Foal Legs Dr Darren Arnold

Treatment of Common
Limb Deformities
Dr Darren P Arnold BSc BVMS
Adelaide Hills Equine Clinic
www.adelaidehillsequine.com.au

Conditions
 Tendon laxity or contraction
 Angular Limb Deformities

Laxity or Contraction
 Uterine malposition is the most common
reason given for these congenital
contractures and laxities.
 Restricted space in the uterus causes
some foals to be twisted or "stuck" in
awkward positions not allowing them to
stretch their limbs and move about.
 Abnormally positioned legs develop
tightened or shortened ligaments and
tendons.

Laxity

 Very common especially in hind limbs
 Most will self correct in 2-5 days.
 Bandages may need to be applied to
protect fetlocks rubbing on ground
 Not so tight as to give support
 Exercise will increase tension naturally
 More severe cases may need trailer shoe
placed on foot

Contracted Tendons

Severe

Mild

Treatment
 Oxytetracycline (Alamycin 10) 30-40ml
 This seems a large dose but is well
tolerated.Rarely causes diahorrea.
 Can be repeated 24 hours later if required
 Theory is it works on the calcium
pathways in musculotendinous junctions in
the leg. Releasing tension.

Contracted Tendons
 Need to be careful not to allow excessive
exercise or they can become over lax and
bend the other way after Oxytet.
 In more severe cases splints can be added
to legs .
 Splints should only really need to be on
for 2-3 weeks maximum or rethink
approach.

Splints

Bandaging/Splinting

Bandage rubs
 Need to be applied with plenty of padding
preferably by vet first time .
 Changed every 3-5 days
 Pay careful attention to joint surfaces

Bandage Rubs

Angular Limb Deformities
 Front and hind fetlocks
 Carpus (knee) Most common
 Hocks

Varus and Valgus

Fetlock Varus

Fetlocks
 Fetlock Varus (Toe in)

Carpal Valgus
 Deviation out from the Knee

Wind Swept Foal

Angular Limb Deformities
Generally
 Most foals with angular limb deformities can self-correct
with management including confinement ,hoof trimming
and shockwave.
 Angular limb deformities due to underdeveloped
cuboidal bones may carry a poor prognosis for
correction.
 Periosteal stripping is not an effective
treatment.(Read et al JAVMA 2002)
 Transphyseal bridging techniques are indicated
in foals that do not self-correct.

Fetlock deviation
 1.Need to act faster the Knees
 8 weeks is too late
 Aggressive first month of life treatment
gives good results
 Trimming and placement of cuffs

cuff

Knees
 Have more time
 Most can be corrected without surgery
 Up to 12 weeks
 Early intervention gives a better result
 Trimming “taking from where there is too
much
 or Cuffing “putting foot were there isn’t
any”

 Shockwave Therapy (ESWT) in horses is a relatively
new approach to treating a wide range of orthopaedic
conditions.
 Originally shockwaves were used in human medicine
to break-up kidney or bladder stones a treatment
called lithotripsy, it was then subsequently found to
beneficial in human orthopaedic conditions such as
heel spurs and tennis elbow.

Shockwave Head

Conditions Treated with
shockwaves
 Tendonitis
 Suspensory ligament
desmitis
 Shinsoreness
 Bone Spavin
 Back pain
 Fibrotyic myopathy
 Annular Limb
deformity

Radiography
 Assess growth plate status
eg,fractures,crushing,closure
 Visualise area that deviation is coming
from
 Calculate degree of deviation

Fractured growth plate
 F#

Treatment options
Bandaging
Not beneficial for angular limb
deformity in lateral or medial
planes. Bandaging/splinting-
reserved for contracted tendons
etc with the addition of
oxytetracycline injections

Periosteal stripping
 Treatment used for over 20 years
 Currently the opinion is that it has been
over used in the past.
 Has potential to leave unsightly scar
 Move away from this as a treatment
universally

Surgery for Severe Deviations

Old method of transphyseal
bridge

New method of transphyseal
bridging
 Insertion of a single screw across the
growth plate.This halts growth on the fast
growing side and allows the slower side to
catch up.
 Once leg is straight the screw is removed.

Screw Placement

Hock
 Tibial growth plate

Feb 2016

April 2016

Advantages and Disadvantages
of screw placement
 Advantages-
 Good cosmetic result as the screw is
placed on inside of leg with valgus
foals(approx 75% of ALD are these).
 Quick response wih straightening of
legs 2-4 weeks in most cases
 Disadvantages
 2 general anesthesia's needed one for
placement one for retrieval
 Potential for infection around the
screw
 Potential for screw to bend/break

Shockwave Therapy
 First used in Newmarket UK.
 Shockwaves are sent thru the growth plate region that is growing
too fast, the shockwaves halt the natural growth of that side for a
period of time.
 Shock wave therapy is first line treatment if this fails screw
placement carried out.First year in UK 40 treated( 3 had screws
placed due to poor perceived response).
 Morphettville Equine Clinic season 2006 2008. 42 foals treated, 32
carpal valgus, 6 fetlock varus,4 carpal and fetock valgus.6 required
screw placement.
 Good response to carpal(knee) valgus, fair response to fetlocks if
done early

Summary UK and South
Australia
 There appears to be a +ve effect with the use of shockwave in
annular limb defects with the carpus>fetlock.
 Corrective farrier work must be used in conjunction with shockwave
 It is difficult in assessing response to a condition that often
spontaneously improves but,clinical impression is that it allows a
more rapid return to normal management ie: foals often need to be
confined for a shorter time.
 The non invasive nature means it can be applied early and if there is
a lack of satisfactory response a transphyseal screw can be placed
 The lack of any cosmetic blemishes is beneficial from a sales point
of view.

The End
Dr Darren Arnold

Foal Legs Dr Darren Arnold

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Foal Legs Dr Darren Arnold