Didáctica ecuestre

22.10.06

Tipos de lesiones

Lesión ósea
La lesión ósea supone la pérdida de la posibilidad de sustentación en el sistema esqueleto/palancas. Los huesos rotos se conocen con la denominación huesos fracturados. Existen clases de fracturas muy diferentes: las fracturas completas constituyen una fisura o solución de continuidad cuya línea de fractura afecta a la totalidad del hueso; los huesos pueden estar rotos en uno o en varios sitios, pueden estar desmenuzados o simplemente agrietados. Su curación es lenta, si bien su consolidación tendrá lugar siempre que se aproximen los extremos es decir, siempre que se sitúe cada uno de ellos frente al otro- y se suprima el movimiento de los extremos del hueso o de los fragmentos del mismo.
Las fracturas se diagnostican mejor mediante los rayos X. La totalidad del sistema esquelético del hombre es relativamente accesible a los rayos X, pero a no ser para las extremidades, para hacer radiografías en el caballo y como consecuencia del grosor de sus tejidos, se necesita un sofisticado aparato de rayos X, del que otra parte no es fácil disponer.
Las fases regenerativas de la curación del hueso son parecidas a las de los tejidos blandos. En el caso del hueso, el resultado final probablemente sea el más perfecto debido a la homogeneidad de su estructura. Para conseguir una consolidación adecuada, es preciso inmovilizar las fracturas completas. En el caballo esto es casi imposible en una extremidad que soporta peso, si bien gracias al desarrollo de la cirugía ortopédica veterinaria mediante el empleo de clavos, placas y tornillos, en la actualidad pueden salvarse muchos caballos que hace una década tenían que ser sacrificados.
Las fisuras pueden tratarse con éxito sin necesidad de inmovilizar la extremidad. Las lesiones más frecuentes de este tipo son las cañas que manifiestan dolor. Los golpes localizados (riesgo que se hallan expuestos los huesos de los atletas) provocan pequeñas fracturas en la caña. La primera radiografía suele ser normal, si bien las posteriores muestran la formación del callo en el lugar en el que las minúsculas fracturas inician su consolidación. El callo es hueso neoformado y se descubre únicamente mediante los rayos X. En la terminología americana, esta lesión se conoce con la denominación de cañas con salientes.
Al principio, la cojera que descubre esta lesión puede ser insignificante si bien de repente aparece dolor que va en aumento, acompañado de cojera y de hipersensibilidad al tacto. El cuadro doloroso y la sensibilidad obligarán a por lo menos tres semanas de disminución de fracturas por golpes que pasan desapercibidas, evolucionan causando trastornos y en algunos casos se produce una fractura espontánea completa.

Lesión del periostio
El periostio es la envoltura o membrana externa de los huesos. En su origen y en las inserciones, los músculos, los ligamentos y los tendones se hallan unidos al periostio. Los desgarros, tirones y choques producen la rotura de sus pequeños vasos sanguíneos con la consiguiente hemorragia. Esta hemorragia se comporta como irritante del hueso, el cual, para protegerse, produce hueso de neoformación en forma de pequeñas crestas o protuberancias que pueden perjudicar la función normal si se hallan próximas a una articulación o a un tendón. Las hemorragias subperiósticas son asimismo causa del dolor intenso.

Lesión de las placas epifisarias
Los huesos largos o huesos de las extremidades crecen a partir de placas especializadas denominadas placas epifisarias. Antes de los dos años, los huesos largos del caballo no han alcanzado su crecimiento (osificación) total; en algunos huesos, como por ejemplo el cúbito, existe lámina epifisaria hasta que el animal tiene tres años como mínimo. En algunos estados de estrés y en el sobreentrenamiento, las citadas placas llegan a irritarse y se inflaman, proceso que se conoce como epifistis , es decir, inflamación de la placa epifisaria.

Lesión de las bolsas serosas
Las bolsas serosas son pequeñas colecciones de líquido distribuidas en diversas localizaciones del organismo, en zonas de posible fricción. Su función es evitar el rozamiento y con ello la lesión de la cara inferior de los músculos que las recubren. Las bolsas serosas pueden inflamarse. Cuando esto ocurre, aumentan de tamaño originando dolor intenso y disminución de movimientos.

Lesión de las articulaciones
La terminología correcta para designar las lesiones articulares es la de artritis. El vocablo artritis va acompañado de un adjetivo que no significa en absoluto que las lesiones articulares sean irreversibles. La lesión articular conocida con la denominación ósteo-artritis se produce cuando en la superficie de los huesos que constituyen la articulación se forman irregularidades que impiden la movilidad de la articulación.
Las articulaciones llegan a dislocarse cuando se someten a movimientos de amplitud superiores a la permitida por su constitución anatómica. Estos movimientos de amplitud excesiva pueden lesionar el tejido muscular circundante así como los ligamentos articulares.

Lesión de ligamentos
Los ligamentos sostienen las articulaciones. Por esta razón, el sobreestiramiento de los ligamentos ocasiona la pérdida de estabilidad de la articulación. En el caso del ligamento suspensor, desaparece la estabilidad a nivel de la articulación del menudillo y por debajo de la misma.

Lesión de los ligamentos interóseos
Estos ligamentos se hallan situados entre dos huesos próximos, como por ejemplo entre la caña y los peronés. Los desgarros de los ligamentos interóseos producen en primer lugar dolor y en segundo lugar una neoformación ósea; dependiendo de la localización del hueso neoformado, puede obstaculizarse la función normal. En las primeras fases después de producida la lesión, suele haber dolor de intensidad variable.

Lesión muscular
La lesión muscular origina movimientos ineficaces, incorrectos y desequilibrados. Como consecuencia del desgarro de las fibras existe debilidad muscular. La atrofia del músculo (desaparición de tejido muscular) se produce como consecuencia de su falta de utilización y/o por pérdida de la conducción como consecuencia de la lesión de nervios motores.

Lesión del tendón
Las lesiones del tendón se producen en su mayor parte como consecuencia de su sobreestiramiento y como consecuencia de la fatiga o debilidad del músculo del que proceden. Hay pérdida de toda actividad funcional en la extremidad. En la extremidad afectada se produce la debilitación de estructuras, debilitación que puede ser permanente. El músculo al que pertenecen los tendones también presenta empeoramiento de la debilidad funcional.
Hasta ahora no se ha logrado estimular el tendón de forma que puedan regenerarse las fibras tendinosas lesionadas.

Lesión del nervio
La compresión de los nervios o las soluciones de continuidad en los mismos significa la ausencia de conducción. Según la clase de tejido nervioso afectado, puede haber pérdida de las sensaciones cutáneas o falta de percepción de la situación en el espacio de una extremidad o parte de la misma. Los músculos disminuyen de tamaño, o se atrofian, si su inervación motora es lesionada.
Todas las funciones dependen de una normal inervación. Si la lesión recae en el tejido nervioso especializado del cerebro o de la médula espinal, la lesión es irreversible y no tiene lugar su curación. Las lesiones nerviosas que recaen fuera del cerebro y de la médula espinal no siempre son irreversibles.

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