered with an adhesive barrier drape to keep the incision clean and dry during recovery.

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5. Case example

22-year-old warm blood with an open infected fracture in Co7.

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Lytic and proliferative lesion of the coccygeal vertebra.

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The clinical photograph shows the surgical approach to the infected fracture.

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The clinical photograph shows the osteomyelitis of the coccygeal vertebra.

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This clinical photograph was taken after the resection of the infected bone.

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The clinical photograph shows the closure.

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6. Aftercare

Following surgery, antibiotics and NSAIDs are routinely administered for 3 days. If indicated, they need to be continued.

Routinely follow up radiographs are taken immediately after surgery and after 2 and 4 months.

The rehabilitation protocol includes 2 months of stall confinement, followed by 1 month of hand-walking, and 2 months of progressive exercise.

Only when the ataxia has completely disappeared, the horse can return to training or other activities.

plate fixation with atlantoaxial arthrodesis