Treatment of Common Limb Deformities
Dr Darren P Arnold BSc BVMS Adelaide Hills Equine Clinic
www.adelaidehillsequine.com.au
Laxity or Contraction Uterine malposition is the most common
reason given for these congenital contractures and laxities.
Restricted space in the uterus causes some foals to be twisted or "stuck" in awkward positions not allowing them to stretch their limbs and move about.
Abnormally positioned legs develop tightened or shortened ligaments and tendons.
www.adelaidehillsequine.com.au
Very common especially in hind limbs Most will self correct in 2-5 days. Bandages may need to be applied to
protect fetlocks rubbing on ground Not so tight as to give support Exercise will increase tension naturally More severe cases may need trailer shoe
placed on foot
www.adelaidehillsequine.com.au
Treatment
Oxytetracycline (Alamycin 10) 30-40ml This seems a large dose but is well
tolerated.Rarely causes diahorrea. Can be repeated 24 hours later if required Theory is it works on the calcium
pathways in musculotendinous junctions in the leg. Releasing tension.
www.adelaidehillsequine.com.au
Contracted Tendons
Need to be careful not to allow excessive exercise or they can become over lax and bend the other way after Oxytet.
In more severe cases splints can be added to legs .
Splints should only really need to be on for 2-3 weeks maximum or rethink approach.
www.adelaidehillsequine.com.au
Bandage rubs
Need to be applied with plenty of padding preferably by vet first time .
Changed every 3-5 days Pay careful attention to joint surfaces
www.adelaidehillsequine.com.au
Angular Limb Deformities
Front and hind fetlocks
Carpus (knee) Most common
Hocks
www.adelaidehillsequine.com.au
Angular Limb DeformitiesGenerally
Most foals with angular limb deformities can self-correctwith management including confinement ,hoof trimming and shockwave.
Angular limb deformities due to underdeveloped cuboidal bones may carry a poor prognosis for correction.
Periosteal stripping is not an effective treatment.(Read et al JAVMA 2002)
Transphyseal bridging techniques are indicated in foals that do not self-correct.
www.adelaidehillsequine.com.au
Fetlock deviation
1.Need to act faster the Knees 8 weeks is too late Aggressive first month of life treatment
gives good results Trimming and placement of cuffs
www.adelaidehillsequine.com.au
Knees Have more time Most can be corrected without surgery Up to 12 weeks Early intervention gives a better result Trimming “taking from where there is too
much or Cuffing “putting foot were there isn’t
any”
www.adelaidehillsequine.com.au
Shockwave Therapy (ESWT) in horses is a relatively new approach to treating a wide range of orthopaedic conditions.
Originally shockwaves were used in human medicine to break-up kidney or bladder stones a treatment called lithotripsy, it was then subsequently found to beneficial in human orthopaedic conditions such as heel spurs and tennis elbow.
www.adelaidehillsequine.com.au
Conditions Treated with shockwaves
Tendonitis Suspensory ligament
desmitis Shinsoreness Bone Spavin Back pain Fibrotyic myopathy Annular Limb
deformity
www.adelaidehillsequine.com.au
Radiography
Assess growth plate status eg,fractures,crushing,closure
Visualise area that deviation is coming from
Calculate degree of deviation
www.adelaidehillsequine.com.au
Treatment optionsBandaging
Not beneficial for angular limb deformity in lateral or medial planes. Bandaging/splinting-
reserved for contracted tendons etc with the addition of
oxytetracycline injections
www.adelaidehillsequine.com.au
Periosteal stripping
Treatment used for over 20 years Currently the opinion is that it has been
over used in the past. Has potential to leave unsightly scar Move away from this as a treatment
universally
www.adelaidehillsequine.com.au
New method of transphyseal bridging
Insertion of a single screw across the growth plate.This halts growth on the fast growing side and allows the slower side to catch up.
Once leg is straight the screw is removed.
www.adelaidehillsequine.com.au
Advantages and Disadvantages of screw placement
Advantages- Good cosmetic result as the screw is
placed on inside of leg with valgus foals(approx 75% of ALD are these).
Quick response wih straightening of legs 2-4 weeks in most cases
Disadvantages 2 general anesthesia's needed one for
placement one for retrieval Potential for infection around the
screw Potential for screw to bend/break
www.adelaidehillsequine.com.au
Shockwave Therapy First used in Newmarket UK. Shockwaves are sent thru the growth plate region that is growing
too fast, the shockwaves halt the natural growth of that side for a period of time.
Shock wave therapy is first line treatment if this fails screw placement carried out.First year in UK 40 treated( 3 had screws placed due to poor perceived response).
Morphettville Equine Clinic season 2006 2008. 42 foals treated, 32 carpal valgus, 6 fetlock varus,4 carpal and fetock valgus.6 required screw placement.
Good response to carpal(knee) valgus, fair response to fetlocks if done early
www.adelaidehillsequine.com.au
Summary UK and South Australia
There appears to be a +ve effect with the use of shockwave in annular limb defects with the carpus>fetlock.
Corrective farrier work must be used in conjunction with shockwave It is difficult in assessing response to a condition that often
spontaneously improves but,clinical impression is that it allows a more rapid return to normal management ie: foals often need to be confined for a shorter time.
The non invasive nature means it can be applied early and if there is a lack of satisfactory response a transphyseal screw can be placed
The lack of any cosmetic blemishes is beneficial from a sales point of view.
www.adelaidehillsequine.com.au
Top Related