THE MERCK VETERINARY MANUAL
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Large Wounds in the Proximal Metatarsal Region in Horses

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Trauma to the dorsal and proximal metatarsal region is relatively frequent and may result in severe skin, tendon, and ligament injury; underlying bone may also be affected. Careful examination of the wound and the surrounding structures is required to detect involvement of additional structures, such as the joints. Initial repair of the skin defect should be attempted after thorough debridement and may require an expansion mesh technique and facilitation of drainage. The wound should be bandaged and the tarsal region immobilized for the first 2 wk. Wound dehiscence is common and necessitates removal of all suture material, an additional debridement, and application of a moist bandage. The wound has to heal by second intention and will always be recognizable by the scar tissue that will form. Scars may limit the motion of the talocrural joint. Sequestration of bone is common over the next 2 mo. To facilitate healing, bone fragments must be surgically removed once they have separated from the underlying bone. Complete healing takes months and requires prolonged medical attention.

Last full review/revision March 2012 by Stephen B. Adams, DVM, MS, DACVS; Joerg A. Auer, DrMedVet, Dr h c, MS, DACVS, DECVS; James K. Belknap, DVM, PhD, DACVS; Jane C. Boswell, MA, VetMB, CertVA, CertES (Orth), DECVS, MRCVS; Peter Clegg, MA, Vet MB, PhD, CertEO, DECVS, MRCVS; Andrew L. Crawford, BVetMed, CertES (Orth), MRCVS; Jean-Marie Denoix, DVM, PhD, Agregé; Marcus J. Head, BVetMed, MRCVS; C. Wayne McIlwraith, BVSc, PhD, DSc, FRCVS, DACVS, DACVSMR; James Schumacher, DVM, MS, DACVS, MRCVS; John Schumacher, DVM, MS, DACVIM; Roger K. W. Smith, MA, VetMB, PhD, DEO, DECVS, MRCVS; Chris Whitton, BVSc, FACVSc, PhD

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