Correção de deformidade flexural da articulação metacarpofalangeana em uma bezerra / Correction of flexural deformity of the metacarpophalangeal joint in a calf

Background: The congenital flexural deformity is common in cattle, often affecting the metacarpophalangeal joint of thethoracic limbs. The deformity may be mild, moderate, or severe, and the therapy depends on the limb’s degree of flexionand the affected joint. In severe deformities, tenotomy of the flexor tendons and desmotomy of the suspensor ligament isrecommended. However, this surgical technique may not be sufficient to promote limb extension, and other interventionsmay be necessary. Thus, the purpose of this report is to describe a technique to correct severe flexural deformities of themetacarpophalangeal joint in calves.Case: A 3-month-old, female, Dutch-bred calf weighing 46 kg was referred for treatment of congenital flexural deformity.On attendance, the patient presented severe deformity in the right thoracic limb and mild in the left thoracic limb both at theheight of the metacarpophalangeal joints. During palpation it was possible to notice that the flexor tendons were contractedin both limbs. Radiographic exams were performed to rule out the presence of other diseases, confirming the diagnosis offlexural deformity. The patient was referred to surgery to correct the anatomical anomaly. The animal was submitted to general anesthesia and placed in right lateral decubitus. In the left thoracic limb, an incision was made in the medial region ofthe metacarpal bone, the tissues were divulsioned until the superficial digital and deep digital flexor tendons were exposed;these structures were sectioned with a scalpel, and the limb was extended, returning to the standard anatomical position. Inthe right thoracic limb, the same procedure was performed, but during the limb extension test, we observed that the limbremained flexed, we then followed with a second incision and section of the deep...

Manejo da deformidade flexural congênita em bezerro - aspectos cirúrgicos e patológicos / Management of a congenital flexural deformity in a calf - surgical and pathological aspects

Background: Flexural deformities are anatomical deviations, in varying degrees, of one or more joints, and may have a congenital or acquired origin. Congenital contracture of the deep digital flexor tendon (DDFT) affects newborn calves and results in hyperflexion of the metacarpal-phalangeal joint, which in severe cases means that the animal must support its own weight on its fetlock joints. The aim of this study is to report the rapid and successful result of applying bilateral total tenotomy technique on a newborn bovine that had been diagnosed with severe bilateral DDFT contracture in the thoracic limbs. Case: A 3-week-old male bovine with a history of difficulty in maintaining a quadrupedal position was attended at the Veterinary Hospital of the Federal University of Tocantins. The animal had severe bilateral locomotor alterations in the thoracic members to the point that he walked on his fetlock joints. The physical examination revealed clinical parameters within the normal range. However, the locomotor system examination showed severe flexor deformity in the bilateral metacarpal-phalangeal joints, and the limbs were being supported on the dorsal face of the fetlock joints, which presented ulcerations, and was suggestive of a shortening of the DDFT. Based on the patients history and clinical examination, as well as the severity of the tendon contractures, surgical treatment using the DDFT bilateral total tenotomy technique was decided upon. Postoperative treatment consisted of 2.5 mg/kg of enrofloxacin intramuscularly (IM), SID, for 5 days and 0.5 mg/kg meloxicam via IM, SID, for 3 days; as well as a dressing (cotton, medical bandage and a PVC mold) on the thoracic limbs to provide support and allow the animal to..(AU)

Trastorno de la alineación de articulaciones metacarpofalángicas en una adolescente con artritis idiopática juvenil / Metacarpophalangeal joint alignment disorder in a teenager diagnosed with juvenile idiopathic arthritis

La artritis idiopática juvenil es una enfermedad inflamatoria, sistémica y crónica que afecta a personas menores de 18 años de edad. Tiene diversas formas clínicas de presentación, pero todas y cada una de ellas pueden causar un elevado número de complicaciones articulares y extraarticulares que pueden desencadenar discapacidad funcional y disminución de la percepción de la calidad de vida relacionada con la salud. Se presenta la imagen poco frecuente de alteraciones de la alineación en las articulaciones metacarpofalángicas de ambas manos en una paciente de 14 años de edad con antecedentes de 3 años de evolución de artritis idiopática juvenil. Se administró tratamiento con esteroides y medicamentos modificadores de la enfermedad. A los 3 meses se encontraba estable, con una escala visual análoga de dolor ocasional de 2 puntos y con esquema terapéutico adecuado para el control de su enfermedad de base(AU)

Juvenile idiopathic arthritis is an inflammatory, systemic and chronic disease that affects people under 18 years of age. It presents various clinical forms of presentation but each and every one of them can generate a high number of joint and extra-articular complications that can trigger functional disability and decrease in the perception of health-related quality of life. There is a rare image of alterations in the alignment at the level of metacarpophalangeal joints of both hands in a 14-year-old patient with a history of three years of evolution of juvenile idiopathic arthritis(AU)

Manejo da deformidade flexural congênita em bezerro - aspectos cirúrgicos e patológicos / Management of a congenital flexural deformity in a calf - surgical and pathological aspects

Background: Flexural deformities are anatomical deviations, in varying degrees, of one or more joints, and may have a congenital or acquired origin. Congenital contracture of the deep digital flexor tendon (DDFT) affects newborn calves and results in hyperflexion of the metacarpal-phalangeal joint, which in severe cases means that the animal must support its own weight on its fetlock joints. The aim of this study is to report the rapid and successful result of applying bilateral total tenotomy technique on a newborn bovine that had been diagnosed with severe bilateral DDFT contracture in the thoracic limbs. Case: A 3-week-old male bovine with a history of difficulty in maintaining a quadrupedal position was attended at the Veterinary Hospital of the Federal University of Tocantins. The animal had severe bilateral locomotor alterations in the thoracic members to the point that he walked on his fetlock joints. The physical examination revealed clinical parameters within the normal range. However, the locomotor system examination showed severe flexor deformity in the bilateral metacarpal-phalangeal joints, and the limbs were being supported on the dorsal face of the fetlock joints, which presented ulcerations, and was suggestive of a shortening of the DDFT. Based on the patient’s history and clinical examination, as well as the severity of the tendon contractures, surgical treatment using the DDFT bilateral total tenotomy technique was decided upon. Postoperative treatment consisted of 2.5 mg/kg of enrofloxacin intramuscularly (IM), SID, for 5 days and 0.5 mg/kg meloxicam via IM, SID, for 3 days; as well as a dressing (cotton, medical bandage and a PVC mold) on the thoracic limbs to provide support and allow the animal to..

Camptodactilia: informe de 14 pacientes con 15 dedos operados con la técnica de Millesi / Comptodactily: report of 14 cases with 15 fingers, surgically treated by the Millesi technique

Se presenta un estudio retrospectivo de 17 años de camptodactilia; 14 casos del sexo femenino con 15 dedos. Correspondieron al tipo congénito 12 y dos al adolescente. La deformidad encontrada fue moderada en 12 dedos y severa en tres. A todos se les efectuó la técnica descrita por Millesi en 1968. La valoración de resultados se basó en la clasificación de Cooney en 1991. Se obtuvieron resultados buenos en 14 dedos y pobres en uno, a quien se le hizo liberación del ligamento cápsulo-palmar y alargamiento del flexor produndo. En todos los dedos se encontró anormalidad en la inserción del lumbrical como está descrito en la literatura mundial. Esta deformidad representa un desequilibrio entre las fuerzas palmares flexoras y las fuerzas extensoras dorsales a nivel de la articulación interfalángica proximal del dedo, debido a la pérdida de fuerza de los músculos intrínsecos.

Síndrome CCC (cuello corto, campodactilia, cardiopatía) con variabilidad: nuevo síndrome autosómico dominante / Syndrome CCC (short neck, camptodactily, cardiopathy) with variability expression: a new autosomic dominant syndrome

Se presenta el cuadro clínico no descrito anteriormente de una familia en la que se encontraron 16 personas que mostraban, en forma constante, cuello corto y ancho, cardiopatía a expensas del ventrículo izquierdo y camptodactilia con hipoplasia de los pliegues de flexión. Todos tenían talla baja con variabilidad en su expresión. Otros datos no constantes fueron paladar alto, depresión del puente nasal, micrognatia, cúbito varo, posición dental anormal e hiperplasia gingival. Al tomar en cuenta las malformaciones constantes se le ha denominado "sindrome CCC", siglas que corresponden a cuello corto, cardiopatía y camptodactilia.