Page 58 - Manual of Equine Field Surgery
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54 LIMB SURGERIES
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or metatarsal bones. These metaphyseal or dia- Transphyseal bridging may also be used in
physeal deformities are usually congenital, and concert with periosteal transection and elevation
their repair is beyond the scope of this book. in foals with severe deformities, as the two proce-
· Preoperative radiographs are important to dures are performed on opposite sides of the limb.
11
confirm the source of the angular limb deformity There is no objective evidence indicating the com-
and to determine if surgical manipulation of the bination results in better or faster correction of
growth plate is indicated. for treatment of the the deformity.
deformity. Dorsopalmar (plantar) and lateral
medial radiographic views of the affected area
will generally confirm the source of the angular REFERENCES
deformity.
Transphyseal bridging requires a functioning 1. Fretz PB, Cyubaluk NF, Pharr JW: Quantitative anal-
physis to be effective and is best indicated for ysis of long bone growth in the horse, Am J Vet Res
deformities associated with physeal dysplasia. If 45:1602, 1984.
the physis is crushed, as occurs in Salter-Harris 2. AL1er JA: Angular limb deformities. In Auer JA, Stick
type V or VI fractures, transphyseal bridging will JA, editors: Equine surgery, ed 2, Philadelphia, 1999,
not be effective because of the inability of the con- WB Saunders.
tralateral side of the physis to respond. If the 3. Heinze CD: Epiphyseal stapling, Proc Am Assoc
Equine Pract 9:203, 1963.
origin of the deformity is associated with the 4. Hunt RJ: Management of angular deformities, Proc
joint (e.g., crushed carpal bones), transphyseal Am Assoc Equine Pract 46:128, 2000.
bridging can cosmetically straighten the external 5. Witte S, Thorpe PE, Hu11t RJ, et al: A lag-screw tech-
appearance of the limb, but the internal misalign- nique for bridging of the medial aspect of the distal
ment may result in degenerative joint disease and tibial physis in horses, J An1 Vet Med Assoc 225:1581,
lameness. 2004.
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