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Orthopedic Disorders of the Foal, An Issue of Veterinary Clinics of North America: Equine Practice, E-Book

Orthopedic Disorders of the Foal, An Issue of Veterinary Clinics of North America: Equine Practice, E-Book

Ashlee Watts

(2017)

Abstract

This issue of Veterinary Clinics of North America: Equine Practice is edited by Dr. Ashlee Watts and focuses on Orthopedic Disorders of Foals. Article topics include: Orthopedic conditions of the dysmature foal; Septic arthritis, osteomyelitis and physitis; Club foot; FLD - carpus and fetlock; ALD - growth augmentation; ALD - growth retardation; Foal Fractures - osteochondral fragmentation, sesamoiditis and coffin bone; Foal Fractures - physeal fractures; OCD development; OCD - surgical options and when to utilize them.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Orthopedic Disordersof the Foal\r i
Copyright\r ii
Contributors iii
CONSULTING EDITOR iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Prelude to an Equine Athlete: Foal Orthopedics v
Routine Orthopedic Evaluation in Foals v
Routine Trimming and Therapeutic Farriery in Foals v
Orthopedic Conditions of the Premature and Dysmature Foal v
Septic Arthritis, Physitis, and Osteomyelitis in Foals v
Flexural Deformity of the Distal Interphalangeal Joint vi
Flexural Limb Deformities of the Carpus and Fetlock in Foals vi
Angular Limb Deformities: Growth Augmentation vi
Angular Limb Deformities: Growth Retardation vi
Osteochondritis Dissecans Development vii
Surgical Management of Osteochondrosis in Foals vii
Foal Fractures: Osteochondral Fragmentation, Proximal Sesamoid Bone Fractures/Sesamoiditis, and Distal Phalanx Fractures vii
Physeal Fractures in Foals vii
Diagnosis and Treatment Considerations for Nonphyseal Long Bone Fractures in the Foal viii
VETERINARY CLINICS OF\rNORTH AMERICA: EQUINE PRACTICE\r ix
FORTHCOMING ISSUES ix
December 2017 ix
April 2018 ix
RECENT ISSUES ix
April 2017 ix
December 2016 ix
August 2016 ix
Preface\r xi
Prelude to an Equine Athlete: Foal Orthopedics xi
Routine Orthopedic Evaluation in Foals 253
Key points 253
ORTHOPEDIC EVALUATION 254
Causes of Lameness 257
Conformation Evaluation: Neonate 260
Conformation Evaluation: One Month and Older 263
SUMMARY 264
REFERENCES 265
Routine Trimming and Therapeutic Farriery in Foals 267
Key points 267
INTRODUCTION 267
EVALUATING THE FOAL 268
TRIMMING THE FOAL 269
Birth to 1 Month 269
One Month 269
Two Months and Onward 271
FLEXOR TENDON FLACCIDITY, FLEXURAL DEFORMITIES, AND ANGULAR LIMB DEFORMITIES IN FOALS 273
Flexor Tendon Flaccidity 273
Flexural Deformities 276
Congenital flexural deformities 276
Acquired flexural deformities 277
Mild acquired flexural deformities 277
Severe acquired flexural deformities 279
Angular Limb Deformities 282
Carpal/tarsal valgus 283
Fetlock varus 286
SUMMARY 288
REFERENCES 288
Orthopedic Conditions of the Premature and Dysmature Foal 289
Key points 289
PREMATURITY AND DYSMATURITY OF THE FOAL 289
PATHOPHYSIOLOGY 290
HYPOTHYROIDISM AND CUBOIDAL OSSIFICATION 291
CLINICAL EVALUATION AND DIAGNOSIS 292
SEQUELAE TO INCOMPLETE OSSIFICATION 294
TREATMENT 294
EVALUATION OF OUTCOME AND LONG-TERM RECOMMENDATIONS 295
SUMMARY 296
REFERENCES 296
Septic Arthritis, Physitis, and Osteomyelitis in Foals 299
Key points 299
INTRODUCTION 299
DIAGNOSIS 300
Septic Synovitis/Arthritis 300
Septic Physitis/Osteomyelitis 302
General Musculoskeletal Infection Diagnostics 304
THERAPY 304
Synovitis/Arthritis 304
Physitis/Osteomyelitis 309
PROGNOSIS 309
SUMMARY 313
SUPPLEMENTARY DATA 313
REFERENCES 313
Flexural Deformity of the Distal Interphalangeal Joint 315
Key points 315
INTRODUCTION 315
CONGENITAL FORM 316
Pathogenesis 316
Clinical Signs and Patient Evaluation 317
Nonsurgical Management 317
Medical treatment 317
Bandaging, splints, and casting 318
Physical therapy and exercise 318
Surgical Management 318
ACQUIRED FORM 319
Pathogenesis 319
Clinical Signs and Patient Evaluation 319
Nonsurgical Management 321
Nutrition 321
Medical treatment 322
Corrective trimming and shoeing 322
Surgical Management 324
Accessory ligament of the deep digital flexor tendon desmotomy 324
Traditional techniques 324
Minimally invasive technique 325
Deep digital flexor tendon tenotomy 327
OUTCOME 328
SUMMARY 328
SUPPLEMENTARY DATA 328
REFERENCES 328
Flexural Limb Deformities of the Carpus and Fetlock in Foals 331
Key points 331
INTRODUCTION 331
PATIENT EVALUATION OVERVIEW 332
DIAGNOSIS 335
PHARMACOLOGIC TREATMENT OPTIONS 335
NONPHARMACOLOGIC TREATMENT OPTIONS 336
Shoeing and Trimming Considerations 336
Physical Therapy 336
Exercise Management 336
Complementary/Integrative Therapies 337
External Coaptation 337
GENERAL GUIDELINES FOR SPLINT APPLICATION 337
HOW OFTEN SHOULD SPLINTS BE REMOVED OR ADJUSTED? 338
Bandage-Splint Layers 338
Dynamic Splints 339
COMBINATION THERAPIES 339
SURGICAL TREATMENT OPTIONS 339
TREATMENT RESISTANCE/COMPLICATIONS 340
EVALUATION OF OUTCOME AND LONG-TERM RECOMMENDATIONS 340
SUMMARY 341
REFERENCES 342
Angular Limb Deformities 343
Key points 343
RISK FACTORS 343
CLINICAL EXAMINATION AND RADIOGRAPHY 345
MEDICAL MANAGEMENT 346
SURGICAL MANAGEMENT 348
REFERENCES 350
Angular Limb Deformities 353
Key points 353
INTRODUCTION 353
PATIENT EVALUATION 354
Foal Conformation Evaluation 354
Radiographs 355
SURGICAL GROWTH RETARDATION PROCEDURES 356
Transphyseal Staples 357
Screw and Wire Transphyseal Bridge 359
Surgical procedure 359
Perioperative and postoperative care 359
Transphyseal Screw 360
Surgical procedure 360
Fetlock 361
Tarsus 362
Perioperative and postoperative care 362
Screw and Screw and Wire Removal 362
SCREW AND WIRE VERSUS TRANSPHYSEAL SCREW: ADVANTAGES, DISADVANTAGES, AND COMPLICATIONS 363
SUMMARY 364
REFERENCES 365
Osteochondritis Dissecans Development 367
Key points 367
INTRODUCTION 367
NORMAL CARTILAGE DEVELOPMENT 367
HOW DOES CARTILAGE TURN INTO BONE? 368
Endochondral Ossification Process 368
Nutrition of Postnatal Cartilage: Role of Cartilage Canals 369
EARLY PATHOGENESIS OF OSTEOCHONDROSIS 371
Current Theories 371
Failure of cartilage canals 371
Shearing of osteochondral junction 371
Molecular alterations in endochondral ossification 372
Genetic factors 372
Early Detection 373
Biomarkers 373
HEALING OR OSTEOCHONDRITIS DISSECANS DEVELOPMENT? 373
Intrinsic Factors 373
Effect of Exercise 374
THERAPEUTIC OPTIONS 374
SUMMARY 374
REFERENCES 375
Surgical Management of Osteochondrosis in Foals 379
Key points 379
INTRODUCTION 379
ETIOLOGY 380
CAUSATIVE FACTORS 380
CLINICAL SIGNS 381
DISTRIBUTION OF LESIONS 382
TREATMENT 382
Conservative Management 382
Surgical Management 382
Femoropatellar Joint 383
Tarsocrural Joint 386
Fetlock Joint 386
Elbow Joint 388
Shoulder Joint 389
Subchondral Cystic Lesions 389
SUMMARY 391
REFERENCES 392
Physeal Fractures in Foals 417
Key points 417
INTRODUCTION 417
PATIENT ASSESSMENT 418
FRACTURE TREATMENT AND PROGNOSIS BY LOCATION 419
Digits or Phalanges 419
Metacarpus or Metatarsus 421
Radius 422
Ulna 423
Humerus 423
Scapula 425
Tibia 426
Femur 427
SUMMARY AND DISCUSSION 429
REFERENCES 429
Diagnosis and Treatment Considerations for Nonphyseal Long Bone Fractures in the Foal 431
Key points 431
INTRODUCTION 431
SCAPULA 432
ULNA 433
RADIUS 434
TIBIA 434
THIRD METACARPAL/METATARSAL FRACTURES 434
HUMERUS AND FEMUR 436
GENERAL EMERGENCY CARE AND TRANSPORT 436
REFERENCES 437