Equis ISSN 2398-2977

MCP / MTP joint: flexural deformity

Contributor(s): Steve Adair, Helen Herinckx, Jessica A Kidd-Millar, Vetstream Ltd, Chris Whitton

Introduction

  • Common condition of growing horses in which the joint is held in an abnormally flexed position   Musculoskeletal: flexural deformity  .
  • Incorrectly called "contracted tendons": this implies a defect in the tendon itself and is incorrect in light of the proposed pathogenesis - this term should consequently be avoided.
  • Affects soft tissue structrues and occurs in the sagittal plane.
  • Tendon laxity also occurs.
  • Cause: relative shortening of the musculotendinous unit.
  • Signs: flexural deformity   Musculoskeletal: flexural deformity  :
    • Congenital: present at birth.
    • Acquired: develops during the growing phase.
  • Metacarpophalangeal joint more commonly affected than metatarsophalangeal joint.
  • Diagnosis: physical examination.
  • Treatment: farriery, analgesices, exercise restriction, surgery, external coaptations, IV oxytetracycline/tetracycline.
  • Prognosis: good to poor depending on degree of deformity and secondary joint changes.
Print off the Owner factsheet on Flexural limb deformities to give to your clients.

Pathogenesis

Etiology

Proposed etiopathogenesis

  • Congenital:
    • Uterine malpositioning.
    • Exposure to teratogens.
    • Dominant gene mutation.
    • Neuromuscular disorder.
    • Influenza outbreak.
    • Majority of causes unknown.
  • Acquired:
    • Likely that etiopathogenesis of acquired flexural deformities is multifactoral and complex but several theories have been proposed for the occurrence of acquired flexural deformities.
    • The main theories are:
      • A mismatch in bone and tendon/ligament growth.
      • Contraction of the musculotendinous unit in response to pain.
  • Have been described in adult horses secondary to desmitis of the ALDDFT   Accessory ligament DDFT: forelimb - desmitis  .

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Wall R A, Robinson P & Adkins A R (2010) The use of an absorbable bone screw as a transphyseal bridge for the correction of fetlock varus deviations in six foals. Equine Vet Educ 22 (11), 571-575 VetMedResource.
  • Kidd J A & Barr A R S (2002) Flexural deformities in foals. Equine Vet Educ 14, 311-321 VetMedResource.
  • Kidd J A (2002) A new method of splinting a congenital metatarsophalangeal flexural deformity in a foal. Equine Vet Educ 14, 308-310 Wiley Online Library.
  • Adams S B et al (1999) Management of flexural limb deformities in young horses. Equine Pract 21 (2), 9-15 VetMedResource.
  • McDiarmid A (1999) Acquired flexural deformity of the metacarpophalangeal joint in five horses associated with tendonous damage in the palmar metacarpus. Vet Rec 144, 475-478 PubMed.
  • Lokai M D (1992) Case selection for medical management of congenital flexural deformities in foals. Equine Pract 14 (4), 23-25 VetMedResource.


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