WOUNDS NEAR SYNOVIAL STRUCTURES

Wounds involving the synovial compartments of joints, tendon sheaths, and bursae can be debilitating and career if not life threatening injuries. Unlike juvenile forms of joint sepsis the most common route for inoculation of adult synovial structures is via direct penetration during wounding. Inoculation of these structures can be obvious from an open wound or more subtle from puncture wounds or extension from distant injury. It is vital to treatment success that wounds associated with synovial structures are considered contaminated until proven otherwise.

Horses with wounds of synovial structures can have obvious trauma with tissue disruption and/or loss or they may require examination due to very subtle wounds as with puncture trauma. Lameness is usually present but can vary in severity. Acute wounds that open a joint may not have lameness that would be typical of synovial sepsis but more consistent with the pain of only the wound itself. Many horses with open and draining septic joints do not demonstrate severe lameness until the outflow is occluded with granulation tissue. When this occurs or the wound is such that a closed synovial environment remains, the horse can demonstrate lameness of grades 4-5/5. […]