Shockwave Case Studies

Case #1

This horse came out of the pasture after being kicked in the hind leg by another horse. Examination showed significant trauma to the lateral aspect of the proximal metatarsus (the outside of the hind leg just below the hock joint). A fragment of bone was recovered from the injury site, the wound was closed and radiographs were taken. See below:

Surgery was not an option for this patient, however we have began shockwave therapy over the injury site in attempt to get better healing time and have the horse return to full function. An updated radiograph is posted on the right to illustrate the effects of the therapy in this case.

Case #2

This horse had an acute injury, affecting a lower hind leg. The horse has had consistent swelling over the fetlock, positive flexions, and lameness in that limb for 2 months. Radiographs and ultrasound images are shown below:

This is a normal attachment of the lateral branch of the suspensory ligament to the lateral sesamoid bone.

This is abnormal showing pieces of the sesamoid bone pulled away with damage to the suspensory ligament. This is called an avulsion fracture.

Here is a radiograph showing the small fragments of bone that have been avulsed.

Here is a radiograph showing the lucency in the lateral sesamoid bone left behind after the avulsion fracture.

We are combining shockwave therapy and tildren therapy in order to repair this injury and stop the bone from resorbing further. Please see our lameness therapies page for further information about tildren therapy.

***Case #2 Follow-Up***

Here is a radiograph of the same horse, 18 months after the therapy. The lucency in the sesamoid bone has completely filled in and the horse is training sound.

Here is the oblique view showing no lucency in the sesamoid bone as well.

Case #3

This is a 4 year Thoroughbred mare that presented with a laceration below the left hock across the cannon bone. The laceration was closed with suture and left to heal. 3 weeks post closure, the wound developed proud flesh and had a draining tract that was consistently draining. Radiographs were taken and a sequestrum was discovered. (See Image 1 below) A sequestrum is a piece of bone that has been fractured from the original bone and is no longer receiving a blood supply. This results in a dead bone that is a constant supply of infection which leads to a draining tract through the skin as the body attempts to expel the infection. Without removal of this dead bone, the wound will continue to drain and never close. Typically, surgery is elected in order to remove the dead bone and scrape away the infected bone so the wound can heal. This surgery can be done standing under sedation or under general anesthesia. Instead of electing this costly and invasive surgery, shockwave treatment was done. The horse received two therapy sessions one week apart. The proud flesh reduced and the wound closed with no more draining. Two weeks after the second session, a new radiograph was taken (see image 2 below). The sequestrum has been completely resorbed and the bone has began to heal. The horse was back in work within a few days of the second radiograph with no lameness.