Equis ISSN 2398-2977

Carpus: growth retardation - angular deformity

Synonym(s): Transphyseal bridging

Contributor(s): Patrick Colahan, Graham Munroe

Introduction

  • To slow growth on the convex (long) side of a growth plate above a joint with an angular deformity   Musculoskeletal: angular deformity  .
  • New chondrocyte production and endochondral ossification is inhibited.
  • Retarded growth results in straightening of limb.
  • This technique describes correction of carpal valgus, with notes on correction of other angular deformities.

Uses

  • Correction of selected angular limb deformities   Musculoskeletal: angular deformity  in foals:
    • Deformities of: the distal third metacarpal/metatarsal region; proximal phalanx; distal tibia; distal radius.
    • Where continued longitudinal skeletal growth is expected, eg foals >2 weeks but <12 months old, ideally around 2-3 months old; in foals with deformities affecting the metacarpophalangeal or metatarsophalangeal joints <8 weeks old.
    • For severe deformities.
    • For deformities where conservative management has failed.
    • In combination with growth acceleration techniques   Carpus: growth acceleration - angular deformity  .

Advantages

Disadvantages

  • Second procedure necessary for implant removal.
  • Delay in implant removal results in over-correction.
  • Poorer cosmesis than growth acceleration techniques.
  • Third procedure necessary if asymmetric straightening in bilaterally affected limbs.
  • Not applicable to metacarpal/metatarsal deviations.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good for:
    • Athletic and breeding career, depending on age and severity of deformity.
    • Tarsal deviations, if foal less than 5 months old.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bramlage L R (1999) The science and art of angular limb deformity correction. Equine Vet Educ 31 (3), 182-182 (Editorial comment) PubMed.
  • Brauer T S, Booth T S & Riedsel E (1999) Physeal growth retardation leads to correction of intracarpal angular deviations as well as physeal valgus deformity. Equine Vet Educ 31 (3), 193-196 PubMed.
  • Caron J P (1988) Angular limb deformities in foals. Equine Vet J 20, 225-228 PubMed.

Other sources of information

  • Bathe A P & Hilton R L (2008)Treatment of Angular Limb Deformities in Foals Using Radial Extracorporeal Shockwave Therapy.In:Proc ESVOT Congress.Munich, Germany. pp 222.
  • Rowlands D S, Boening K J & Bathe A P (2005)Treatment of Angular Limb Deformities in Foals using Radial Extracorporeal Shockwave Therapy: Prospective Trial.In:Proc BEVA Congress. EVJ Ltd, Newmarket. pp119.
  • Witte S, Thorpe P E, Hunt R J, Spirito M A & Rodgerson D H (2004)Growth Retardation at the Distal Tibial Physis through Single Screw Placement.In: 50th AAEP Annual Convention.Denver, USA.


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