La Ortho - Angular Defomrity

Question 1

Valgus deformity

Answer 1

Limb deviates laterally
Distal to reference point

Question 2

Varus deformity

Answer 2

Deviates medially
Distal to reference point

Question 3

ALG causes

Answer 3

Perinatal factors
Acquired

Question 4

Windswept ALD

Answer 4

Tarsal valgus and tarsal varus

Question 5

Perinatal facots

Answer 5

Maternal illness during pregnancy
Periarticular laxity
Incomplete ossification of cuboidal bones

Question 6

Acquired factors

Answer 6

Unbalanced nutrition
Excessive exercise/trauma
- asymmetrical physeal growth

Question 7

Specific prenatal factors

Answer 7

Periarticular laxity
Cuboidal bone hypoplasia
Teratogenic insults
Placentitis
Hormonal /nutritional imbalance

Question 8

Specific postnatal factors

Answer 8

Poor limb conformation
Excessive growth rate
Physeal injuries
Overload due to contralateral limb lameness

Question 9

Visual exam

Answer 9

Keep perspective of where youre located vs where the foal is located
Always check multiple directions/views to achieve a proper diagnosis

Question 10

Periarticular laxity

Answer 10

Soft tissues around joint are too elastic
Can be manually corrected
Radiographs will appear normal

Question 11

Treating periarticular laxity

Answer 11

Exercise restriction - stall confinement
Excess loading will lead to pathologic loading

Question 12

Treating severe cases of periarticular laxity

Answer 12

Severe cases
Tube casts
Splint bandages
Orthotic devices
- goal is to support structures while bone straightens

Question 13

Incomplete ossification

Answer 13

Premature/dysmature
>1 joint affected
May lead to permanent ALD without protection
Can be manually corrected
Radiographs abnormal

Question 14

Treating incomplete ossification

Answer 14

Exercise restriction
External support for periarticular laxity
Improve in 2-4 weeks
Reradiograph to follow

Question 15

asymmetric physeal growth

Answer 15

Metaphysis or epiphysis
Present at birth but more common to develop in growth
Radiographs are abnormal - one side of metaphysis is hypertrophic = different lengths
Manually correction is NOT possible

Question 16

Cause for APG

Answer 16

???
Unbalanced nutrition
Rapid growth
Trauma - path forces/fracture
Osteochondrosis
Osteomyelitis

Question 17

Treating APG

Answer 17

Exercise restriction - in all cases! Goal is to prevent physeal trauma
Mild to mod cases - balance foot for equal loading mechanics
Severe - surgery to balance

Question 18

Goal for balancing foot

Answer 18

Hoof wall development to be equal on both sides

Question 19

Corrective shoes for APG

Answer 19

Trim every 2 weeks
Maintain symmetric shape - can add acrylic for shape

Question 20

Conservative management

Answer 20

Catching early = very good prognosis
Failure to catch or treat - abnormal loads placed on limb just progresses the deformity

Question 21

When is it ideal to act for APG

Answer 21

Prior to 2 months for fetlock
4 months for tarsus
6 months for carpus

Question 22

When does the majority of growth occur for various bones?

Answer 22

Fetlock - 2 months
Tarsus - 4 months
Carpus - 6 months

Question 23

When does the physeal close in various bones?

Answer 23

Fetlock - 3 months
Tarsus - 1-2 years
Carpus - 1-2 years

Question 24

When is it ideal for conservative management for APG?

Answer 24

Fetlock - 2-3 wks
Tarsus - >6 wks
Carpus - <2-3 months

Question 25

Flexural limb deformity

Answer 25

Deviation in sagittal plane - laxity or deformity

Question 26

Occurrence of flexural limb deformity

Answer 26

Can occur in metacarpophalangeal joint, distal interphalangeal joint, carpal joints Common in young foals

Question 27

What causes FLD

Answer 27

Congenital - laxity & deformity Acquired - deformity

Question 28

Congenital

Answer 28

Flexural laxity - flexor muscle flaccidity Flexural deformity - lack mobility in affected joint, painful

Question 29

Acquired FLD

Answer 29

Flexural deformity Nutrition - too rapid growth, bone outgrows soft tissue Pain - flexion withdrawal reflex, muscle contraction over time = Flexural deformity

Question 30

Flexural laxity

Answer 30

Muscle laxity - toes off ground, fetlock on ground, back at knee Controlled exercise Balance foot Light bandages - protect legs - DO NOT provide support, make muscle tendon unit work to strengthen it Extended heel shoes

Question 31

Risk with bandaging FLD

Answer 31

Too much support = more laxity

Question 32

Flexural deformity

Answer 32

May not be able to stand - esp with carpus FPT is common due to no nursing Cant straighten

Question 33

Oxytetracycline in FLP

Answer 33

Deformity Given IV inhibits myofibroblast contraction - allows muscle to relax and have better prognosis

Question 34

Bandaging flexural deformity

Answer 34

Want to protect/relax muscle tendon unit Must change frequently, pressure sores are common Bandages come all the way to the ground - unlike in laxity

Question 35

Toe extensions w FD

Answer 35

Toe extensions are common, when FD is on distal interphalangeal jt Increases tensile forces of DDFT

Question 36

Distal check ligament desmotomy

Answer 36

DF in distal interphalangeal joint Releases load & transfers weight to DDFT

Question 37

Proximal check ligament desmotomy

Answer 37

P3 is normal, fetlock is not FD in metacarpophalangeal joint Lengthen muscle/tendon unit Releases tension w forward bend so leg relaxes back to a more normal stance