Complications after two transphyseal bridging techniques for treatment of angular limb deformities of the distal radius in 568 Thoroughbred yearlings.
Abstract: Surgical correction of carpal angular limb deformities by growth retardation is commonly undertaken with a screws and tension band wire loop technique (S&W) or a single transphyseal screw (STS). This study compares complications after S&W and STS bridging in the distal radius of Thoroughbred yearlings. Objective: To compare the prevalence of complications serious enough to require follow-up radiographs following either S&W or STS surgery for growth manipulation in the distal radius of Thoroughbred yearlings. Methods: Medical records and radiographs from Thoroughbred yearlings (age range 261-457 days) treated for carpal angular limb deformities at a single hospital over 2 years were reviewed. Each of the techniques was used exclusively during a single year. The complication threshold criterion for inclusion was the need for nonroutine radiographs of the operated site anytime after implant insertion or removal. Results: Of 568 horses, 253 received S&W and 315 received STS. Horses were of similar age at the time of surgery for STS and S&W. Single transphyseal screws were left in place for a significantly shorter amount of time (16 days). Sex, the limb(s) treated and medial vs. lateral placement were not significantly different between techniques. Complications included physitis post implant removal, metaphyseal collapse post implant removal, infection, overcorrection and seroma formation severe enough to require radiography. Physitis and metaphyseal collapse occurred significantly more frequently with STS compared with S&W. Infection, overcorrection and seromas were not significantly different between techniques. Conclusions: The STS and S&W techniques are both viable treatment options for correction of carpal angular limb deformities. However, horses treated with the STS technique have a significantly increased risk of developing physitis or metaphyseal collapse. Conclusions: Horses treated with STS bridging have a significantly increased risk of developing the post correction complications of moderate to severe physitis and metaphyseal collapse compared with horses treated with S&W bridging.
© 2011 EVJ Ltd.
Publication Date: 2011-09-05 PubMed ID: 21895754DOI: 10.1111/j.2042-3306.2011.00470.xGoogle Scholar: Lookup
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Summary
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This research article investigates the complications related to two surgical methods, screws and tension band wire loop (S&W) and single transphyseal screw (STS) techniques, used for the correction of carpal angular limb deformities in Thoroughbred yearlings. The study reveals that although both procedures are viable options, STS bridging carries a greater risk of severe complications like physitis or metaphyseal collapse.
Objective
- The main objective of this study is to compare the prevalence of complications, particularly those serious enough to require follow-up radiographs, between S&W or STS surgeries used for manipulating the growth in the distal radius of Thoroughbred yearlings. Both these surgical techniques are commonly used to correct carpal angular limb deformities by retardating growth.
Methods
- The data for this study is derived from medical records and radiographs of Thoroughbred yearlings, ranging in age from 261 to 457 days, which were treated for carpal angular limb deformities at a single hospital over a two-year period. One surgical technique was employed exclusively each year.
- The criterion for inclusion in this study was the need for nonroutine radiographs of the operated site at any time after the insertion or removal of implants.
Results
- Out of 568 horses studied, 253 underwent the S&W technique and 315 the STS. There were no significant differences between these two groups in terms of the horses’ age at surgery, the limb(s) treated, medial vs lateral implant placement, or the sex of the horses.
- However, it was observed that STS were left in-place for a notably shorter period (16 days).
- Notable post-surgical complications included physitis and metaphyseal collapse following implant removal, infection, overcorrection, and severe seroma formation requiring radiography. It was found that complications such as physitis and metaphyseal collapse were significantly more frequent with STS compared to S&W. Meanwhile, issues like infection, overcorrection, and seromas were not significantly different between the two techniques.
Conclusions
- Based on the findings, the study concludes that both S&W and STS techniques are effective treatment options for correcting carpal angular limb deformities in horses. However, the STS procedure poses a significantly increased risk of developing complications like physitis or metaphyseal collapse after surgery.
- Therefore, horses undergoing STS bridging are at a significantly increased risk of developing post-correction complications such as moderate to severe physitis and metaphyseal collapse, in comparison to those treated with the S&W bridging method.
Cite This Article
APA
Carlson ER, Bramlage LR, Stewart AA, Embertson RM, Ruggles AJ, Hopper SA.
(2011).
Complications after two transphyseal bridging techniques for treatment of angular limb deformities of the distal radius in 568 Thoroughbred yearlings.
Equine Vet J, 44(4), 416-419.
https://doi.org/10.1111/j.2042-3306.2011.00470.x Publication
Researcher Affiliations
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA. ercdvm@gmail.com
MeSH Terms
- Animals
- Bone Screws / veterinary
- Carpal Joints / abnormalities
- Carpal Joints / surgery
- Female
- Forelimb / pathology
- Horse Diseases / congenital
- Horse Diseases / surgery
- Horses
- Limb Deformities, Congenital / surgery
- Limb Deformities, Congenital / veterinary
- Male
- Orthopedic Procedures / adverse effects
- Orthopedic Procedures / veterinary
- Postoperative Complications / veterinary
Citations
This article has been cited 1 times.- Modesto RB, Rodgerson DH, Masciarelli AE, Spirito M. Standing placement of transphyseal screw in the distal radius in 8 Thoroughbred yearlings. Can Vet J 2015 Jun;56(6):605-9.
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