Flexural Limb Deformities of the Carpus and Fetlock in Foals.

Early recognition and treatment of congenital and acquired flexural deformities of the carpi and fetlocks of foals can lead to conformation correction and an athletic future. Treatment is often based on rigid external coaptation assisted by systemic medical treatment. Foals that readily respond to treatment and correct conformation faults can have normal adult athletic expectations.

Routine Trimming and Therapeutic Farriery in Foals.

Hoof care in the first few months of life is serious business and should never be taken lightly. Farriery plays a vital role in both the development of the hoof and the conformation of the limb. Management of the feet and limbs during this period will often dictate the success of the foal as a sales yearling or mature sound athlete. A sound foot care program is time-consuming, whereas assembly-line trimming is quick and easy, but the former is much more beneficial.

Flexural Deformity of the Distal Interphalangeal Joint.

Flexural deformities in young horses are commonly referred to as contracted tendons, which is a term that is not consistent with what is currently understood about their cause. Flexural deformity of the distal interphalangeal joint can be either congenital (present at birth) or acquired (develop at a later stage of growth typically between 1 and 6 months of age). These 2 manifestations are commonly managed differently depending on the cause, age of onset, severity, duration, complicating factors, and owner expectations. Early recognition and appropriate intervention are essential to ensure that it is not performance limiting.

Bilateral contracture of the carpal and digital flexor muscles resulting in carpal flexural deformity in a cat.

Case summary: A 12-year-old neutered female domestic shorthair cat was presented with bilateral progressive forelimb lameness that was unresponsive to anti-inflammatory drugs. Bilateral carpal flexural deformity with hyperflexion of multiple toes of the right forelimb was observed. In the absence of abnormalities detected on radiographs and ultrasound, a bilateral contracture of the carpal and digital flexor muscles was diagnosed. Treatment consisted of single-session bilateral selective tenectomies (5 mm) of the flexor carpi ulnaris, flexor carpi radialis and superficial digital flexor muscle tendons on the left forelimb and tendons of the flexor carpi ulnaris muscle, and branches of the third and fourth digit of the deep digital flexor muscle on the right forelimb. Two months postoperatively, selective tenectomies (10 mm) were performed due to contracture recurrence on the left forelimb. The subjective outcome was rated as good 6 months postoperatively. Relevance and novel information: Digital and/or carpal contractures are rarely described in (feline) veterinary medicine and are limited to a few case reports. The exact aetiology remains unknown. A traumatic/iatrogenic origin seems to be the most likely cause. Surgery is indicated, consisting of selective tenectomy and/or tenotomy, and is associated with minor complications and an excellent outcome. This case report describes the presence, treatment and successful outcome of a cat with bilateral carpal and digital flexor muscle contractures resulting in carpal flexural deformity with valgus deviation treated with selective tenectomies.

Congenital digital flexural deformity (knuckling): Epidemiology, the association of trace elements and surgical treatment in neonatal bovine calves.

Objectives: This study aimed to investigate the prevalence and pattern of congenital flexural deformity (knuckling), to identify the association between trace elements and vitamins with the deformity, and to apply different surgical techniques for correcting this congenital malformation in newborn bovine calves. Materials and Methods: The study was implemented on 17 newborn calves with carpal (knee) and fetlock (foot) knuckling presented to the Veterinary Teaching Hospital of Bangladesh Agricultural University, Mymensingh, from January to December 2020. The serum biochemical alterations and clinical outcomes were assessed on days 0 and 21 following surgery. Two surgical methods: tendon transection and tendon elongation by Z-tenotomy, were performed for surgical restoration. Results: We found that knuckling comprised 12% of the total congenitally malformed calves. The male calves had a higher prevalence (52%, n = 9) and the same in the winter season (65%, n = 11). The majority of the knuckling was bilateral types (88%, n = 15), involving the carpal joint (82%, n = 14) and moderately angulated (59%, n = 10). The serum level of magnesium, iron, vitamin D, and zinc were significantly (p < 0.05) changed from the pre-surgical stage to the stage of non-lameness after surgery. The disorder was surgically treated by tendon transection or tendon elongation procedure and had a good prognosis. Conclusion: The current study concluded that the development of knuckling in calves might be related to a deficiency/excess of specific minerals and vitamins and that it can be effectively corrected by surgical intervention; however, early diagnosis and the use of proper surgical techniques are crucial for improving the prognosis.

Rhabdomyolysis and Acute Renal Failure Associated with Oxytetracycline Administration in Two Neonatal Foals Affected by Flexural Limb Deformity.

Oxytetracycline (OTC) administration has become a frequent practice in equine neonatology for the treatment of flexural limb deformity. The cause of this condition remains unclear but clinical studies revealed that following IV administration of OTC a relaxation of the metacarpophalangeal joint occurs in foals affected by flexural deformity. Studies concluded that OTC administration in neonatal foals did not adversely affect the kidneys. Other adverse effects of OTC have never been reported. This report presents two cases with different outcomes of 3-day-old foals which presented acute collapse and progressive depression after OTC administration. The clinical aspects, the increased activity of serum enzymes indicative of muscular damage, the presence of myoglobin in urine were clear diagnostic indicators of severe rhabdomyolysis, and the gross and histological findings confirmed a myopathy associated with renal damage in one case. Adverse effects on the musculoskeletal and urinary systems in healthy foals were first reported and were probably associated with multiple doses administered to foals less than 24-48 h old and/or at dosing intervals less than 24-48 h. The risk of development of rhabdomyolysis and nephrotoxicity in neonatal foals treated with OTC for flexural deformity from now on should be considered.

Radiographic analysis of the angle in the lateromedial projection of the metacarpophalangeal joint and the distal interphalangeal joint in metacarpophalangeal flexural deformities in calves.

The bone alignment of the metacarpophalangeal joint (MPJ) of the distal interphalangeal joint (DIPJ) in metacarpophalangeal flexural deformity (MPFD) in calves was evaluated by radiography. This study was designed by retrospective study of radiographs. Lateral to medial radiographs of distal forelimbs were taken from 19 MPFD affected calves (35 forelimbs) and 21 normal calves (42 forelimbs). Based on the radiographs, the lateral angles of MPJ were measured from the metacarpal bone axis and proximal phalanx axis, and lateral angles of DIPJ were measured from the middle phalanx axis and distal phalanx axis. Mean lateral angle of MPJ in the normal limbs was 175.9 (95% CI 174.5 to 177.4). Mean lateral angles of MPJ in MPFD were as follows: mild: 167.1 (158.9-175.2), moderate: 165.1 (158.5-171.7) and severe: 150.6 (146-155.1). MPJ angle in MPFD limbs was narrower than that in the normal limbs (mild, moderate and severe: P=0.017, P=0.003 and P<0.001, respectively). Mean lateral angle of DIPJ in the normal limbs was 211.9 (210.7-213.2). Mean lateral angles of DIPJ in moderate: 200.6 (195.2-206.1) and severe: 204.9 (203.3-206.5) MPFD were narrower than that in the normal limbs (both P<0.001). There was no significant difference between the normal limbs and mild: 210.3 (206.9-213.7) MPFD limbs (P=0.7). The clinical severity of MPFD corresponded well with the lateral angle of MPJ. The flexion of DIPJ in moderate and severe MPFD was similar to the flexion of MPJ in MPFD. This suggested that the lateral to medial radiographs accurately reflected the MPJ flexion and the DIPJ in MPFD in calves, providing useful information for the treatment of MPFD.

Effects of two different deep digital flexor tenotomy techniques on distal articular angles of equine cadaver forelimbs / Efeito de duas técnicas de tenotomia do flexor digital profundo sobre os ângulos articulares distais dos membros anteriores de equinos: estudo post-mortem

Deep digital flexor (DDF) tenotomy is a technique employed for years to treat selected disorders of the musculoskeletal system in horses. Although two different surgical approaches (i.e. mid-metacarpal and pastern) have been described for performing the procedure, in vitro quantitative data regarding the modifications induced by either technique on the distal articular angles is lacking. Therefore, the purpose of the study reported here was to investigate the viability of a proposed biomechanical system of induced-traction used to compare the two DDF tenotomy techniques by measuring the distal articular angles of equine cadaver forelimbs. Ten pairs of forelimbs were collected and mounted to a biomechanical system developed to apply traction at the toe level. Dorsal articular angles of the metacarpophalangeal (MP), proximal interphalangeal (PIP) and distal interphalangeal (DIP) joints were determined by geometric lines on radiographs taken before and after performing each technique. Comparisons between each tenotomy group and its own control, for each joint, and between the two tenotomy groups using as variable the difference between the tenotomy and control groups were tested. Despite the lack of statistical significance, the DDF tenotomy technique at the pastern level produced extension, to a lesser and greater extent, of the PIP and DIP joints, respectively when compared to the mid-metacarpal level. No remarkable differences could be observed for the MP joint. The developed traction-induced biomechanical construct seemed to be effective in producing valuable quantitative estimations of the distal articular angles of equine cadaver forelimbs subjected to different DDF tenotomy techniques.

A tenotomia do flexor digital profundo (FDP) é uma das técnicas cirúrgicas empregadas para o tratamento de algumas anormalidades osteomusculares, como as deformidades flexurais e a laminite em equinos. Embora diferentes acessos cirúrgicos (i.e. terço médio do metacarpo e quartela) possam ser utilizados, informações quantitativas obtidas in vitro, referentes aos ângulos articulares distais estabelecidos após a execução de ambos os acessos não são conhecidas. Dessa forma, o objetivo deste trabalho foi estudar a viabilidade de um sistema biomecânico de tração induzida na comparação de duas técnicas de tenotomia do FDP por meio da mensuração dos ângulos articulares distais em peças anatômicas de equinos. Dez pares de membros anteriores foram coletados e montados em um sistema biomecânico de tração induzida aplicada na região da pinça do casco. Os ângulos articulares dorsais das articulações metacarpo falangeana (MF), interfalangeana proximal (IFP) e interfalangeana distal (IFD) foram determinados através de linhas geométricas traçadas com base no exame radiográfico realizado antes e após a realização de cada técnica. Comparações entre cada técnica e seu respectivo controle, para cada articulação, e entre as duas técnicas, utilizando as diferenças angulares obtidas antes e após cada técnica, foram testadas. Embora não se tenha obtido diferença estatisticamente significativa, a técnica de tenotomia do FDP ao nível da quartela produziu um maior e menor grau de extensão das articulações IFD e IFP, respectivamente, quando comparado à técnica no terço médio do metacarpo. Diferenças inexpressivas foram observadas na articulação MF. O sistema biomecânico de tração induzida se mostrou eficiente na determinação quantitativa dos valores aproximados das angulações articulares distais de membros anteriores de equinos submetidos às duas técnicas de tenotomia do FDP.