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Wedge closing osteotomy for treatment of severe angular limb deformity in a mangalarga marchador neonate
Oliveira de Paula Lage, Alvaro...
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Introduction: Angular deformities in the musculoskeletal system, classified as valgus or varus, can result from various factors such as genetics, perinatal issues, incomplete ossification, periarticular laxity, overload, trauma, infection, or fracture non-union in equids.
Corrective surgical treatments include osteotomy, ostectomy in sagittal/frontal planes, and closing wedge ostectomy. We report a case of closing wedge ostectomy for distal tibial valgus in a 1-day-old Mangalarga Marchador male foal weighing 48 kg.
Clinical History: The foal presented with severe right tibial malformation, bearing weight on the limb but with moderate lameness in the right pelvic limb.
Evidence-Based Diagnosis: Radiographic and tomographic evaluation revealed frontal plane deformity resulting in distal tibial valgus.
Relevant clinical findings: The foal was bearing weight on the limb, capable of walking and trotting, but exhibited moderate mechanical lameness of the right pelvic limb.
Treatment And Management: For correction, the cutting plane was calculated following Paley (2003). Post ostectomy, the tibia was stabilized using three LC-DCP plates (one 4.5 mm and two 3.5 mm) and two crossed Steiman pins. Postoperative drug therapy included ceftiofur, gentamicin, metronidazole, phenylbutazone, meloxicam, firocoxib, DMSO, morphine, omeprazole, and local wound care.
Evolution: The foal fully weight-bore on the limb for up to 15 days postoperatively, with uncomplicated wound healing. Subsequently, the foal developed moderate limb lameness due to bacterial osteomyelitis and non-union at the ostectomy site, despite antibiotic treatment, leading to euthanasia.
Discussion/Conclusion: This case highlights the importance of preoperative planning and surgical technique selection for success and concerns about postoperative infection and bacterial resistance.
References
- Auer JA, Lischer C, Haab M. Displacement osteotomies/ostectomies in the horse. Equine Veterinary Education. 2021 May 4;34(6):291–8.
- Radtke A, Morello S, Muir P, Arnoldy C, Bleedorn J. Application of computed tomography and stereolithography to correct a complex angular and torsional limb deformity in a donkey. Veterinary Surgery. 2017 Oct 12;46(8):1131–8.
- Paley D, Herzenberg JE, Tetsworth K, McKie J, Bhave A. Deformity planning for frontal and sagittal plane corrective osteotomies. The Orthopedic Clinics of North America [Internet]. 1994 Jul 1;25(3):425–65. Available from: https://pubmed.ncbi.nlm.nih.gov/8028886/
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Affiliation of the authors at the time of publication
Universidade Vila Velha, Medicina Veterinária/Cirurgia de Animais de Grande Porte, Vila Velha, Brasil ; 2 Universidade Vila Velha, Medicina Veterinária/ Anestesiologia, Vila Velha, Brasil ; 3 Universidade Vila Velha, Medicina Veterinária/ Cirurgia de Animais de Pequeno Porte, Vila Velha, Brasil
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