Australian veterinary journal2008; 86(5); 195-CE1; doi: 10.1111/j.1751-0813.2008.00275.x

Surgical treatment of carpal flexural deformity in 72 horses.

Charman, RE
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Vasey, JR

Abstract: Carpal flexural deformities (CFD) are frequently encountered in the horse, with both congenital and acquired forms described. The success of surgical correction of CFD, both in terms of the ability to achieve a straight palmar carpal angle and the impact on future athletic performance, requires further investigation. Objective: To report the surgical management and outcome of treatment of flexural deformity of the carpus in 72 horses up to 12 months of age. Methods: Information was obtained from the medical records of horses surgically treated for CFD and through follow-up contact with owners. At the time of examination each case was graded on the severity of the flexural deformity as grade 1, 2, or 3, in order of ascending severity. Surgical treatment consisted of tenotomy of the ulnaris lateralis and flexor carpi ulnaris muscles. Re-assessment of the palmar carpal angle was made in the immediate postoperative period and again from at least 8 months after surgery via telephone contact with owners and/or breeders. A successful outcome was defined as achievement of a straight palmar carpal angle. Long term outcome was assessed in terms of fullfilment of intended use for horses reaching 3 years of age at the time of the study. Results: A total of 135 surgical procedures were performed on 72 horses. A successful outcome was recorded in 111 limbs (82%). Excluding cases lost to follow-up, surgical correction was more successful in restoring a straight palmar carpal angle in grade 1 limbs (25/25, 100%) compared to grade 2 limbs (78/87, 89%) and grade 3 limbs (8/14, 57%). For those horses that had reached 3 years of age, 26 of 36 Thoroughbreds started in a race (72%) and 12 of 14 non-Thoroughbreds fulfilled their intended use (86%). Conclusions: Tenotomy of the ulnaris lateralis and flexor carpi ulnaris tendons for treatment of grade 1 and 2 CFD's has an excellent prognosis for restoration of a straight palmar carpal angle and for intended athletic pursuit of the horse. In cases of grade 3 CFD, the prognosis following surgery is guarded, especially in neonates. Horses treated in this study were up to 12 months of age, indicating that this deformity may not always be self-limiting as previously thought, and treatment may be required for successful resolution of flexural deformity of the carpus in older animals. The results of this study will help veterinarians to make recommendations regarding the surgical treatment of CFDs.

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Publication Date: 2008-05-06 PubMed ID: 18454839DOI: 10.1111/j.1751-0813.2008.00275.xGoogle Scholar: Lookup

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The research article largely examines surgical methods applied and their success rates in treating a condition called carpal flexural deformities in 72 horses of different ages but no older than 12 months.

Objective and Methodology

The main objective of the study was to report the surgical management and reveal the outcome of treatments directed at carpal flexural deformities in horses. The study involved 72 horses up to the age of 12 months.
For the purpose of the study, patient data was obtained both from medical records of horses that had undergone surgery for the condition and through follow-ups with the owners.
The severity grade of the condition in the horses was examined and graded from 1 to 3 with 3 being the most severe.
The surgical treatment deployed involved two procedures called tenotomy of the ulnaris lateralis and flexor carpi ulnaris muscles.
Post-surgery, the horses were reassessed particularly their palmar carpal angle immediately and once again after at least 8 months. Contact was made with the horse owners or breeders for this evaluation.
A successful therapy was determined by the achievement of a straight palmar carpal angle.
The study also defined long-term results based on whether the horses were able to fulfill their intended use after reaching 3 years of age.

Results and Conclusions

The study carried out a total of 135 surgical procedures on the 72 horses.
Successful outcomes were recorded for 111 limbs, which make up 82% of the cases.
Not counting the cases lost to follow-ups, surgical correction for grade 1 deformities had a 100% success rate, while surgeries on grade 2 deformities had an 89% success rate. For the most severe cases, grade 3 deformities, the success rate was significantly lower at 57%.
On reaching 3 years of age, 72% of thoroughbred horses could start a race and 86% of non-thoroughbreds could fulfill their intended use.
The study concluded that treating grade 1 and 2 carpal flexural deformities by tenotomy of ulnaris lateralis and flexor carpi ulnaris tendons gives an excellent prognosis for the restoration of a normal palmar carpal angle and enables the horse to undertake its intended athletic pursuit.
In cases of grade 3 deformities, the prognosis after surgery is guarded, especially in newborns.
The 12-month age limit of the horses in this study suggests that the deformity may stick around longer than anticipated, meaning treatment may be needed in older animals to correct it properly.

The study offers valuable insights that would help veterinarians to make informed recommendations regarding the surgical treatment of carpal flexural deformities.

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APA

Charman RE, Vasey JR. (2008). Surgical treatment of carpal flexural deformity in 72 horses. Aust Vet J, 86(5), 195-CE1. https://doi.org/10.1111/j.1751-0813.2008.00275.x