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Eq SX Musc Skel Exam > Developmental Orthopedic diseases > Flashcards

Developmental Orthopedic diseases Flashcards

(59 cards)

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1
Q

Growth of long bones occurs thru

A

endochondral ossification

-increased length primarily contributed by metaphyseal side of growth plate

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2
Q

Two types growth plates

A
  1. discoid-typical physis at end of long bones

2. spheroid-centers of ossification in epiphysis and cuboidal bones of carpus and tarsus

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3
Q

7 zones of ossification cartilage to bone

A
  1. reserve zone-resting germinal chondrocytes
  2. proliferative zone-chondrocytes begin to divide
  3. zone of maturation (hypertrophy)-weakest zone, stop dividing
  4. zone of calcification-matrix becomes calcified
  5. zone of degeneration-vascular ingrowth
  6. primary spongiosa
  7. secondary spongiosa
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4
Q

Physiologic closure often precedes

A

radiographic closure

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5
Q

angular deformities definition

A

deviations of the alignment of the boney column in the frontal plane

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6
Q

Most angular deformities occur at the level of the

A

physis

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7
Q

angular limb deformities are referred to by

A

associated joint

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8
Q

Windswept

A

foals with valgus deviation of one tarsus and varus deviation of contralateral tarsus

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9
Q

Offset knees

A

lateral position of the metacarpus down the axis of the limb

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10
Q

Slight valgus is protective against injury in horses with

A

offset knees

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11
Q

Rotational deformities

A

pidgeon toed/splay footed

no treatment

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12
Q

Cuboidal bones of carpus and tarsus ossify in

A

Last 2-3 months of gestation

  • premature foals have incomplete ossification
  • soft cartilage suscepible to crushing
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13
Q

Normal conformation of neonate

A

Mild to moderate carpal valgus

External rotation

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14
Q

Goal at weaning

A

Have fetlock joint aligned straight with metacarpus/metatarsus and parallel to phalangeal joints

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15
Q

Weanling with no carpal valgus and no outward rotation likely to

A

become carpal varus and internally rotated as it grows

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16
Q

Perinatal factors angular deformity

A
  1. Incomplete ossification cuboidal bones
    - premature/dysmature/twinned foals
  2. Periarticular laxity-should resolve in 2-3 weeks of life
  3. Aberrant intrauterine ossification
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17
Q

Developmental factors angular deformity

A
  1. Nutrition-rapid growth/excessive weight gain

2. Trauma/excessive exercise

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18
Q

Diagnosis angular deformity

A
  1. Stand at face of each limb separately
  2. Eval radius relative to metacarpus
  3. Eval metacarpus/tarsus relative to foot
  4. Eval tibial to metatarsus
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19
Q

The toe should be facing same direction as

A

face of carpus

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20
Q

Evaluate breakover to see if foot travels in straight line

A

Indicates joints are aligned parallel to ground

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21
Q

Monitor foals every

A

2-4 weeks to see if deformities are improving

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22
Q

Radiographs indicated in foals at risk

A

incomplete ossification (to start early intervention to prevent crushing)

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23
Q

radiographing carpus and fetlocks

A

Dorsal-palmar view most important

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24
Q

Radigraphing tarsus

Study These Flashcards
A

Dorso-plantar and lateromedial views required

-particularly to assess for collapse of cuboidal bones

25
Treatments
1. Hoof care starting 1 month old - valgus rasp lateral wall 2. Stall rest 3. External coaptation - change q 1-2 weeks, switch to bandage for a few days when rads indicate closure
26
Stall rest schedule
1. incomplete ossification of cuboidal bones - rest up to 1 month, re radiograph biweekly 2. Severe angular limb deformity w/normal cuboidals - 4-6 weeks and sx if not corrected 3. Periarticular laxity with normal cuboidals - handwalk with mare 10-20 minutes/day or swim - typically resolves in 2 weeks - strict rest and coaptation contraindicated
27
Principal indication for use of splints or casts in foals with angular limb deformity
is incomplete ossification of cuboidal bones
28
Splints and casts should not extend
distal to fetlock | -tendons need to take some load
29
Surgery indicated when
1. Deformity too severe to correct spontaneously 2. Deformities worsening 3. Deformities causing other deformities
30
Classifying deformities
1. mild: < 5 degrees 2. moderate: 5-10 degrees 3. severe: > 10 degrees
31
Two kinds of surgical intervention
1. Growth retardation on convex side | 2. Growth acceleration on concave side
32
Periosteal stripping/ PT
Growth acceleration - no over correction - growth altered for 2-3 weeks after sx - performed when significant amount of rapid growth potential still exists - controversial
33
Transphyseal bridge (TPB)
Growth retardation - implant fixed at either side of physis, removed when correction acheived - Screw and wire technique - Correction can lag 2-3 weeks after placement - can cause significant SC scarring
34
Transphyseal screw (TPS)
Growth retardation - fetlock/carpus/tarsus deformities - breach of physis causes concern for overcorrection after removal from damage - correction begins immediately - more cosmetic
35
Advanced surgical correction
1. Closing wedge ostectomy | 2. Step osteotomoy/ostectomy
36
Three common locations congenital hyperflexion
1. Distal interphalangeal joint 2. Fetlock joint 3. Carpus
37
Treatment of congenital hyperflexion
1. limited exercise 2. oxytetracycline - acute renal failure possible 3. Splinting - splints should extend to the ground - fetlock and carpal contracture 4. Heel extension 5. Analgesia 6. Surgery
38
acquired hyperflexion most often involves
coffin/fetlock joint
39
Acquired hyperflexion associated with
Pain as major precipitating factor, leading to activation of flexor withdrawal reflex
40
Possible inciting causes of acquired hyperflexion
1. trauma 2. joint sepsis 3. chronic lameness 4. physitis 5. OCD 6. Excess nutrition
41
Hyperflexion treatment
1. Address nutrition if it has changed 2. Controlled exercise if not too painful 3. ANALGESIA 4. Hoof care-gradually lower heel 5. Cast-incorporate hoof, rarely used
42
Desmotomy of ALDDFT
Complication: excessive fibroplasia Pressure bandage post-op 3 weeks Prognosis if treated < 1 yr old 86% return to work Prognosis if treated > 1 yr old 78%
43
Tenotomy of DDFT reserved for
severe deformities-considered a salvage procedure
44
Fetlock joint contracture commonly occurs
between 10-18 months of age - growth spurt in distal radial physis - forelimb more common than hind - frustrating to treat
45
Classification fetlock contracture
Mild: < 180 degrees flexion -fetlock remains palmpar/plantar to toe Moderate: > 180 degrees extension when standing -fetlock dorsal to toe but can extend to 180 when walking Severe: > 180 degrees flexion at all times, flexor tendons and suspensory ligament are lax, extensor tendon is taught, resist further flexion -may knuckle over if neglected
46
Hoofcare theories for fetlock contracture
1. Heel elevation - decrease tension on DDFT and increase strain on SDFT 2. Lower heel - invoke reverse myotactic reflex 3. Toe extension - prolong breakover thus stretching palmar soft tissue structures
47
Fetlock contracture splints
May promote laxity and stretch palmar structures at fetlock is pullback into splint -early cases only
48
Fetlock contracture sx
1. Desmotomy of ALDDFT | 2. Desmotomy of accessory ligament of superficial digital flexor Tendon
49
Static cervical stenotic myelopathy tends to occur
C3-C5 or | C5-C7 (T1)
50
Dynamic cervical stenotic myelopathy
C5-C7 (T1)
51
Surgery for wobblers not until
1. Thorough neuro exam 2. Plain cervical rads 3. Testing to rule out dz (EPM) 4. Myelogram to confirm sites of compression
52
Factors influence prognosis of surgery for wobblers
1. Number of sites of compression (3 or more is poor) 2. Static or dynamic (dynamic may be better) 3. Pre-operative grade (1-4) expect 1-2 grades impr 4. duration of signs? 5. Temperament/age/intended use of horse
53
Wobblers length of rehab after sx
1 yr
54
Wobblers prognosis after sx
60% return to intended function 88% improved at least 1 grade 60% improved at least 2 grades
55
Wobblers surgical procedure
Metal cylinder (basket) called Kerf Cut Cynlinder bridges intervertebral disk and joint of vertebral bodies. Stabilizes and causes eventual fusion.
56
Wobblers sx complications
1. Seroma formation 2. Infection 3. Vertebral body fx 4. Implant migration 5. Recurrent laryngeal neuropathy 6. Horner's syndrome 7. Airway obstruction upon extubation
57
Accipitoatlantoaxial Malformation (OAAM)
- most common in arabian foals (inherited recessive) - small abnormal atlas, abnormally fused with occiput - hypoplastic and malformed dens-can sublux - Foals usually euthanised
58
The abnormal/lack of articulation between atlas and occuput
Often leads to scoliosis
59
OAAM Clinical signs
1. Ataxia 2. Scoliosis 3. Clicking noise when head manipulated

Eq SX Musc Skel Exam (20 decks)

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