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Equine > Eq2-mid2- angular limb deformities > Flashcards

Eq2-mid2- angular limb deformities Flashcards

1
Q

Perinatal deformities

A
  • cuboidal bone ossification
  • about 260 days gestation
  • ossification centers: distal radial, tibial epiphysis, carpal and tarsal bones
  • ulnar styloid process - last ossification center - ossification progress toward the periphery
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2
Q

Causes of incomplete ossification

A
  • shortened gestation - abnormal uterine position - placental insufficiency, placentitis - metabolic diseases - colic and shock
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3
Q

Grading of Incomplete ossification

A
  • Grade 1: some cuboidal bones of carpus and tarsus have no evidence of ossification - Grade 2: All cuboidal bones have some evidence of ossification - Grade 3: All cuboidal bones are ossified, but small and rounded edges are present. Joint spaces are wide, proximal physes of McIII/MtIII are closed - Grade 4: Cuboidal bones are shaped
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4
Q

Treatment of incomplete ossification

A
  • stall rest: straight limb and incomplete ossification - Exercise on the wekened partially ossified carpal and tarsal bones - abnormal ossification - radiological examination every 2 weeks - splint and cast - splint not below end of fetlock: If the hoof is incorporated in the cast, it will weaken the flexor- and extensor-tendon - splint should be changed every 3 to 4 days, cast evere 10-14 day - if the cast stays on for too long it will lead to flaccid flexor carpi ulnaris and ulnaris lat. (- back at the knee?)
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5
Q

Acquired deformities

A

Acquired ALDs are results of disproportionate bone growth Rapid bone growth: - Proximal P1: 0-2 months - Distal Mc/Mt: 0-2months - Distal radius: 0-6months - Distal tibia: 0-4 months Developmental factors, genetic predisposition, dietary imbalance, trauma, excersice, physeal dysplasia, heavy birth weigh etc.

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6
Q

Treatment of Acquired deformities

A
  • Carpal deviation up to 4 degrees are normal - Foals have a natural growth correction - 50% have moderate or severe forelimb deformities - more heavily loaded side of bone (concave): grows faster - Less heavily loaded side (convex): grow slower
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7
Q

Non-surgical techniques of Acquired deformities

A
  • Stall rest and controlled exercise - Disproportionate growth at level of physis greater than 10 degrees - stall rested and exercised in controlled fashion (4-6 weeks) - foot manipulation - balancing the force on the growth plate - more effective in fetlock deviation than in carpal
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8
Q

Foot manipulation

A
  • mild fetlock deformities: controlled exercise and hoof trimming - should be repeated every 2 to 4 weeks - Valgus: outside hoof is lowered - Varus, pigeon toe in conformation: inside hoof wall is lowered - trimming or foot extension shoes - Valgus: extension placed on medial aspect of hoof - Varus: extension placed on lateral aspect of hoof
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9
Q

Surgical techniques of acquired deformities

A

HCPTE (hemicircumferential periosteal transsection and elevation): - growth acceleration - foal after 2 weeks of age - ALD more than 10 degrees - Periosteal transection has its effect 2 months of age - the surgery performed on concave aspect of the limb - valgus-lateral, varus-medial

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10
Q

Technique of HCPTE in distal radius

A
  • horse in lateral recumbency - Valgus: 3cm vertical incision between common and lateral digital extensor tendon, 4-5 cm proximal to the distal radial physis - Inverted T shaped incision in periosteum, elevate flaps - 20% of foals rudimentary ulna is ossified, can be removed with rongeurs - additionally foot manipulation may be used
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11
Q

Technique of HCPTE-distal McIII/MtIII and P1

A
  • concave most distal aspect of metaphysis of McIII/MtIII - before 3 months of age after that limited growth at distal physis - P1-level of extensor branch of suspensory ligament - periosteal incision are T-shaped, the horizontal incision 1 cm distal to the physis
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12
Q

Bench knees

A
  • valgus deformity at distal radius and varus deformity of proximal third of McIII - if this conformation diagnosed the first 2 months: periostal elevation - distal lateral radius and medial distal McIII - Periostal stripping over total length of Mc/Mt
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13
Q

Technique in Growth retardation

A
  • increase static compression at the physis - implants applied at convex surface - bridge the physis temporarily - cerclage wire - single transphyseal screw - distal McIII/MtIII, distal radial/tibialphysis - dorsal recumbency - 10mm proximal to the physis - 4.5 cortex screw : 3,2 mml drill sleeve in 70 degrees to the physis
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14
Q

combination of growth acceleration and retardation

A
  • faster and more complete correction - the advantage of using implants is that they can stay in place as long as they are needed
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15
Q

Implant removal

A
  • prevent overcorrection of the deformity - monthly radiological examination - implant removal before complete limb straightening Complications: - surgical site infection - septic physitis
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16
Q

Flexural limb deformities

A
  • persistent hyperflexion: contracted tendons - tendon units not contracted - relative to short
17
Q

Congenital flexural deformities

A
  • congenital factors - teratogenic agents - intrauterine positioning - genetic predisposition
18
Q

Digital hyperextension deformities

A
  • newborn foal: mild degree of digital hyperextension - flaccidity of the flexor muscles - usually corrects itself within few weeks
19
Q

Treatment of digital hyperextension deformities

A
  • mild digital hyperextension: dont need treatment - minimal trimming of feet - moderate exercise: strengthen musculotendinous unit - Farriery: palmar/planter extension (Dallmer cuff shoes), helps maintain the hoof sole on the ground - light bandaging: minimize the skin trauma - splint bandage and cast incorporating the foot: contraindicated - mild deformity resolve spontaneously
20
Q

Ruptured common digital extensor tendon

A
  • common congenital disorders - characteristic swelling in tendon sheath dorso-lat aspect of carpus - recognised soon after birth - secondary after flexura deformity - tendon defect palpable in tendon sheath - ultrasound
21
Q

Ruptured common digital extensor tendon - clinical signs and treatment

A

clinica signs: - characteristic swelling at the carpus - during walk knuckles at the fetlock joint frequently - in severe cases may not be able to stand treatment: - well-padded splint bandage change in 3-5 days, for 2-4 weeks

22
Q

Flexura deformities - treatment

A

Exercise: - moderate exercise: the foal should not be allowed to be over tired Treatment: intravenous oxytetracycline - 3g oxytetracycline in 500 ml saline - the treatment may be repeated 2 times in first week - decrease in matrix metalloproteinase 1 (MMP-1) - inhibits tractional structuring of collagen fibrils

23
Q

Farriery (hovslager?) - toe extension

A
  • dorsal hoof extension - suffering flexura deformity DIP, MCP/MTP joints - hoof acrylic used
24
Q

Farriery (hovslager?) - splint/cast

A
  • usefull for MCP/MTP, carpal region - DIP joint - half limb cast not effective - splint - PVC pipe, iberglass - pressure sores - sedation
25
Q

Carpal flexor deformity

A
  • transection of flexor carpi ulnaris and ulnaris lateralis tendon 2 cm proximal to accessory carpal bone
26
Q

Acquired flexural deformity

A
  • mismatch in bone and tendon/ligament growth
  • contraction of musculotendinous unit
  • between 4 weeks and 4 months
  • longitudinal growth of the bone greater than the tendon
  • passive elongation of DDFT limited - ALDDFT - DIP joint
  • rapid growth of radius around 1 year - SDFT: flexural deformity of MCP region
  • 1-4 months: DIP
  • 1-6 months: PIP, MCP
27
Q

Congenital flexural deformity

A
  • Birth up to 1 month
  • carpus/MCP
28
Q

Contractural deformities of the distal interphalangeal joint (clob-foot)

A
  • the dorsal hoof wall assumes a more vertical angle
  • the heels may not contact the ground
    1. stage: dorsal hoof wall 60-90 degrees
    1. stage: dorsal hoof wall over 90 degrees
29
Q

MCP/MTP region

A
  • congenital or 10-18 months of age
  • the foot are normal, but the pastern assumes more upright position
  • grade 1: straight MCP/MTP
  • Grade 2: ange around 180 degrees
  • Grade 3: greather more 180 degrees
  • palpation of flexor tendon: which structures are involved
  • Acquired flexural deformities MCP joint
    • desmitis ALDDPT
    • SDFT rupture
30
Q

MCP/MTP region non-surgical treatment

A
  • nutrition
  • overfeeding of foal
  • mineral imbalance (calcium/phosphorus)
  • Farriery: the heels should be rasped back - toe extension
  • glue-on rubber shoe
31
Q

Contractural deformities of the distal interphalangeal joint (clob foot)

  • clinical signs, treatment
A

clinical signs:

  • until 3 months of age rapid growth of the metacarpus

Treatment:

  • balanced nutritional intake
  • NSAIDs
  • toe extension
  • exercise
  • desmotomy of the DDFT check ligament
32
Q

Desmotomy of the accessory (check) ligament of the DDFT

A
  • can be unilateral or bilateral
  • lateral recumbency
  • 5cm skin incision proximal and midlle third of MvIII
  • subcutaneous tissue and fascia bluntly separated
  • tendinous structures are identified
  • ALDDFT sharply transected
  • subcutan tissue and skin closure
33
Q

Tenotomy of the deep digital flexor tendon

A
  • grade 2 flexural deformity
  • hoof-ground angle greather than 115 degrees
  • midmetacarpal
  • midpastern: through the digital flexor tendon sheath
34
Q

Contractural deformities of the metacarpophalangeal joint

  • clinical signs, treatment
A

clinical signs:

  • at yearling age rapid growth of the radius

Treatment:

  • balanced nutritional intake
  • corrective shoing
  • NSAIDs
  • physical therapy
  • desmotomy of the check lig.
35
Q

Desmotomy of the accessory (check) ligament of the superficial digital flexor tendon

A
  • landmarks: medial distal physis of radius, chestnut, cecphalic vein
  • 10 cm skin incision centered along the chesnut, cranial to the cephalic vein
  • approaches cranial to the flexor carpi radialis
  • desmotomy of accessory lig.
  • proximal border of ligament nutrient artery of SDFT
36
Q
A

Equine (8 decks)

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