Surgical correction of angular and torsional metatarsal deformity with cylindrical osteotomy and locking compression plates in a calf

Closing wedge ostectomy with transfixation pin-cast stabilization for correction of angular limb deformities of the metatarsophalangeal region in four cattle

CASE DESCRIPTION

4 calves were evaluated because of lameness and an angular limb deformity of the metatarsophalangeal region.

CLINICAL FINDINGS

3 calves (ages, 5 days, 10 days, and 1 month) had a congenital varus deformity of the metatarsophalangeal region characterized by medial subluxation of the first phalanx of digits 3 and 4 at the metatarsophalangeal joints. A 6-month-old heifer had a valgus deformity of the metatarsophalangeal region secondary to a malunion of a Salter-Harris type II fracture. The degree of deformity angulation ranged from 16° to 54° for the 4 patients.

TREATMENT AND OUTCOME

A closing wedge ostectomy with transfixation pin-cast application was performed on the affected limb of all 4 patients. The ostectomy healed with only minor complications (disuse osteopenia distal to the transfixation pins [n = 4] and cast sores [1]) that were easily resolved with no long-term adverse effects. Duration of follow-up for the 4 patients ranged from 6 to 17 months, and the owners reported satisfactory ambulation with no (n = 2) or only mild (2) residual lameness in the affected limb.

CLINICAL RELEVANCE

Results suggested that a closing wedge ostectomy with transfixation pin-cast stabilization is an alternative for management of angular limb deformities of the metatarsophalangeal region in cattle. Such treatment improved the quality of life for all 4 patients. However, 2 of the 4 patients had congenital deformities confirmed to be heritable. There are ethical concerns associated with treating animals with heritable disorders, and exhibition and breeding of such animals should be avoided.

Corrective Osteotomy of a Metacarpal Deviation Caused by Fracture in a 9-Month-Old German Fleckvieh Heifer

OBJECTIVE

To describe the surgical treatment of a metacarpal deviation caused by an untreated Salter-Harris type I fracture in a heifer.

STUDY DESIGN

Case report.

ANIMAL

9-month-old German Fleckvieh heifer.

METHODS

A closing wedge osteotomy was performed to correct deviation of fused metacarpal III and IV. A triangular bone wedge was removed and the proximal and distal fragments of the bone were brought into apposition and stabilized with an 11-hole T-plate. A full-limb cast was applied postoperative.

RESULTS

Radiographs were taken at 2, 4, and 6 weeks postoperative. No postoperative complications occurred and the heifer was discharged from the clinic 51 days after surgery. Radiographs taken 6 months after discharge showed periosteal callus formation around the closing wedge osteotomy. At 24 months postoperative, implants were intact and the heifer was in good general condition.

CONCLUSION

Closing wedge osteotomy was successfully performed in a heifer with a metacarpal deviation, correcting the malunion after a untreated Salter-Harris type I fracture. Radiographs showed evidence of osteotomy healing and the heifer had full use of the affected leg at 24 months postoperative.

Surgical correction of bilateral metacarpophalangeal valgus with curved osteotomies and type II external skeletal fixation in a seven-month-old alpaca

OBJECTIVE

To report the successful surgical correction of severe bilateral metacarpophalangeal valgus angular limb deformities in a seven-month-old intact male alpaca cria using curved osteotomies stabilized with type II external skeletal fixation.

METHODS

Using a 21 mm crescentic shaped oscillating saw blade, bilateral osteotomies were performed in the distal metaphyses of the fused third and fourth metacarpal bones to correct valgus angular limb deformity of the metacarpophalangeal joints. Axial alignment of each limb was achieved by medially rotating the distal metacarpus in the frontal plane along the curved osteotomies. The osteotomies were stabilized using type II external skeletal fixators.

RESULTS

The alpaca was immediately weight-bearing following the surgical procedure and no to minimal lameness was observed during healing of the osteotomies. Evaluation at five and 10 months following the surgery demonstrated acceptable axial alignment in the left forelimb while moderate to severe varus deformity (overcorrection) was observed in the right.

CLINICAL SIGNIFICANCE

Curved osteotomy of the distal metacarpus stabilized with type II external skeletal fixation can provide a favourable outcome in older alpaca crias affected with metacarpophalangeal angular limb deformities. Placement of the distal transfixation pins relative to the metacarpal physes should be carefully evaluated as overcorrection is possible, especially if growthpotential remains in only one physis of the fused third and fourth metacarpal bones.