Flexural deformities in foals

Question 1

what plane do flexural limb deformities occur in

Answer 1

sagittal plane

Question 2

how are flexural limb deformities best assesses

Answer 2

by viewing from the side

Question 3

flexural limb defomrities are more common in …….

Answer 3

forelimbs

Question 4

what are the 2 types of flexural limb deformitiy

Answer 4

Hyperextension (laxity)
hyperflexion (contracture)

Question 5

what joints are generally affected by congenital hyperextension

Answer 5

usually distal limb- fetlock and phalangeal joints

Question 6

What is the appearance of hyperextension

Answer 6

Toe is elevated and palmar/plantar fetlock is sunken.

Question 7

What causes congenital hyperextension

Answer 7

Flaccidity of flexor muscles after birth

Question 8

Describe the treatment for congenital hyperextension

Answer 8

Self corrects in few weeks, bandages to protect skin, glue on heel extension shoes

Question 9

What joints commonly get congenital hyperflexion in foals

Answer 9

Coffin, pastern, fetlock, carpal or tarsal joints

Question 10

What can congenital hyperflexion cause

Answer 10

dystocia
foal can’t stand

Question 11

Descibe the medical treatment of congenital hyperflexion

Answer 11

Light exercise
oxytet in saline IV
toe extensions and heel reduction
NSAIDs and omeprazole
splits/casts

Question 12

why d o we give oxytet to foals with congenital hyperflexion

Answer 12

inhibits tractional structuring of collagen fibrils
so tendons & ligaments more susceptible to elongation during normal weight bearing.

Question 13

Why is important to give omeprazole with NSAIDs in foals

Answer 13

Risk of gastric ulcers with NSAIDs

Question 14

when would you use surgical treatment of congenital hyperflexion

Answer 14

If medical treatments fail - rarely required

Question 15

what causes acquired hyperflexion

Answer 15

Pain cause flexion withdrawal reflex and subsequent muscle contraction:

1. Rapid bone growth with tendons unable to keep up
2. specific injury (septic arthritis, fracture, foot abscess)

Question 16

what is ‘club foot’

Answer 16

acquired coffin joint contracture

Question 17

when does club foot generally occur

Answer 17

1-4 months old

Question 18

Describe stage 1 club foot

Answer 18

dorsal hoof wall has not past vertical – good prognosis

Question 19

Describe stage 2 club foot

Answer 19

dorsal hoof wall has progressed past vertical – guarded prognosis

Question 20

What are the treatments for acquired coffin joint contracture (club foot)?

Answer 20

Toe extensions and heel reduction
NSAIDs and omeprazole
reduce nutrition to reduce growth

Question 21

How do toe extension and heel reduction help with coffin joint contracture?

Answer 21

Stretches DDFT during weight bearing

Question 22

What is the surgical treatment for stage 1 club foot?

Answer 22

Desmotomy of accessory check ligament of DDFT

Question 23

What is the surgical treatment is available for stage 2 club foot?

Answer 23

Tenotomy of DDFT

Question 24

What causes acquired fetlock joint contracture in 10-18 month old horses?

Answer 24

Radius/tibia growing rapidly, functional shortening of SDFT and suspensory ligament

Question 25

Describe what happens in stage 2 acquired fetlock contracture

Answer 25

Fetlock positioned in front of vertical, but can move behind vertical during weight bearing.

Question 26

Describe stage 3 acquired fetlock joint contracture

Answer 26

Fetlock positioned in front of vertical always.

Question 27

Describe medical management of acquired fetlock joint contracture

Answer 27

toe extensions
NSAIDs (and omeprazole)
Reduce foals growth rate by reducing nutrition
Splint to force fetlock into extension
Address other causes of pain

Question 28

when can medical management of Acquired fetlock joint contracture be used

Answer 28

on suitable for stage 1 only

Question 29

What surgical treatments can be done for acquired fetlock joint contracture?

Answer 29

Desmotomy of accessory check ligament of SDFT/DDFT or tenotomy of SDFT/DDFT