Foal Orthopaedics Flashcards
What are different developmental orthopaedic diseases?
- Angular limb deformities
- Flexural limb deformities
- Physitis (non-septic) - inflammation of growth plate
- (Osteochondrosis)
- Orthopaedic infections - synovial sepsis / septic physitis
How are angular limb deformities diagnosed? Ddx?
- Clinical exam - palpate + manipulate
- Radiography
-Ddx = injury (fracture), incomplete ossification of cuboidal bones
What are angular limb deformities?
- Valgus = lateral deviation
- Varus = medial deviation
- Check each joint / bone separately / Soft tissue laxity
What does ALD manipulation tell you?
- If you can’t straighten limb manually = bone problem
- If you can straighten limb manually = dysmature / peri-articular laxity
What should be done with radiography of ALD?
- Long cassettes
- Centred over deviation centre
- Views = dorsopalmar = carpus + fetlock
-DP + lateromedial = tarsus - Check if joints + physes parallel
What are causes of acquired ALD?
- Imbalanced nutrition - excessive energy / mineral imbalance (lack Cu / excessive Zn)
- Genetics (rapid growth)
- Trauma = damage to growth cartilage, overload opposite limb
What does treatment of ALD depend on?
– Aetiology of ALD
– Age = Remaining growth potential
– Joint involved
– ALD severity
– Concomitant problems
What is Tx of ALD?
- Conservative = limited exercise, bandages + splints
-Corrective hoof trimming + glue on shoes
-Limit mare + foal nutrition - Surgery = Growth acceleration of concave side / Growth retardation of convex side (pin/bridge)
-Osteotomy / ostectomy
What should be done with hoof balance for ALD?
- Valgus = medial extension
- Varus = lateral extension
- Every 2-3wks, lightly rasp concave side
What ALD has the best prognosis?
- If treated early
- Physis / epiphysis ALDs
Poor prognosis if diaphyseal, crushed cuboidal bones, severe angulation, secondary DJD
What origin + insertion + use of SDFT?
- origin = distal humerus + proximal radius
- insertion = accessory ligament - distopalmar radius (AL-SDFT)
-distal PI
-proximal PII - Use = flexion of MCP / MTP joint
What is origin, insertion + use of DDFT?
- origin = humeral epicondyle
-medial olecranon
-proximal radius - insertion = palmar PIII
- Use = Flexion of DIP join
What causes digital hyperextension? Tx?
- Flexor tendon laxity
- Tx = mild / moderate = exercise
-Severe = protect hell bulbs / palmar fetlocks
What flexural limb deformities has the worst prognosis?
- If congenital = when born, try straighten immediately
Dx of flexural limb deformities?
- Inspection - lying down / standing
- Palpation + manipulation - can it be straightened?
-palpate each flexor tendon to check which one is worse
Tx of FLDs?
- Conservative = farriery, physio, splints, meds (Oxytet)
- Surgical = depends on location + response to conservative Tx
Tx of FLD of DIP joint?
- Conservative =
-Farriery = lower heel, extend toe shoe (acrylic)
-Decrease nutrition
-Increase exercise
-Analgesia! - Surgical = Desmotomy of AL-DDFT + conservative Tx
-good prognosis if deformity less than 90o
-guarded prognosis if deformity more than 90o
Tx of FLD of fetlock/carpal joint?
- Conservative =
-Palmar/plantar splint - mould to limb, change frequent
-Oxytet
-Analgesia - Surgery =
-If SDFT = ALSDFT desmotomy
-If DDFT = AL-DDFT desmotomy +/- AL-SDFT desmotomy
What is aetiology of septic arthritis?
- Systemic disease
- Impaired defences
- Failure of passive transfer IgG
- Sub-infective dose of bacteria
What are CS of septic arthritis?
- Reluctant to stand
- Joint effusion
- Peri-articular swelling
- Lameness
- Filling of mare’s udder
Dx of septic synovitis?
- Full history
- Physical exam - umbilicus / other joints
- Radiography - bone involvement
- Ultrasound - umbilicus + affected joint
- Synoviocentesis
How is septic physitis diagnosed?
- Radiography = irregular / widened physis, radiolucency, soft tissue swelling
- Blood culture = septicaemia
What is treatment of septic arthritis?
- Tx underlying causes = FPT, umbilical infection
- Lavage synovial structure
- Aggressive antimicrobial therapy
- NSAIDs
