Complications after two transphyseal bridging techniques for treatment of angular limb deformities of the distal radius in 568 Thoroughbred yearlings.

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.