Standing placement of transphyseal screw in the distal radius in 8 Thoroughbred yearlings.

This retrospective study describes placement of distal radial transphyseal screws in Thoroughbred yearlings with carpal varus deformities while standing, and identifes short- and long-term complications following the procedure. Data gathered from 2009 to 2013 identified 8 yearlings that met the inclusion criteria. Horses were sedated intravenously and a single 4.5-mm cortical screw was placed in the distal lateral radial physis following application of local anesthetic and surgical preparation of a pre-placed hole. All horses were evaluated weekly after surgery and screw removal was performed standing and under sedation when correction of the angular limb deformity was achieved. The mean time for screw removal was 46 days. No short- or long-term complications were identified. Findings indicate that placing a single transphyseal screw in the lateral aspect of the distal radial physis with the horse standing is a viable option to treat varus angular limb deformity of the carpus in horses.

Placement debout d'une vis transphysaire dans le radius distal chez 8 Thoroughbred âgés d'un an. Cette étude rétrospective décrit le placement d'une vis transphysaire dans le radius distal de chevaux Thoroughbred âgés d'un an ayant des difformités du varus carpien, lorsqu'ils sont debout, et elle identifie les complications à court et à long terme après l'intervention. Les données recueillies de 2009 à 2013 ont identifié 8 chevaux âgés d'un an qui satisfaisaient aux critères d'inclusion. Les chevaux ont été mis sous sédation par intraveineuse et une seule vis corticale de 4,5 mm a été placée dans le cartilage diaphyso-éphysaire après l'application d'anesthésie locale et de la préparation chirurgicale d'un trou pratiqué au préalable. Tous les chevaux ont été évalués une fois par semaine après la chirurgie et l'enlèvement de la vis a été réalisé debout et sous sédation lorsque la correction de la difformité angulaire du membre a été obtenue. Le temps moyen de l'enlèvement des vis était de 46 jours. Aucune complication à court ou à long terme n'a été identifiée. Les résultats indiquent que le placement d'une seule vis transphysaire dans l'aspect latéral du cartilage diaphyso-éphysaire distal radial, lorsque le cheval se tient debout, est une option viable pour traiter la difformité angulaire de type varus du carpe chez les chevaux.(Traduit par Isabelle Vallières).

Correction of severe congenital flexural carpal deformities with semicircular external skeletal fixation system in calves.

OBJECTIVE: To present a novel technique for the treatment of severe congenital flexural forelimb deformities in calves. METHODS: Thirteen calves of different breeds and sex with severe congenital flexural forelimb deformities were enrolled in the study. A semicircular external skeletal fixation system composed of 6-hole, 45° carbon-fiber arches, 6 mm threaded rods, half-pin fixation bolts, 6 mm hexagonal nuts, and negative profile end-threaded half-pins were used for pancarpal arthrodesis. Complications, time to first use of the limb, fixator removal time, preoperative and postoperative sagittal plane angles of the fused joints, and functional outcomes were evaluated clinically and radiographically. Final assessments were determined according to functional and cosmetic outcomes. RESULTS: All of the surgically treated carpal joints obtained fusion. Seven of the calves started to use the limb immediately after recovering from anesthesia. In the other six calves, the time ranged from one to two days. Time to fixator removal ranged from 25 to 36 days (mean 30 days). Final outcome was excellent in 11 cases, and good in two cases. CLINICAL SIGNIFICANCE: The technique was found to be a useful method for the treatment of severe congenital flexural forelimb deformities in calves. The cost of the operation is negligible compared to the economic value of beef cattle.

Complications after two transphyseal bridging techniques for treatment of angular limb deformities of the distal radius in 568 Thoroughbred yearlings.

REASONS FOR PERFORMING STUDY: Surgical correction of carpal angular limb deformities by growth retardation is commonly undertaken with a screws and tension band wire loop technique (S&W) or a single transphyseal screw (STS). This study compares complications after S&W and STS bridging in the distal radius of Thoroughbred yearlings. OBJECTIVE: To compare the prevalence of complications serious enough to require follow-up radiographs following either S&W or STS surgery for growth manipulation in the distal radius of Thoroughbred yearlings. METHODS: Medical records and radiographs from Thoroughbred yearlings (age range 261-457 days) treated for carpal angular limb deformities at a single hospital over 2 years were reviewed. Each of the techniques was used exclusively during a single year. The complication threshold criterion for inclusion was the need for nonroutine radiographs of the operated site anytime after implant insertion or removal. RESULTS: Of 568 horses, 253 received S&W and 315 received STS. Horses were of similar age at the time of surgery for STS and S&W. Single transphyseal screws were left in place for a significantly shorter amount of time (16 days). Sex, the limb(s) treated and medial vs. lateral placement were not significantly different between techniques. Complications included physitis post implant removal, metaphyseal collapse post implant removal, infection, overcorrection and seroma formation severe enough to require radiography. Physitis and metaphyseal collapse occurred significantly more frequently with STS compared with S&W. Infection, overcorrection and seromas were not significantly different between techniques. CONCLUSION: The STS and S&W techniques are both viable treatment options for correction of carpal angular limb deformities. However, horses treated with the STS technique have a significantly increased risk of developing physitis or metaphyseal collapse. POTENTIAL RELEVANCE: Horses treated with STS bridging have a significantly increased risk of developing the post correction complications of moderate to severe physitis and metaphyseal collapse compared with horses treated with S&W bridging.