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LA Sx Exam 1 > Angular Limb Deformities > Flashcards

Angular Limb Deformities Flashcards

1
Q

Pigeon toed

A

Varus

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2
Q

Medial deviation of the limb distal to point of origin

A

Varus

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3
Q

Lateral deviation of the limb distal to point of origin

A

Valgus

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4
Q

What is appositional growth?

A

Increase in bone thickness

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5
Q

Addition of new bone from the periosteum

A

Appositional growth

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6
Q

Longitudinal growth comes from what?

A

Physis

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7
Q

Compressive forces on endochondral cartilage retards growth

A

Delpech law

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8
Q

What is the most common etiology of angular limb deformities?

A

Disproportionate growth @ metaphyseal growth plates

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9
Q

Rate of growth is mostly _____, but it can be modified w/_____

A

Genetic, diet

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10
Q

SH fractures and physitis can cause this problem that impairs longitudinal growth

A

Premature physeal closure

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11
Q

Caused by disproportional growth or microtrauma

A

Physitis

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12
Q

Which side of the growth plate does physitis usually occur?

A

Medial

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13
Q

A straightened limb axis but ALD persists is called what?

A

Compensatory ALD

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14
Q

Limb looks straight, but dynamic assessment is still abnormal

A

Compensatory ALD

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15
Q

Are SH fractures in the proximal or distal limb more damaging to a horse’s athletic capacity?

A

Distal

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16
Q

What are perinatal factors that contribute to ALD?

A

Incomplete ossification, peri-articular laxity, aberrant intrauterine ossification

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17
Q

What causes incomplete ossification?

A

Twins/prematurity, placentitis, systemic disease of the mare

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18
Q

Where is incomplete ossification most common?

A

Tarsus

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19
Q

What are clinical signs of incomplete ossification?

A

Bunny hops instead of trotting

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20
Q

Which aspect of the tarsus is affected by incomplete ossification?

A

Dorsal aspects

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21
Q

Unstable joints causes uneven loading which leads to uneven physis growth

A

Peri-articular laxity

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22
Q

What causes peri-articular laxity?

A

Hormonal imbalances, intrauterine position, idiopathic

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23
Q

What is the most common cause of peri-articular laxity?

A

Idiopathic

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24
Q

Deformity can be manually corrected

A

Incomplete ossification and peri-articular laxity

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25
Q

Deformed long bone usually at the epiphysis

A

Aberrant intrauterine ossification

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26
Q

Where is the most common site to see aberrant intrauterine ossification?

A

Distal MT3

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27
Q

What compensatory ALD follows abberant intrauterine ossification of distal MT3?

A

Proximal P1

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28
Q

Will also cause other deformities along the leg because the legs will grow unevenly from an affected physis

A

Aberrant intrauterine ossification

29
Q

What are acquired factors that contribute to ALD?

A

Unbalanced nutrition, excessive exercise, trauma, genetics

30
Q

What nutrtional factors influence ALD?

A

Excessive grain intake

ZN tox/ Cu deficiency

31
Q

What horse breed has a high potential for rapid growth?

A

Throroughbreds

32
Q

Other than ALD, what developmental orthopedic diseases arise from unbalanced nutrition?

A

Osteochontrosis, FLDs

33
Q

How does excessive trauma cause ALD?

A

Causes physitis and premature closure of physis

34
Q

Where should you stand to assess the angle of deviation of a foot?

A

In front of the frontal plane of the limb (not in front of the toe)

35
Q

How soon will foals grow into the normal degree of valgus that they are born with at the fetlock?

A

2-4 months

36
Q

How much carpal valgus is considered normal in young foals?

A

Up to 5*

37
Q

What radiographic view do you us to dx ALD in forelimbs? In hindlimbs?

A

Fore: DP
Hind: DP and lateral

38
Q

What on hindlimb rads will help you determine the amount of deviation in the limb?

A

Misalignment between the tibia and MT3

39
Q

Allows ID of degree and location of deformity

A

Radiographs

40
Q

If the deformity can be straightened manually, what types of ALD go on your list of ddx?

A

Incomplete ossification of cuboidal bones and peri-articular laxity

41
Q

What are non-surgical treatments incomplete ossification?

A

1 month strict stall rest

42
Q

How do you treat peri-articular laxity non-surgically?

A

Controlled exercise

43
Q

How soon does peri-articular laxity self correct?

A

2 weeks

44
Q

If ALD is <10*, how should you treat it?

A

Medically first, then surgical if it doesn’t correct on its own

45
Q

Why do you NOT want to incorporate ossification of cuboidal bones in a cast for ALD treatment?

A

Prevents laxity of digital flexors

46
Q

Are splints or casts better for ALD management?

A

Splints

47
Q

Effective for fetlock ALD and should only be used alone with very mild ALD

A

Hoof wall extensions

48
Q

Which side of the hoof should a hoof wall extension be placed?

A

Convex side

49
Q

If you have valgus deviation, which side of the limb does the hoof extension go on?

A

Medial

50
Q

If you have varus deviation, which side of the limb does the hoof extension go on?

A

Lateral

51
Q

What are surgical options for treating ALD?

A

Periosteal stripping, transphyseal bridging, corrective ostectomy/osteotomy

52
Q

Growth acceleration on the concave side of the limb

A

Periosteal stripping

53
Q

How does stripping the periosteum allow for growth acceleration?

A

Frees physis from restrictive effects of periosteum + cascade of growth factors

54
Q

Is periosteal stripping effective

A

NO

55
Q

What is the most common modality for treating ALD?

A

Transphyseal bridging

56
Q

Growth retardation

A

Transphyseal bridging

57
Q

Used for ALD >10* or ALD <10* that is unresponsive to non-sx management

A

Transphyseal bridging

58
Q

When is transphyseal bridging done and why?

A

After rapid physeal growth phase so limb doesn’t revert post-op

59
Q

What methods of transphyseal bridging are there?

A

Screws and wires, single transphyseal screw

60
Q

Does not disturb the physis in a permanent way, just affects the growth from the physis

A

Screws and wires

61
Q

Implants do not cross physis

A

Screws and wires

62
Q

Faster correction and more cosmetic than screws and wires, but implant crosses physis

A

Single transphyseal screw

63
Q

What are risks of using a single transphyseal screw?

A

Physisits, premature physeal closure, overcorrection

64
Q

What technique is perferred fro distal MC/MT3 and distal tibial ALD?

A

Single transphyseal screw

65
Q

Used for correction of fetlock ALD after closure of growth plates

A

Ostectomy/osteotomy

66
Q

What is the main cause of ALD in miniature horses?

A

Complete ulna/fibula stops growth @ lateral aspect

67
Q

When should you do surgery to correct ALD in miniature horses?

A

Before 4 mo of age

68
Q

Are miniature horses more likely to have varus or valgus ALD?

A

Valgus

LA Sx Exam 1 (17 decks)

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