Single-incision percutaneous drilling technique to achieve hemiepiphysiodesis of the distal metacarpus in foals with metacarpophalangeal varus deformities.
Authors: Dubois Benjamin B, Rodgerson Dwayne H
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Minimally Invasive Hemiepiphysiodesis for Metacarpal Varus in Foals Metacarpophalangeal varus deformities in young foals can compromise long-term soundness and athletic potential, yet surgical correction presents challenges around implant management and tissue trauma. Dubois and Rodgerson describe a single-incision percutaneous drilling approach to ablate the distal lateral metacarpal growth plate, performed on 16 limbs across 11 thoroughbred foals with a median age of 113.5 days under general anaesthesia, using radiographic guidance to position a 4.5-mm drill bit to create multiple passes through the physis in a fan-like pattern. All treated limbs showed complete arrest of varus progression at follow-up (median 422 days; range 366–452), with farm managers reporting subjectively excellent cosmetic and radiographic outcomes at yearling age, and no mention of postoperative complications. The technique's minimally invasive nature—requiring no implant placement, only a small skin incision, and straightforward equipment—makes it practically accessible to equine surgeons; however, the authors acknowledge that additional quantitative kinematic or radiographic data comparing this method to established alternatives (such as periosteal stripping or implant-based hemiepiphysiodesis) would strengthen evidence for its routine adoption in managing distal limb conformation abnormalities.
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Practical Takeaways
- •This minimally invasive drilling technique offers a simpler alternative to traditional hemiepiphysiodesis methods for correcting varus deformities in young foals, potentially reducing surgical time and implant-related complications
- •Early intervention (around 90-130 days of age) appears effective at preventing progression of lateral metacarpal varus deformities
- •Outcomes depend on subjective assessment; request objective measurements and comparison with other techniques before adopting as first-line approach
Key Findings
- •Single-incision percutaneous drilling technique successfully stopped progression of metacarpophalangeal varus deformity in all 16 limbs (11 foals) treated
- •Procedure achieved consistent physis ablation without implant placement in foals with median age 113.5 days
- •Yearling-age follow-up (median 422 days post-op) showed subjectively excellent radiographic and cosmetic outcomes with high owner satisfaction