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Eq SX Musc Skel Exam > Developmental Orthopedic diseases > Flashcards

Developmental Orthopedic diseases Flashcards

1
Q

Growth of long bones occurs thru

A

endochondral ossification

-increased length primarily contributed by metaphyseal side of growth plate

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2
Q

Two types growth plates

A
  1. discoid-typical physis at end of long bones

2. spheroid-centers of ossification in epiphysis and cuboidal bones of carpus and tarsus

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3
Q

7 zones of ossification cartilage to bone

A
  1. reserve zone-resting germinal chondrocytes
  2. proliferative zone-chondrocytes begin to divide
  3. zone of maturation (hypertrophy)-weakest zone, stop dividing
  4. zone of calcification-matrix becomes calcified
  5. zone of degeneration-vascular ingrowth
  6. primary spongiosa
  7. secondary spongiosa
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4
Q

Physiologic closure often precedes

A

radiographic closure

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5
Q

angular deformities definition

A

deviations of the alignment of the boney column in the frontal plane

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6
Q

Most angular deformities occur at the level of the

A

physis

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7
Q

angular limb deformities are referred to by

A

associated joint

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8
Q

Windswept

A

foals with valgus deviation of one tarsus and varus deviation of contralateral tarsus

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9
Q

Offset knees

A

lateral position of the metacarpus down the axis of the limb

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10
Q

Slight valgus is protective against injury in horses with

A

offset knees

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11
Q

Rotational deformities

A

pidgeon toed/splay footed

no treatment

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12
Q

Cuboidal bones of carpus and tarsus ossify in

A

Last 2-3 months of gestation

  • premature foals have incomplete ossification
  • soft cartilage suscepible to crushing
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13
Q

Normal conformation of neonate

A

Mild to moderate carpal valgus

External rotation

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14
Q

Goal at weaning

A

Have fetlock joint aligned straight with metacarpus/metatarsus and parallel to phalangeal joints

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15
Q

Weanling with no carpal valgus and no outward rotation likely to

A

become carpal varus and internally rotated as it grows

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16
Q

Perinatal factors angular deformity

A
  1. Incomplete ossification cuboidal bones
    - premature/dysmature/twinned foals
  2. Periarticular laxity-should resolve in 2-3 weeks of life
  3. Aberrant intrauterine ossification
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17
Q

Developmental factors angular deformity

A
  1. Nutrition-rapid growth/excessive weight gain

2. Trauma/excessive exercise

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18
Q

Diagnosis angular deformity

A
  1. Stand at face of each limb separately
  2. Eval radius relative to metacarpus
  3. Eval metacarpus/tarsus relative to foot
  4. Eval tibial to metatarsus
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19
Q

The toe should be facing same direction as

A

face of carpus

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20
Q

Evaluate breakover to see if foot travels in straight line

A

Indicates joints are aligned parallel to ground

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21
Q

Monitor foals every

A

2-4 weeks to see if deformities are improving

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22
Q

Radiographs indicated in foals at risk

A

incomplete ossification (to start early intervention to prevent crushing)

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23
Q

radiographing carpus and fetlocks

A

Dorsal-palmar view most important

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24
Q

Radigraphing tarsus

A

Dorso-plantar and lateromedial views required

-particularly to assess for collapse of cuboidal bones

25
Q

Treatments

A
  1. Hoof care starting 1 month old - valgus rasp lateral wall
  2. Stall rest
  3. External coaptation - change q 1-2 weeks, switch to bandage for a few days when rads indicate closure
26
Q

Stall rest schedule

A
  1. incomplete ossification of cuboidal bones
    - rest up to 1 month, re radiograph biweekly
  2. Severe angular limb deformity w/normal cuboidals
    - 4-6 weeks and sx if not corrected
  3. Periarticular laxity with normal cuboidals
    - handwalk with mare 10-20 minutes/day or swim
    - typically resolves in 2 weeks
    - strict rest and coaptation contraindicated
27
Q

Principal indication for use of splints or casts in foals with angular limb deformity

A

is incomplete ossification of cuboidal bones

28
Q

Splints and casts should not extend

A

distal to fetlock

-tendons need to take some load

29
Q

Surgery indicated when

A
  1. Deformity too severe to correct spontaneously
  2. Deformities worsening
  3. Deformities causing other deformities
30
Q

Classifying deformities

A
  1. mild: < 5 degrees
  2. moderate: 5-10 degrees
  3. severe: > 10 degrees
31
Q

Two kinds of surgical intervention

A
  1. Growth retardation on convex side

2. Growth acceleration on concave side

32
Q

Periosteal stripping/ PT

A

Growth acceleration

  • no over correction
  • growth altered for 2-3 weeks after sx
  • performed when significant amount of rapid growth potential still exists
  • controversial
33
Q

Transphyseal bridge (TPB)

A

Growth retardation

  • implant fixed at either side of physis, removed when correction acheived
  • Screw and wire technique
  • Correction can lag 2-3 weeks after placement
  • can cause significant SC scarring
34
Q

Transphyseal screw (TPS)

A

Growth retardation

  • fetlock/carpus/tarsus deformities
  • breach of physis causes concern for overcorrection after removal from damage
  • correction begins immediately
  • more cosmetic
35
Q

Advanced surgical correction

A
  1. Closing wedge ostectomy

2. Step osteotomoy/ostectomy

36
Q

Three common locations congenital hyperflexion

A
  1. Distal interphalangeal joint
  2. Fetlock joint
  3. Carpus
37
Q

Treatment of congenital hyperflexion

A
  1. limited exercise
  2. oxytetracycline
    - acute renal failure possible
  3. Splinting
    - splints should extend to the ground
    - fetlock and carpal contracture
  4. Heel extension
  5. Analgesia
  6. Surgery
38
Q

acquired hyperflexion most often involves

A

coffin/fetlock joint

39
Q

Acquired hyperflexion associated with

A

Pain as major precipitating factor, leading to activation of flexor withdrawal reflex

40
Q

Possible inciting causes of acquired hyperflexion

A
  1. trauma
  2. joint sepsis
  3. chronic lameness
  4. physitis
  5. OCD
  6. Excess nutrition
41
Q

Hyperflexion treatment

A
  1. Address nutrition if it has changed
  2. Controlled exercise if not too painful
  3. ANALGESIA
  4. Hoof care-gradually lower heel
  5. Cast-incorporate hoof, rarely used
42
Q

Desmotomy of ALDDFT

A

Complication: excessive fibroplasia
Pressure bandage post-op 3 weeks
Prognosis if treated < 1 yr old 86% return to work
Prognosis if treated > 1 yr old 78%

43
Q

Tenotomy of DDFT reserved for

A

severe deformities-considered a salvage procedure

44
Q

Fetlock joint contracture commonly occurs

A

between 10-18 months of age

  • growth spurt in distal radial physis
  • forelimb more common than hind
  • frustrating to treat
45
Q

Classification fetlock contracture

A

Mild: < 180 degrees flexion
-fetlock remains palmpar/plantar to toe
Moderate: > 180 degrees extension when standing
-fetlock dorsal to toe but can extend to 180 when walking
Severe: > 180 degrees flexion at all times, flexor tendons and suspensory ligament are lax, extensor tendon is taught, resist further flexion
-may knuckle over if neglected

46
Q

Hoofcare theories for fetlock contracture

A
  1. Heel elevation
    - decrease tension on DDFT and increase strain on SDFT
  2. Lower heel
    - invoke reverse myotactic reflex
  3. Toe extension
    - prolong breakover thus stretching palmar soft tissue structures
47
Q

Fetlock contracture splints

A

May promote laxity and stretch palmar structures at fetlock is pullback into splint
-early cases only

48
Q

Fetlock contracture sx

A
  1. Desmotomy of ALDDFT

2. Desmotomy of accessory ligament of superficial digital flexor Tendon

49
Q

Static cervical stenotic myelopathy tends to occur

A

C3-C5 or

C5-C7 (T1)

50
Q

Dynamic cervical stenotic myelopathy

A

C5-C7 (T1)

51
Q

Surgery for wobblers not until

A
  1. Thorough neuro exam
  2. Plain cervical rads
  3. Testing to rule out dz (EPM)
  4. Myelogram to confirm sites of compression
52
Q

Factors influence prognosis of surgery for wobblers

A
  1. Number of sites of compression (3 or more is poor)
  2. Static or dynamic (dynamic may be better)
  3. Pre-operative grade (1-4) expect 1-2 grades impr
  4. duration of signs?
  5. Temperament/age/intended use of horse
53
Q

Wobblers length of rehab after sx

A

1 yr

54
Q

Wobblers prognosis after sx

A

60% return to intended function
88% improved at least 1 grade
60% improved at least 2 grades

55
Q

Wobblers surgical procedure

A

Metal cylinder (basket) called Kerf Cut Cynlinder bridges intervertebral disk and joint of vertebral bodies. Stabilizes and causes eventual fusion.

56
Q

Wobblers sx complications

A
  1. Seroma formation
  2. Infection
  3. Vertebral body fx
  4. Implant migration
  5. Recurrent laryngeal neuropathy
  6. Horner’s syndrome
  7. Airway obstruction upon extubation
57
Q

Accipitoatlantoaxial Malformation (OAAM)

A
  • most common in arabian foals (inherited recessive)
  • small abnormal atlas, abnormally fused with occiput
  • hypoplastic and malformed dens-can sublux
  • Foals usually euthanised
58
Q

The abnormal/lack of articulation between atlas and occuput

A

Often leads to scoliosis

59
Q

OAAM Clinical signs

A
  1. Ataxia
  2. Scoliosis
  3. Clicking noise when head manipulated

Eq SX Musc Skel Exam (20 decks)

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