Improvement in Bilateral Carpal Valgus Deviation in 9 Foals After Unilateral Distolateral Radial Periosteal Transection and Elevation.
Authors: Baker William True, Slone Donnie E, Ramos Jose A, Santschi Elizabeth M, Lord Linda K, Adams Stephen B, Lynch Timothy M, Hughes Faith E
Journal: Veterinary surgery : VS
Summary
Carpal valgus deviation—a lateral deviation of the carpus—represents a significant developmental orthopaedic concern in young foals, and whilst various surgical interventions exist, evidence for their efficacy remains limited. Baker and colleagues investigated whether unilateral distolateral radial periosteal transection and elevation (a procedure that disrupts and elevates the periosteum on the outer surface of the radius) could improve bilateral carpal valgus in nine naturally affected foals, comparing the surgically treated limb against the contralateral control limb using serial radiographic measurements of the carpal valgus angle at two-week intervals. Remarkably, both the operated and unoperated limbs showed comparable reductions in angular deviation, with no statistically significant difference in either the total correction achieved or the rate of improvement between limbs. These findings suggest that the periosteal transection procedure provided no additional benefit beyond what occurred with conservative management alone—a finding that challenges the routine use of this surgical technique for bilateral carpal valgus in foals treated between 19 and 43 days of age. For practitioners managing such cases, this evidence supports a more conservative initial approach of stall confinement followed by controlled exercise, potentially reserving surgery for foals that fail to progress adequately or where unilateral deviation persists.
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Practical Takeaways
- •Unilateral distolateral radial periosteal transection and elevation did not improve bilateral carpal valgus better than conservative management alone in young foals
- •Carpal valgus deviation may self-correct through natural growth and remodeling in foals under 6 weeks old, suggesting surgical intervention may not be necessary at this age
- •Conservative management with stall rest followed by paddock exercise appears sufficient for carpal valgus correction in foals treated in the first 6 weeks of life
Key Findings
- •All 9 foals showed reduction in carpal valgus angle (CVA) in both surgical and control limbs
- •No significant difference in total angular correction between surgically treated and untreated limbs
- •No significant difference in rate of correction between surgical and control limbs
- •Surgery performed between 19-43 days of age had no additional benefit over natural correction