Foal Legs Dr Darren Arnold

Treatment of Common Limb Deformities

Dr Darren P Arnold BSc BVMS Adelaide Hills Equine Clinic

www.adelaidehillsequine.com.au

Conditions

Tendon laxity or contraction

Angular Limb Deformities


Laxity or Contraction Uterine malposition is the most common

reason given for these congenital contractures and laxities.

Restricted space in the uterus causes some foals to be twisted or "stuck" in awkward positions not allowing them to stretch their limbs and move about.

Abnormally positioned legs develop tightened or shortened ligaments and tendons.


Laxity


Very common especially in hind limbs Most will self correct in 2-5 days. Bandages may need to be applied to

protect fetlocks rubbing on ground Not so tight as to give support Exercise will increase tension naturally More severe cases may need trailer shoe

placed on foot


Contracted Tendons


Severe


Mild


Treatment

Oxytetracycline (Alamycin 10) 30-40ml This seems a large dose but is well

tolerated.Rarely causes diahorrea. Can be repeated 24 hours later if required Theory is it works on the calcium

pathways in musculotendinous junctions in the leg. Releasing tension.


Contracted Tendons

Need to be careful not to allow excessive exercise or they can become over lax and bend the other way after Oxytet.

In more severe cases splints can be added to legs .

Splints should only really need to be on for 2-3 weeks maximum or rethink approach.


Splints


Bandaging/Splinting


Bandage rubs

Need to be applied with plenty of padding preferably by vet first time .

Changed every 3-5 days Pay careful attention to joint surfaces


Bandage Rubs


Angular Limb Deformities

Front and hind fetlocks

Carpus (knee) Most common

Hocks


Varus and Valgus


Fetlock Varus


Fetlocks

Fetlock Varus (Toe in)


Carpal Valgus

Deviation out from the Knee


Wind Swept Foal


Angular Limb DeformitiesGenerally

Most foals with angular limb deformities can self-correctwith management including confinement ,hoof trimming and shockwave.

Angular limb deformities due to underdeveloped cuboidal bones may carry a poor prognosis for correction.

Periosteal stripping is not an effective treatment.(Read et al JAVMA 2002)

Transphyseal bridging techniques are indicated in foals that do not self-correct.


Fetlock deviation

1.Need to act faster the Knees 8 weeks is too late Aggressive first month of life treatment

gives good results Trimming and placement of cuffs


cuff


Knees Have more time Most can be corrected without surgery Up to 12 weeks Early intervention gives a better result Trimming “taking from where there is too

much or Cuffing “putting foot were there isn’t

any”


Shockwave Therapy (ESWT) in horses is a relatively new approach to treating a wide range of orthopaedic conditions.

Originally shockwaves were used in human medicine to break-up kidney or bladder stones a treatment called lithotripsy, it was then subsequently found to beneficial in human orthopaedic conditions such as heel spurs and tennis elbow.


Shockwave Head


Conditions Treated with shockwaves

Tendonitis Suspensory ligament

desmitis Shinsoreness Bone Spavin Back pain Fibrotyic myopathy Annular Limb

deformity


Radiography

Assess growth plate status eg,fractures,crushing,closure

Visualise area that deviation is coming from

Calculate degree of deviation


Fractured growth plate

F#


Treatment optionsBandaging

Not beneficial for angular limb deformity in lateral or medial planes. Bandaging/splinting-

reserved for contracted tendons etc with the addition of

oxytetracycline injections


Periosteal stripping

Treatment used for over 20 years Currently the opinion is that it has been

over used in the past. Has potential to leave unsightly scar Move away from this as a treatment

universally


Surgery for Severe Deviations


Old method of transphyseal bridge


New method of transphyseal bridging

Insertion of a single screw across the growth plate.This halts growth on the fast growing side and allows the slower side to catch up.

Once leg is straight the screw is removed.


Screw Placement


Hock

Tibial growth plate


Feb 2016


April 2016


Advantages and Disadvantages of screw placement

Advantages- Good cosmetic result as the screw is

placed on inside of leg with valgus foals(approx 75% of ALD are these).

Quick response wih straightening of legs 2-4 weeks in most cases

Disadvantages 2 general anesthesia's needed one for

placement one for retrieval Potential for infection around the

screw Potential for screw to bend/break


Shockwave Therapy First used in Newmarket UK. Shockwaves are sent thru the growth plate region that is growing

too fast, the shockwaves halt the natural growth of that side for a period of time.

Shock wave therapy is first line treatment if this fails screw placement carried out.First year in UK 40 treated( 3 had screws placed due to poor perceived response).

Morphettville Equine Clinic season 2006 2008. 42 foals treated, 32 carpal valgus, 6 fetlock varus,4 carpal and fetock valgus.6 required screw placement.

Good response to carpal(knee) valgus, fair response to fetlocks if done early


Summary UK and South Australia

There appears to be a +ve effect with the use of shockwave in annular limb defects with the carpus>fetlock.

Corrective farrier work must be used in conjunction with shockwave It is difficult in assessing response to a condition that often

spontaneously improves but,clinical impression is that it allows a more rapid return to normal management ie: foals often need to be confined for a shorter time.

The non invasive nature means it can be applied early and if there is a lack of satisfactory response a transphyseal screw can be placed

The lack of any cosmetic blemishes is beneficial from a sales point of view.


The End

Dr Darren Arnold


Foal Legs Dr Darren Arnold

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