Surgical correction of metacarpophalangeal valgus deformity in an alpaca

A 1-month-old alpaca cria presented with a 13 degree valgus deformity of the left metacarpophalangeal joint. The angular limb deformity was centered on the distal metacarpal physes. Transphyseal bridging of the physes was recommended. Two 2.7 mm cortical bone screws were placed either side of the distal metacarpal physes and a figure of eight wire was placed medially around the screw heads. The screws extended through the medial metacarpus into the axial cortex of the lateral metacarpus. Seven weeks after surgery the limb was straight and the screws and wire were removed. Transphyseal bridging of the distal metacarpal physes can be effectively used for the treatment of metacarpophalangeal valgus in crias with open physes.     

Angiomicrographic investigation of the vessels associated with physes in young pigs

There is little information available relating to the vasculature of physes of pigs, hence the object of the present study was to establish the distribution of blood vessels in normal physes of pigs at one and 15 days old. By the use of an angiomicrographic technique it was possible to demonstrate that vessels were in two main categories; first, those which entered the physis from the epiphysis and terminated, or branched and then terminated half to two thirds of the distance into the depth of the physis; second, vessels which crossed the full depth of the physis. Since vessels that cross the physis from epiphysis to metaphysis were a frequent feature of normal physes they do not seem to be a congenital defect which predisposes to the development of dyschondroplasias in young pigs.     

RADIOGRAPHIC CHANGES IN RHESUS MACAQUES AFFECTED BY SCURVY

Spontaneous vitamin C deficiency, or scurvy, was recognized in juvenile rhesus monkeys maintained in a research center as a result of being fed a commercial diet for 2 to 3 months with low levels of vitamin C. Most severely affected animals (13) were radiographed repeatedly up to day 300 following detection of the disease. Early radiographic changes consisted of widened, lucent metaphyses with lateral flaring and radiopaque metaphyseal lines at the junction of the metaphyses and physes. Physeal slippage was noted commonly. Following institution of vitamin C therapy, calcification of subperiosteal hemorrhage occurred in the metaphyseal regions. Metaphyses and physes returned to normal radiographic appearance within 15 to 30 days. Initially, the ubperiosteal hemorrhage progressed and a longer time was required for resolution of the calcified hematomas. The macaques improved clinically and were released from the hospital when fractures were stable at 4–5 weeks after admission. Of the 13 macaques studied, all but one returned as normal members of the colony.     

Focal premature physeal closure (hyena disease) in calves.

Focal premature closure of long-bone physes was the cause of conformational abnormalities that affected about 1% of a herd of dairy replacement calves. Affected calves were noticed to "bunny hop" by 3 months of age, and by 6 months of age, they developed abnormal conformation characterized by short pelvic limbs. This condition resembled "hyena disease," which has been described in dairy calves in Europe and Japan. With the exception of the aforementioned abnormalities and femoropatellar joint distention, a group of 5 affected calves examined were clinically normal. At necropsy, focal to almost complete closure of physes was found in the humeri, tibias, and femurs. Cause was not established for the condition; however, it was discovered that the calves had been given supplemental vitamin A/D3 in amounts greater than 10 times those recommended.     

Bilateral angular carpal deformity in a dog with craniomandibular osteopathy

A four-month-old West Highland White Terrier was presented to the Small Animal Teaching Hospital at the University of Liverpool with the complaint of a bilateral angular carpal deformity. A 20° valgus deformity was present in both thoracic limbs, centred on the distal radial physes. Both distal ulnas were grossly thickened and there was concomitant thickening of the rostral mandible and calvarium. The dog exhibited signs of resentment on palpation of the mandible and signs of pain were elicited on flexion and extension of both elbow joints. No signs of pain were evident on palpation of the ulnas or calvarium. Radiographic images of both ulnas showed marked amorphous periosteal new bone formation. The distal ulnar physes were closed centrally and both elbow joints had humeroulnar subluxation. Radiographic changes to the calvarium and mandibular rami were consistent with a diagnosis of craniomandibular osteopathy. A bilateral ulna ostectomy was performed to correct the angular limb deformity and elbow subluxations. Histology of the ostectomised pieces showed changes consistent with craniomandibular osteopathy.     

Surgical Correction of Angular Limb Deformity of the Forelimbs of a 7-month-old Calf

Severe angular limb deformity of the forelimbs of a 7-month-old calf was treated by temporary physeal bridging of the distal radial physes using screws and wires. Marked straightening of the deformed forelegs and improvement in ambulation were noted when the calf was evaluated at three and nine months after surgery.     

Physeal form of the longbones of the foal

The possible relationship between physeal diseases and physeal form prompted investigation of change in steepness of the physis in young foals. The distal and proximal aspects of the longbones were sawn sagittally in the right and frontally in the left bones. The slabs were washed to remove saw debris, arranged in order and inspected. The proximal physes had a flat or gently arched form, without obvious inclination. In the distal physes there were distinct inclinations. Inspection of an identical slab from the medial aspect of the distal radius of two series of foals of different breeds showed that the degree of inclination of the physis with respect to the long axis of the bone increased with age. In a further series of foals, the angle of inclination was measured from radiographs of identical sagittal and frontal slabs of the distal radius. A line drawn through the secondary spongiosa was produced to intersect a line drawn along the physis where it was mostly steeply inclined, and the angle measured. The angle decreased (physeal inclination increased) with increasing age, up to 35–90 days. The steepness in the lateral aspect of the physis was similar to that in the medial aspect, although evident in a different plane.     

Surgical correction of carpal valgus deformity in three alpacas

Two alpaca crias and one 14-month-old alpaca were referred for treatment of bilateral carpal valgus. In one cria, hemi-circumferential periosteal transection and elevation combined with an ulna osteotomy was performed initially without success, however transphyseal bridging with screws and wires was used successfully in both crias to straighten the limbs. As the distal radial and ulna growth plates had closed in the 14-month-old alpaca, bilateral wedge ostectomies of the distal radius and transfixation casts were used to straighten and stabilise the limbs. The ostectomy sites healed and the alpaca is ambulatory, although carpal flexion is significantly reduced. Until the relationship between the growth rate of crias and the success of hemicircumferential periosteal transection and elevation and ulna osteotomy is established, transphyseal bridging may provide a more reliable result in crias with carpal valgus deformity and open physes. Wedge ostectomy and application of a transfixation cast can be used to correct severe carpal valgus deformities in alpacas with closed physes.     

Bilateral wedge ostectomy on an 18-month-old llama with severe bilateral carpal valgus.

An 18-month-old llama was admitted with severe (45 degrees and 40 degrees) bilateral carpal valgus. The llama had grown normally until it was 6 months old, when the carpal deviations had commenced. Radiography revealed abnormalities at the distal ulnar physes. Premature closure of these physes or abnormal distal ulnar growth may have been the cause of the carpal valgus. The owners requested surgical correction of the condition. Medial wedge osteotomies of each radius were performed 3 weeks apart. Internal fixation of the osteotomized radial bones was accomplished with small right-angled T plates, and the limbs were placed in full-limb casts for 3 weeks and tube casts for 3 more weeks. Both limbs healed in straight alignment, and the llama was able to walk and run normally. Dorsal subluxation of the right radiocarpal joint was noticed after the operation. This was believed to be caused by the uncorrected dorsal bowing of the distal portion of the radius, which had occurred secondary to the severe carpal valgus.     

SCINTIGRAPHIC CHARACTERIZATION OF THE EQUINE FOREDIGIT AND METACARPOPHALANGEAL REGION FROM BIRTH TO SIX MONTHS OF AGE

Both foredigits and metacarpophalangeal joints of six Quarter Horse foals were scanned serially to six months of age using ⁹⁹Tc-methylene diphosphonate. Dorsal scans were made on day 1 and at two, four, six, ten, 14, 18, 22 and 26 weeks of age. Scans were assessed visually for distal third metacarpal, proximal phalangeal, and middle phalangeal physeal appearance and closure. Scans were also evaluated by computer region-of-interest (ROI) and line-profile analysis to characterize the physes quantitatively. Physeal region radioactivity relative to a disphyseal reference region was greatest at four weeks for all physes. Scintigraphic physeal closure of all physes occurred at approximately six months of age with a range of four and one half to greater than six months. The study was conducted to allow better assessment of diffuse and focal physeal disease by determining developmental times at which normal physeal region radioactivity has decreased enough to not obscure abnormal radioactivity and by quantifying scintigraphic physeal appearance which enables computer analysis to detect visually indeterminate physeal abnormalities.     

Use of the Wagner apparatus to lengthen the antebrachium of a growing dog

A six-month-old male golden retriever was presented with a shortened radius and ulna and valgus deformity of the carpus secondary to premature closure of the distal radial and ulnar physes. Osteotomies of the radius and ulna were performed and the antebrachium was lengthened over eight weeks using a Wagner apparatus. This external fixation distractor is used in humans for limb-lengthening procedures. In this case, it was used to correct the angular deformity and to lengthen the limb.     

Physeal Fractures in the Horse:I. Classification and Incidence

Seventy appendicular skeletal physeal fractures in 67 horses were reviewed and classified using the Salter-Harris classification. All the horses were less than 2 years old (mean age at injury 6.2 months). The mean age at injury for pressure physeal fractures (5.2 months) was significantly less (p < .05) than for traction physeal fractures (8.3 months). The majority (67.2%) of the horses were female. Forty-eight (69%) pressure physes and 22 (31%) traction physes were affected. The most common pressure and traction physeal fracture sites were the proximal femoral physis and the proximal ulnar physis, respectively. Sixty-seven physeal fractures were classified: 14 as Type I (20.9%), 42 as Type II (62.7%), six as Type III (8.9%), and five as Type IV (7.5%). Forty-six pressure physeal fractures were classified: six as Type I (13.0%), 30 as Type II (65.2%), five as Type Hi (10.9%), and 5 as Type IV (10.9%).     

Spontaneous femoral capital physeal fractures in adult cats: 26 cases (1996-2001)

OBJECTIVE: To determine clinical, radiographic, and histologic abnormalities in adult cats > 1 year old with spontaneous (ie, nontraumatic) femoral capital physeal fractures. DESIGN: Retrospective study. ANIMALS: 26 cats. PROCEDURE: Medical records of cats > 1 year old with femoral capital physeal fractures and no history of trauma were examined. RESULTS: Mean +/- SD age of the cats was 22.5 +/- 6.5 months. Twenty-five cats were neutered males. Mean weight of the cats was significantly greater than mean weight of a group of age- and sex-matched control cats. Of 16 cats for which age at the time of neutering was known, 14 had been neutered before 6 months of age. Nine cats had bilateral fractures. Severity of femoral neck osteolysis and sclerosis increased with increased duration of clinical signs. The contralateral femoral capital physis, distal femoral physes, and proximal tibial physes were radiographically open in 13 of 18,19 of 24, and 24 of 24 cats, respectively. Histologically, the epiphysis contained normal articular cartilage and bone, but attached growth plate cartilage lacked the normal columnar arrangement of chondrocytes. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that adult cats with spontaneous femoral capital physeal fractures were most likely to be heavier, neutered males with delayed physeal closure.     

Corrective osteotomy for bilateral forelimb varus deformities in a working dog

Bilateral varus antebrachial deformity in a 7-month-old working dog was surgically corrected. The deformity was a sequela to premature closure of the distal radial physes after trauma to the forelimbs. Treatment was by ulnectomy and oblique radial osteotomy. Stabilisation of the fractures was maintained by an external fixation device. The treatment was successful and the dog returned to work as a sheep dog.     

Hypertrophic osteodystrophy of the proximal humerus in two dogs

Two dogs, 3 and 6 months of age, were presented with painful, swollen shoulder and carpal joints; reluctance to stand; and pyrexia. Radiographs in both cases revealed an irregular lucent zone in the metaphysis of the proximal humerus, parallel and adjacent to the physis. The same lucent zone was also evident in the physes of the distal radial and ulnar metaphyses. Clinical signs and radiographs were consistent with hypertrophic osteodystrophy. Clinical signs resolved in both dogs with administration of carprofen, tramadol, and intravenous fluids. No signs of recurrence were reported at 3-month follow-ups.     

A XERORADIOGRAPHIC STUDY OF THE DEVELOPING QUARTERHORSE FOREDIGIT AND METACARPOPHALANGEAL REGION FROM SIX TO TWELVE MONTHS OF AGE

The purpose of the project was to provide a reference for radiographic anatomy of the developing equine foredigit and metacarpophalangeal region. Using xeroradiographic techniques, both foredigits and metacarpophalangeal regions of six Quarter Horse foals were radiographed at 1 day of age and then at 2-week intervals until the foals were 6 weeks old. The foals were then radiographed at 4-week intervals until they were 12 months old. The period from birth to 6 months has been described in a previous report. This paper deals with the period from 6 to 12 months of age. Lateromedial and dorsopalmar xeroradiographs of each foredigit and metacarpophalangeal region and a dorsal 65° proximal-palmarodistal oblique view of the distal part of the digit were made at each examination. Foals were weighed and were measured at the withers immediately prior to each examination. Representative xeroradiographs were selected and appropriately labeled to demonstrate normal radiographic anatomy of these regions. Earliest radiographic visualization of distal epiphyseal ossification in metacarpal 2 and metacarpal 4 was extremely variable and ranged from 4 to 38 weeks. It was not possible to determine accurately the ages at which distal physes of the small metacarpal bones closed. In one foal, three of four of these physes were closed at 26 weeks, while in another foal, none had closed when last radiographed at 54 weeks. Radiographic closure of the proximal physis of the middle phalanx ranged from 18 to 30 weeks (mean = 26 weeks). Radiographic closure of the proximal physis of the proximal phalanx ranged from 22 to 38 weeks (mean = 30 weeks). Radiographic closure of the distal physis of metacarpal 3 ranged from 18 to 38 weeks (mean = 29 weeks).     

Radiologic anatomy of the normal appendicular skeleton of the lion (Panthera leo). Part 1: thoracic limb.

Thoracic limb specimens from 12 euthanized free-ranging lions (Panthera leo, 16-170 mo old) underwent radiographic evaluation. The radiographic anatomy was described but excluded any areas of the bones with possible bone pathology. Comparisons between adult and juvenile lions were made and physes described. Differences or similarities (or both) to cheetahs (Acinonyx jubatus) and domestic cats and dogs were also noted. No dissections were made to corroborate the anatomic observations, but comparisons were made to macerated museum specimens. On the basis of evaluation, the scapula has a prominent acromion, hamate, and suprahamate processes, as well as prominent nutrient foramina. The humerus is similar to that of domestic cats. The humeral and ulnar nutrient foramina originate more medially than that in domestic cats. A supracondylar foramen may sometimes be observed radiologically, although one was present on all the macerated specimens in this study. Its radiologic visibility depends on the angle of incidence of the primary beam. The lateral "anconeal tubercle" of the olecranon (situated between the processus anconeus and tuber olecrani) is usually more prominent than the medial one and tends to be hook shaped, pointing cranially. There are no sesamoids in the region of the elbow. The first digit is large with two palmar metacarpophalangeal sesamoids and a prominent sesamoid in the tendon of the M. abductoris digiti I longus, all indications of a high degree of functionality. All physes close before 66 mo of age.     

Rickets in a Thoroughbred-cross foal: case report and review of the literature

Rickets is a metabolic bone disease associated with failure of endochondral ossification and impaired osteoid mineralization in growing animals. As a consequence, affected individuals can develop gross and microscopic bone malformations. The most common causes of rickets in domestic species include vitamin D and phosphorus deficiency. Rickets has been described in multiple species; however, comprehensive postmortem characterizations with confirmatory histopathology in equids have not been published. A 6-mo-old, Thoroughbred-cross foal was diagnosed with rickets based on gross autopsy findings and microscopic examination of the ribs and long bones. Grossly, all costochondral junctions of the ribs were enlarged with a “rachitic rosary” appearance, and there were multiple fracture calluses in the rib bodies. Epiphyses and metaphyses of the long bones appeared widened on sagittal section, and their physes were irregularly thickened. Histologically, there were poorly organized columns of hypertrophic chondrocytes within the physes of affected bones, islands of chondrocytes embedded within the primary and secondary spongiosa, and faintly eosinophilic seams of poorly mineralized osteoid within the bone trabeculae. Areas of focally increased osteoclastic activity were observed in some of the sections, perhaps pointing to a more complex metabolic bone disease in a growing animal. Low serum concentrations of calcium and 25-hydroxyvitamin D were detected in an antemortem sample. The pathogenesis of these imbalances was not definitively established, but lack of sunlight exposure, low concentration of vitamin D precursors in the diet (perhaps secondary to malnutrition), or both, were suspected; a genetic basis cannot be ruled out.     

Single transphyseal screws for the correction of moderate to severe angular limb deformities in 28 Thoroughbred foals

This study reports on the effective use of a single transphyseal screw for the treatment of moderate to severe angular limb deformities (ALDs) of the fetlocks and carpi of 28 young Thoroughbred foals. The objective was to evaluate the surgical management of foals with moderate to severe ALDs treated with single transphyseal screws. Evaluation of medical records of 28 Thoroughbred foals treated with single transphyseal screws placed across the distal radial, metacarpal and metatarsal physes was undertaken. The angle of joint deviation was measured prior to implantation and at removal of the implants, and the degree of improvement was calculated. A total of 39 screws were placed: 24 in the distal metacarpus or metatarsus and 15 in the distal radial physis. Varus or valgus deformities in the fetlock improved by 4–5° over a period of 15–30 days. Varus or valgus deformities in the carpi improved by 8–11° in 11–56 days. One case failed to improve adequately due to implant infection. Single transphyseal screws were effective in treating moderate to severe varus and valgus ALD of the fetlocks and carpi in young Thoroughbred foals. Further investigation into their use in the distal radius in young foals is needed. While single transphyseal screws are almost exclusively used by some clinics in the distal metatarsal and metacarpal physes, many clinicians do not use them in the distal radial physis of young foals due to fear of over‐correction, physitis and metaphyseal collapse. This was not observed in any of our cases.     

DISPROPORTIONATE DWARFISM IN TWO BOVINE SIBLINGS

Disproportionate dwarfism is reported in two bovine siblings. Affected animals were similar in appearance and were characterized by shortening of the limbs. Pelvic limbs were noticeably shorter than the pectoral limbs. The axial skeleton was not noticeably affected, but the back sloped because of the shorter pelvic limbs. Sloping of the back was accompanied by thoracic kyphosis and lumbar lordosis.
Comparison of the length of bones from an affected animal with those from a normal animal indicated that major growth retardation occurred in the femur, tibia, and metatarsal bones. Histological examination of the physes indicated a reduction in cartilage cell maturation and matrix calcification. This was associated with a reduction of osteogenesis and the formation of thickened, shortened primary trabeculae surrounded by fibrous and poorly vascularized bone marrow.