Single-incision drilling technique to achieve hemiepiphysiodesis of the distal metacarpus - complications and outcome in 207 foals with metacarpophalangeal varus deformities.
Authors: Boorman Sophie, Rodgerson Dwayne H
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Single-Incision Hemiepiphysiodesis for Metacarpophalangeal Varus in Foals Metacarpophalangeal (MCP) varus deformities in foals require timely intervention to prevent long-term lameness and performance issues, yet surgical correction must balance efficacy against potential complications and future soundness. Boorman and Rodgerson reviewed 207 Thoroughbred foals treated between 2017 and 2020 with a single-incision drilling technique to achieve hemiepiphysiodesis of the distal lateral metacarpal physis at an average age of 97 days, with outcomes compared to 171 age- and sex-matched maternal siblings using yearling radiographs, sales data, and racing performance records. The technique proved remarkably safe: only three horses developed calcinosis circumscripta lesions adjacent to the physis (successfully managed with removal), no radiographic abnormalities appeared on prepurchase examinations, and crucially, no differences emerged in sales performance or racing records between treated foals and their untreated siblings. For practitioners, this demonstrates that single-incision hemiepiphysiodesis offers a reliable, implant-free alternative that avoids the costs and complications associated with internal fixation whilst delivering both cosmetic correction and functional outcomes equivalent to untreated cohorts. Awareness of calcinosis circumscripta as a potential complication remains important, though the benign nature of these lesions and their successful management suggests they need not alter surgical decision-making.
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Practical Takeaways
- •This single-incision drilling technique is a safe, effective alternative to implant-based hemiepiphysiodesis that avoids second surgery and associated costs while achieving excellent cosmetic and performance outcomes
- •Surgeons should monitor for calcinosis circumscripta development as a potential complication, though it occurs rarely and is manageable if it develops
- •Corrected foals show normal athletic performance through racing, supporting treatment as a viable option for improving conformation without long-term consequences
Key Findings
- •Single-incision hemiepiphysiodesis successfully corrected metacarpophalangeal varus deformities in 207 Thoroughbred foals with mean surgical age of 97 days
- •Only 3 horses (1.4%) developed calcinosis circumscripta lesions adjacent to the physis, which were successfully removed
- •No radiographic abnormalities were detected at yearling prepurchase examination in treated foals
- •Treated horses showed no differences in sales or racing performance compared to 171 matched maternal sibling controls