Download Evaluation of Risk Factors Associated With Cast Complications in

WOUND & ORTHOPEDIC MANAGEMENT
Evaluation of Risk Factors Associated With Cast
Complications in Horses: 398 Cases (1997–2006)
John C. Janicek, DVM, MS, Diplomate ACVS*;
Scott R. McClure, DVM, PhD, Diplomate ACVS;
Tim B. Lescun, BVSc, MS, Diplomate ACVS; Stefan Witte, DVM, Diplomate ACVS;
Carly R. Whittal, DVM; and Canaan Whitfield, DVM
Cast complications occur in 50% of cases. Bandage casts have fewer complications, and casting the
limb flexed increases complications. Authors’ addresses: Department of Veterinary Medicine and
Surgery, University of Missouri, 900 East Campus Drive, Columbia, MO 76227 (Janicek and Whittal);
Department of Veterinary Clinical Sciences, Iowa State University, 1600 South 16th Street, Ames, IA
50011-1250 (McClure); Department of Veterinary Clinical Sciences, Purdue University, 625 Harrison
Street, West Lafayette, IN 47907 (Lescun); and Department of Large Animal Medicine, University of
Georgia, 501 DW Brooks Drive, Athens, GA 30602 (Witte and Whitfield). e-mail: jcjanicek@
yahoo.com. *Corresponding author. © 2011 AAEP.
1.
Introduction
Complications associated with casting are recognized. Limited data are available about incidence
and risk factors of cast complications. The objective of this study was to identify complications and
risk factors for cast complications.
2.
Materials and Methods
This study was a multicenter retrospective case series involving 398 horses with half- or full-limb
casts. Medical records were reviewed, and data,
including signalment, initial problem, limb affected,
reason for casting, type of cast, limb position, and
complications were recorded. Multiple logistic regression was used to assess associations between
variables and incidence of complications.
Research Abstract
NOTES
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2011 Ⲑ Vol. 57 Ⲑ AAEP PROCEEDINGS
3.
Results
In 49.5% of horses, a cast complication occurred.
Complications occurred in 34% of bandage casts and
52% of traditional casts. Of 197 horses with complications, 77% exhibited clinical signs, most commonly increased lameness and visible sores. Cast
sores were the most common complication (45%); 5%
of the casts broke, and 0.7% of horses developed a
secondary fracture. The median time to complications being noted was 12 days for traditional casts
and 8 days for bandage casts. Limbs cast in a
flexed position had complications 71% of the time
compared with neutral (48%) and extended (47%)
positions. Institution (0.014), cast type (0.001), and
limb position (0.016) were found to be significant
factors for developing complications.
WOUND & ORTHOPEDIC MANAGEMENT
4.
Discussion
Results indicate that nearly one-half of all equine
patients requiring cast application will encounter
some type of cast complication. Limbs cast in a
flexed position had complications 71% of the time
compared with neutral (48%) and extended (47%)
positions. Cast complications occur in 50% of the
cases. Bandage casts have fewer complications,
and casting the limb flexed increases complications.
AAEP PROCEEDINGS Ⲑ Vol. 57 Ⲑ 2011
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