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LA Sx Exam 1 > Angular Limb Deformities > Flashcards

Angular Limb Deformities Flashcards

1
Q

Pigeon toed

A

Varus

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2
Q

Medial deviation of the limb distal to point of origin

A

Varus

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3
Q

Lateral deviation of the limb distal to point of origin

A

Valgus

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4
Q

What is appositional growth?

A

Increase in bone thickness

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5
Q

Addition of new bone from the periosteum

A

Appositional growth

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6
Q

Longitudinal growth comes from what?

A

Physis

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7
Q

Compressive forces on endochondral cartilage retards growth

A

Delpech law

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8
Q

What is the most common etiology of angular limb deformities?

A

Disproportionate growth @ metaphyseal growth plates

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9
Q

Rate of growth is mostly _____, but it can be modified w/_____

A

Genetic, diet

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10
Q

SH fractures and physitis can cause this problem that impairs longitudinal growth

A

Premature physeal closure

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11
Q

Caused by disproportional growth or microtrauma

A

Physitis

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12
Q

Which side of the growth plate does physitis usually occur?

A

Medial

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13
Q

A straightened limb axis but ALD persists is called what?

A

Compensatory ALD

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14
Q

Limb looks straight, but dynamic assessment is still abnormal

A

Compensatory ALD

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15
Q

Are SH fractures in the proximal or distal limb more damaging to a horse’s athletic capacity?

A

Distal

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16
Q

What are perinatal factors that contribute to ALD?

A

Incomplete ossification, peri-articular laxity, aberrant intrauterine ossification

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17
Q

What causes incomplete ossification?

A

Twins/prematurity, placentitis, systemic disease of the mare

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18
Q

Where is incomplete ossification most common?

A

Tarsus

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19
Q

What are clinical signs of incomplete ossification?

A

Bunny hops instead of trotting

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20
Q

Which aspect of the tarsus is affected by incomplete ossification?

A

Dorsal aspects

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21
Q

Unstable joints causes uneven loading which leads to uneven physis growth

A

Peri-articular laxity

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22
Q

What causes peri-articular laxity?

A

Hormonal imbalances, intrauterine position, idiopathic

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23
Q

What is the most common cause of peri-articular laxity?

A

Idiopathic

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24
Q

Deformity can be manually corrected

A

Incomplete ossification and peri-articular laxity

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25
Deformed long bone usually at the epiphysis
Aberrant intrauterine ossification
26
Where is the most common site to see aberrant intrauterine ossification?
Distal MT3
27
What compensatory ALD follows abberant intrauterine ossification of distal MT3?
Proximal P1
28
Will also cause other deformities along the leg because the legs will grow unevenly from an affected physis
Aberrant intrauterine ossification
29
What are acquired factors that contribute to ALD?
Unbalanced nutrition, excessive exercise, trauma, genetics
30
What nutrtional factors influence ALD?
Excessive grain intake | ZN tox/ Cu deficiency
31
What horse breed has a high potential for rapid growth?
Throroughbreds
32
Other than ALD, what developmental orthopedic diseases arise from unbalanced nutrition?
Osteochontrosis, FLDs
33
How does excessive trauma cause ALD?
Causes physitis and premature closure of physis
34
Where should you stand to assess the angle of deviation of a foot?
In front of the frontal plane of the limb (not in front of the toe)
35
How soon will foals grow into the normal degree of valgus that they are born with at the fetlock?
2-4 months
36
How much carpal valgus is considered normal in young foals?
Up to 5*
37
What radiographic view do you us to dx ALD in forelimbs? In hindlimbs?
Fore: DP Hind: DP and lateral
38
What on hindlimb rads will help you determine the amount of deviation in the limb?
Misalignment between the tibia and MT3
39
Allows ID of degree and location of deformity
Radiographs
40
If the deformity can be straightened manually, what types of ALD go on your list of ddx?
Incomplete ossification of cuboidal bones and peri-articular laxity
41
What are non-surgical treatments incomplete ossification?
1 month strict stall rest
42
How do you treat peri-articular laxity non-surgically?
Controlled exercise
43
How soon does peri-articular laxity self correct?
2 weeks
44
If ALD is <10*, how should you treat it?
Medically first, then surgical if it doesn't correct on its own
45
Why do you NOT want to incorporate ossification of cuboidal bones in a cast for ALD treatment?
Prevents laxity of digital flexors
46
Are splints or casts better for ALD management?
Splints
47
Effective for fetlock ALD and should only be used alone with very mild ALD
Hoof wall extensions
48
Which side of the hoof should a hoof wall extension be placed?
Convex side
49
If you have valgus deviation, which side of the limb does the hoof extension go on?
Medial
50
If you have varus deviation, which side of the limb does the hoof extension go on?
Lateral
51
What are surgical options for treating ALD?
Periosteal stripping, transphyseal bridging, corrective ostectomy/osteotomy
52
Growth acceleration on the concave side of the limb
Periosteal stripping
53
How does stripping the periosteum allow for growth acceleration?
Frees physis from restrictive effects of periosteum + cascade of growth factors
54
Is periosteal stripping effective
NO
55
What is the most common modality for treating ALD?
Transphyseal bridging
56
Growth retardation
Transphyseal bridging
57
Used for ALD >10* or ALD <10* that is unresponsive to non-sx management
Transphyseal bridging
58
When is transphyseal bridging done and why?
After rapid physeal growth phase so limb doesn't revert post-op
59
What methods of transphyseal bridging are there?
Screws and wires, single transphyseal screw
60
Does not disturb the physis in a permanent way, just affects the growth from the physis
Screws and wires
61
Implants do not cross physis
Screws and wires
62
Faster correction and more cosmetic than screws and wires, but implant crosses physis
Single transphyseal screw
63
What are risks of using a single transphyseal screw?
Physisits, premature physeal closure, overcorrection
64
What technique is perferred fro distal MC/MT3 and distal tibial ALD?
Single transphyseal screw
65
Used for correction of fetlock ALD after closure of growth plates
Ostectomy/osteotomy
66
What is the main cause of ALD in miniature horses?
Complete ulna/fibula stops growth @ lateral aspect
67
When should you do surgery to correct ALD in miniature horses?
Before 4 mo of age
68
Are miniature horses more likely to have varus or valgus ALD?
Valgus

LA Sx Exam 1 (17 decks)

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