Equine Limb Perfusion

Step 1 – Illustration the Hoof Puncture Wound

Step 1 of three in equine limb perfusion procedure.


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Equine limb perfusion is a procedure used to treat infections deep within the hoof or other structures of the distal limb. Infections of the distal limb in a horse can pose career ending, if not life threatening, complications if not treated in a timely manner. Systemic administration of antibiotic agents are often not successful because the level of agent in the tissues of the limb cannot reach therapeutic levels. Regional perfusion delivers a high local concentration of antibiotic right where it is needed, and confines it to the affected limb where it can permeate all the surrounding tissues with a therapeutic dose, providing a rapid eradication of the infection before it does permanent damage to delicate structures within the limb. The procedure is broken down into three steps and illustrated with associated key anatomical structures to explain how the procedure works.

You are viewing Step 1 –  This is an illustration of a hoof puncture wound. These types of injuries are complicated to treat because they are contained within the hoof capsule. There are many structures which are involved, all in close proximity to each other. Within this tightly confined space and any inflammation of soft tissues can lead to impaired blood flow, and an inability to treat systemically with antibiotics.

View Step 2 – which illustrates how the limb is prepped for the perfusion procedure.

View Step 3 – which illustrates how the therapeutic dose permeates from the blood vessels into the surrounding tissues.

Key Elements of image:

  • Third metacarpal bone
  • Proximal phalanx bone (P1)
  • Middle phalanx bone (P2)
  • Distal phalanx bone (P3)
  • Distal sesamoid bone (navicular bone)
  • Proximal sesamoid bone
  • Metacarpophalangeal joint
  • Proximal interphalangeal joint
  • Distal interphalangeal joint
  • Deep digital flexor tendon
  • Superficial digital flexor tendon
  • Straight sesamoidean ligament
  • Oblique sesamoidean ligament
  • Collateral sesamoidean ligament
  • Impar distal sesamoidean ligament
  • Intersesamoidean ligament
  • Terminal arch
  • Coronal artery
  • Coronal vein
  • Dorsal rami of proximal phalanx
  • Palmar rami of proximal phalanx
  • Dorsal rami of middle phalanx
  • Palmar rami of middle phalanx
  • Lateromedial palmar anastamosis
  • Digital cushion