Carpal Valgus Research Articles

Correção de desvio angular valgo do carpo em potros puro-sangue com implante de parafuso transfiseal único

ABSTRACT The objective of this study was to demonstrate the effectiveness of the single transphyseal screw technique in foals diagnosed with carpal valgus deviation. This study included 22 thoroughbred animals of both sexes, with a mean age of 30 days. All animals had a carpal valgus deviation >5° with irregular development of the distal epiphysis of the radius. All animals were surgically treated to correct the carpal valgus deviation by creating a bridge using a single transphyseal screw. Surgical intervention was performed for 40 limbs, comprising 19 right and 21 left thoracic limbs. This corresponded to four animals with carpal valgus deviation >5° in only one of the limbs and 18 with the deviation in both limbs. It was observed that 38/40 treated limbs (95%) achieved normal angulation according to the literature, i.e., angulation between 0° and 5°. No statistical differences were observed between the affected limbs. The single transphyseal screw technique can be used for the correction of carpal valgus deviation in foals. It is indicated in animals with an average age of 30 days (20-55 days), as its main advantages are rapid application, simple execution, and limited trans- and post-surgical complications, making it an effective procedure in thoroughbred foals with carpal valgus angular deviation.

Surgical Correction of Carpal Valgus Deformity with Transphyseal Staple in a Goat Kid

Surgical Correction of Carpal Valgus Deformity with Transphyseal Staple in a Goat Kid

Breed-typical front limb angular deformity is associated with clinical findings in three chondrodysplastic dog breeds.

Angular front limb deformity (ALD) refers to an excessively curved limb conformation, which is seen in some chondrodysplastic dog breeds. Common characteristics of ALD include carpal valgus (VALG), front limb rotation (ROT), elbow incongruity, and lateral radial head subluxation. These may cause lameness and discomfort in affected dogs. The clinical impact and breed-specific characteristics of front limb conformation in chondrodysplastic breeds are unknown. This prospective and cross-sectional study aimed to investigate differences in front limb conformation between three chondrodysplastic breeds. We further evaluate whether front limb conformation is associated with clinical findings and limb function. We propose novel methods to classify findings in the interosseous space and to quantify lateral radial head subluxation. Data from a total of 224 front limbs from 112 dogs of three chondrodysplastic dog breeds (30 Standard Dachshunds, 29 Skye terriers, and 53 Glen of Imaal terriers) were included in the study. Front limb VALG and ROT were measured with a goniometer. From the radiographs, the elbow joint was graded for incongruity (INC), and the humeroradial angle (HRA) was measured to assess lateral radial subluxation. The association of front limb conformation with clinical signs and limb function was investigated using orthopedic examination, goniometric and kinetic measurements, and radiography. The breeds differed significantly in their front limb conformation. The Dachshund had the least ROT and the least radial head subluxation. The Skye terrier had the most VALG, the most radial head subluxation, and the largest prevalence of moderate and severe INC. The Glen of Imaal terrier had the most ROT. In addition, INC, ROT, VALG, and HRA were found to be independent of each other and were associated with several measurable clinical abnormalities and limb function such as pain, lameness, limited range of motion, and elbow joint osteoarthritis. This implies that VALG, ROT, and HRA could be used in addition to INC grading when choosing musculoskeletal characteristics of dogs suitable for breeding.

Short term outcomes and complications of distal ulnar ostectomy in 23 juvenile dogs with carpal valgus secondary to discordant radial-ulnar physeal growth.

ObjectiveThe goal of this study was to report short term clinical and radiographic outcomes after distal ulnar ostectomy in dogs with carpal valgus due to discordant radial-ulnar growth.Study designRetrospective case study.Sample groupClient owned dogs under 1 year of age with carpal valgus and open distal radial physes pre-operatively.MethodsMedical records from four veterinary referral centers were searched from January 1, 2015 to January 1, 2022 for juvenile dogs that had been treated with distal ulnar ostectomy for carpal valgus due to premature closure of the distal ulnar physis. Patients were excluded if they were skeletally mature at the time of ostectomy; medical records were incomplete; radial physis was closed at surgery; or definitive corrective osteotomy was performed. Radiographs were evaluated pre-operatively and for short term follow up at ~8 weeks. Complications and short term clinical outcomes were evaluated also.Results31 limbs from 23 dogs were evaluated. Patients ranged from 4 to 10.8 months of age. All dogs presented for visible carpal valgus and varying degrees of thoracic limb lameness. Sixty-four percent of patients showed resolution of lameness while an additional 13% showed an improvement in clinical lameness without complete resolution. Complications were seen in 32% of patients with 70% percent of those being minor, bandage related complications. Radiographically, 38% of limbs showed bridging callus formation of the ostectomy at an average of 7.5 weeks post operatively and 75% percent of patients with elbow incongruity improved radiographically. There was no significant difference in radial joint angles pre-operatively and at the time of follow up.ConclusionDistal ulnar ostectomy ameliorates lameness in juvenile dogs with premature distal ulnar physeal closure and shows lack of progression of distal carpal valgus deformity, but does not improve joint angulation.Clinical significanceDistal ulnar ostectomy is associated with mild bandage-related complications and halting of progressive limb deformity within the time frame evaluated, and should therefore be considered a treatment for premature closure of the distal ulnar physis. It does not lead to deformity correction at 8 weeks following surgery but is associated with improved elbow congruity.

Thoracic Limb Angular Deformity in Chondrodystrophic Dogs: Repeatability of Goniometric Measurement of External Rotation and Carpal Valgus

Abstract Objective We aimed to provide repeatable methods for quantifying antebrachial valgus and rotation in dogs with and without complex angular deformities. Thus, we investigated the repeatability of two methods to measure carpal valgus and one method to measure external rotation of the thoracic limb in a standing position. Study Design This was a prospective observer agreement study with a sample of 18 non-chondrodystrophic dogs as baseline and 43 chondrodystrophic dogs. The rotation measurements (ROT), modified valgus measurements (VALG-M), and established carpal valgus measurements (VALG) were done independently by two investigators. Repeatability was assessed with intraclass correlation coefficient (ICC). Results The measured mean (± standard deviation) angles of ROT, VALG-M, and VALG for non-chondrodystrophic dogs were 14 degrees (± 5 degrees), 9 degrees (± 4 degrees), and 4 degrees (± 3 degrees) and 30 degrees (± 13 degrees) and 23 degrees (± 11 degrees) for ROT and VALG-M for chondrodystrophic dogs respectively. In non-chondrodystrophic dogs, ICC was low with mean errors of 1 to 6 degrees, whereas in chondrodystrophic dogs, intra- and intertester ICC was high for ROT and VALG-M with mean errors of 3 to 8 degrees. Conclusion The ROT and VALG-M methods can be used as reliable tools to objectively quantify aspects of thoracic limb alignment for research, clinical, and screening purposes in both non-chondrodystrophic and chondrodystrophic dogs. The mean values of ROT, VALG-M, and VALG can be used as references for non-chondrodystrophic dogs in the standing position.

Single Screw Transphyseal Bridging for Correction of Unilateral Carpal Valgus in a 5-Week Old Thoroughbred Foal

Single Screw Transphyseal Bridging for Correction of Unilateral Carpal Valgus in a 5-Week Old Thoroughbred Foal

The Effects of FGF4 Retrogenes on Canine Morphology.

Two FGF4 retrogenes (FGF4L1 on chromosome 18 and FGF4L2 on chromosome 12) have been identified to cause dwarfism across many dog breeds. Some breeds are nearly homozygous for both retrogenes (e.g., Dachshunds) and others are homozygous for just one (e.g., Beagles and Scottish Terriers). Since most breeds do not segregate both of these retrogenes, it is challenging to evaluate their individual effects on long bone length and body size. We identified two dog breeds selected for hunting ability, the Alpine Dachsbracke and the Schweizer Niederlaufhund, that segregate both of these retrogenes. Using individual measurements of height at the shoulder, back length, head width, thorax depth and width, and thoracic limb measurements, we evaluated the combined effects of FGF4 retrogenes within these breeds. We applied multivariable linear regression analysis to determine the effects of retrogene copy numbers on the measurements. Copy numbers of both retrogenes had significant effects reducing height at the shoulders and antebrachial length, with FGF4L1 having a much greater effect than FGF4L2. FGF4L1 alone influenced the degree of carpal valgus and FGF4L2 alone increased head width. Neither retrogene had an effect on thorax width or depth. Selectively breeding dogs with FGF4L1 and without FGF4L2 would likely lead to a reduction in the FGF4L2-related risk of intervertebral disc herniation while maintaining the reduction in leg length resulting from FGF4L1.

Metaphyseal Osteopathy in a Caucasian Shepherd Crossbred Dog

A six-month old, 24 kg, intact male Caucasian Shepherd crossbred dog was presented at the Sokoine University of Agriculture Teaching Animal Hospital with a history of difficulty standing and walking, and bilateral swelling of the distal antebrachial and crural metaphyeal region. The owner also reported prior calcium supplementation in form of dietary tablets. Upon physical examination; the animal was lethargic with fever, bilateral ocular discharge, tachypnea and reduced appetite. Hard painful bilateral swelling of the distal antebrachial and crural metaphyseal region was observed. Differential cell count showed neutrophilia and monocytosis. Sclerosis and paracortical cuffing of the distal antebrachial and crural metaphyseal region were seen on radiographic examination. Similar changes were also visualised in the proximal crural metaphyseal region. Further, cranial bowing of the radius with lateral deviation of the foot (carpal valgus) were also observed. Metaphyseal osteopathy was diagnosed based on the history, clinical and radiographic findings. The exact cause of metaphyseal osteopathy is unknown, however there have been reports linking it to breed predisposition and mineral over supplementation. Administration of corticosteroids and supportive care are recommended in dogs with metaphyseal osteopathy. However, a bony change that is paracortical cuffing requires several months for resorption.

Correction of Carpal Valgus and Flexural Deformity with z-Tenotomy and Anastomosis Procedure in a Dog

AbstractThis study aimed to describe a staged bilateral z-tenotomy and anastomosis procedure of flexor carpi ulnaris and superficial digital flexor tendons for the correction of carpal valgus and flexural deformity in a 1-year-old male-neutered Akita dog. Bilateral carpal valgus and flexural deformity were observed with palpably taut flexor carpi ulnaris tendons. The dog had a mild, weight-bearing bilateral forelimb lameness with the left forelimb more severely affected. Both forelimbs were treated with staged z-tenotomy and anastomosis procedure of both flexor carpi ulnaris and superficial digital flexor tendons. Successful tendon lengthening and correction of carpal valgus were achieved via z-tenotomy and anastomosis of affected tendons. No complications were observed. An 18-month follow-up revealed no evidence of lameness or carpal valgus. Though tendon injuries commonly occur in small animal patients, there is a shortage of reported cases, especially involving musculotendinous contractures. There are even fewer reports of successful tenotomy procedures. This case report supports successful outcome of the z-tenotomy procedure in a canine patient.

Congenital Ulnar Carpal Bone Luxation in a Miniature Donkey Treated by Pancarpal Arthrodesis

AbstractAn 18-month-old miniature donkey was presented for evaluation and treatment of a left carpal valgus present since birth. Clinical examination confirmed the severe and unstable carpal valgus. Radiographs and computed tomography revealed a caudally luxated ulnar carpal bone, malformation of the distal radial epiphysis, as well as a complete collapse of the lateral part of the radiocarpal joint. Outward rotation of the limb distal to the joint collapse was also visible. Surgical treatment was elected and a pancarpal arthrodesis performed using two short 3.5 mm locking compression plates. Ten months later, the donkey was pasture sound and radiographs showed complete fusion of the carpal joints.

Evaluation of Abnormal Limb Conformation in Jumping Thoroughbred Horses

Subjective, objective and photographic image using software Auto CAD programme were used for evaluation of limb conformation in 51 jumping thoroughbred horses. The abnormal limb conformations were included: standing under in front (58%), steep shoulder (55%), carpus valgus (45%), calf knee (31%), standing under behind (31%), short pelvis (31%) and straight hocks (16%). Linear and angular limb measurements showed standing under in front had increased elbow joint lateral angle, and decreased fore fetlock joint lateral angle. Steep shoulder displayed a significant increase (P< 0.05) in shoulder joint lateral angle and significant decrease in forearm front length. calf knee horses had significant decrease in the lateral angle of carpus joint. Short pelvis had a significant decrease in lateral length of pelvis and significant increase in croup angle and stifle joint lateral angle. Straight hocks showed the lateral length of both pelvis and gaskin showed a significant decrease and significant increase in the stifle joint lateral angle. Therefore, the current use of linear and angular measurements in relationships to abnormal limb conformation in the present study will allow for estimation of the future performance and soundness in jumping thoroughbred horses. In addition can be considered for selection athletic horse with less risk of lameness.

Evaluation of Abnormal Limb Conformation in Jumping Thoroughbred Horses.

Subjective, objective and photographic image using software Auto CAD programme were used for evaluation of limb conformation in 51 jumping thoroughbred horses. The abnormal limb conformations were included: standing under in front (58%), steep shoulder (55%), carpus valgus (45%), calf knee (31%), standing under behind (31%), short pelvis (31%) and straight hocks (16%). Linear and angular limb measurements showed standing under in front had increased elbow joint lateral angle, and decreased fore fetlock joint lateral angle. Steep shoulder displayed a significant increase (P< 0.05) in shoulder joint lateral angle and significant decrease in forearm front length. calf knee horses had significant decrease in the lateral angle of carpus joint. Short pelvis had a significant decrease in lateral length of pelvis and significant increase in croup angle and stifle joint lateral angle. Straight hocks showed the lateral length of both pelvis and gaskin showed a significant decrease and significant increase in the stifle joint lateral angle. Therefore, the current use of linear and angular measurements in relationships to abnormal limb conformation in the present study will allow for estimation of the future performance and soundness in jumping thoroughbred horses. In addition can be considered for selection athletic horse with less risk of lameness.

A 3D printed model for radius curvus surgical treatment planning in a dog

ABSTRACT: An 8 month-old, 10 kg male Azawakh dog was presented due to worsening forelimb gait and exercise intolerance. The right forelimb presented gross angular limb deformity with carpal valgus and radial procurvatum. Surgical planning based on radiographs allowed calculation of the centers of rotation and angularity (CORAs). The computer tomography data were used to generate 3D reconstructions of the antebrachium to aid the detection of the orthopaedic problems. With proper imaging software, the nature of the deformity and its degree were quantified using a previously unreported method based on the CORAs as a 3D printed model of anatomical area of interest. This 3D printed model was used by the surgeon to simulate the surgery with all orthopaedic steps, which included a partial ulna osteotomy and a double cuneiform osteotomy of the radius performed at the level of CORAs and stabilized with bone plates and screws. After 7 weeks, radiographs revealed bone union. At 8 months after surgery the animal presented a complete recovery of the involved forelimb. CORAs method combined with computed tomography and 3D model was useful to plan and simulate surgical procedures, including the corrective surgery of forelimb deformities in a dog which improved the surgical efficiency comparatively to the conventional pre-operative study.

Protocolo anestésico para correção de deformidade flexural em potro: relato de caso

Uma potra quarto de milha de 14 dias de idade e pesando 68kg foi encaminhada para o Hospital Veterinário das Faculdades Integradas de Ourinhos para correção de deformidade flexural bilateral (carpo valgo) pela técnica de epifisiodese por parafuso em membros torácicos. No exame pré-anestésico, os parâmetros avaliados foram: frequência cardíaca (FC) – 120bpm; frequência respiratória (f) – 80mpm; desidratação – 0%; temperatura retal – 37,5°C; e palpação de pulso – forte e regular. A medicação pré-anestésica, foi realizada com detomidina (5μg/kg), via intramuscular. Após 15 minutos foi introduzido cateter 14G pela veia jugular, a paciente foi induzida à anestesia com propofol 1% (4mg/kg), IV, seguida de intubação endotraqueal e mantida sob anestesia inalatória com isoflurano. A seguir, foi realizado o bloqueio dos nervos ulnar, mediano e cutâneo medial do antebraço bilateral aplicando-se 5mL de lidocaína 2% (com vasoconstritor) em cada ponto. A fluidoterapia foi instituída com Ringer lactato na taxa de 3mL/kg/h. No período transanestésico, os valores referentes às variáveis estudadas (mínimo e máximo) foram: FC – 55 e 85bpm; ƒ – 10 e 20mpm; temperatura retal – 36,5 e 37,6°C; pressão arterial sistólica (PAS) – 40 e 65mmHg; pressão arterial diastólica (PAD) – 20 e 30mmHg; pressão arterial média (PAM) – 25 e 45mmHg; glicemia – 130 e 145mg/dL; saturação de oxihemoglobina (SpO2) – 92 e 99; CO2 respirado final (ETCO2) – 47 e 71; e V% – 0,7 e 1,3. O período anestésico foi de 90 minutos, nesse intervalo houve hipotensão (PAM&lt;60mmHg), não respondendo à infusão contínua de dobutamina (0,2μg/kg/min) IV. O período de recuperação anestésica foi de 60 minutos, assistido manualmente, e não houve nenhuma intercorrência durante esse período. Conclui-se que o bloqueio dos nervos ulnar, mediano e cutâneo medial do antebraço foi eficiente para realização da técnica cirúrgica instituída, dado que a vaporização do anestésico inalatório se manteve abaixo dos valores referentes a 1 concentração alveolar mínima para a espécie.

Improvement in Bilateral Carpal Valgus Deviation in 9 Foals After Unilateral Distolateral Radial Periosteal Transection and Elevation.

To evaluate the effect of periosteal transection and elevation in foals with naturally occurring carpal valgus deviation. Prospective clinical study. Foals (n = 9) with bilateral carpal valgus. Foals with bilateral carpal valgus had distolateral radial periosteal transection and elevation (PE) including distal ulnar transection on 1 limb. Foals were stall confined until the skin incisions healed, and then allowed free exercise in a small paddock or round pen. Dorsopalmar carpal radiographs were obtained at 14 day intervals to determine the carpal valgus angle (CVA) until it was <5°. All limbs had a reduction in CVA and there was no significant difference in total carpal valgus angular correction or the rate at which the correction occurred between the surgical and control limb. Unilateral distolateral radial PE had no effect on carpal angulation in 9 foals with naturally occurring bilateral carpal valgus deviation when performed between 19 and 43 days.

A retrospective review of antebrachial angular and rotational limb deformity correction in dogs using intraoperative alignment and type 1b external fixation

AIM: The aim of this study was to report the outcome of acute antebrachial angular and rotational limb deformity (AARLD) correction using a standard radial ostectomy, an unarticulated type 1b external skeletal fixator (ESF) and intra-operative alignment with no pre-operative planning.METHODS: A retrospective evaluation was performed of dogs with carpal valgus, radial procurvatum and rotational deformity of the forelimb. All 39 cases presented and were treated surgically at a referral hospital in Melbourne, Australia, between September 2008 and March 2012. Surgical correction involved a standard closing cuneiform radial ostectomy, distal ulnar ostectomy and application of an unarticulated type 1b ESF. The method used intra-operative limb alignment and did not use pre-operative planning. Outcome was assessed via client phone interviews in all cases. Five cases were evaluated post-operatively using centre of rotation and angulation (CORA) methodology.RESULTS: As reported by owners of the 39 cases following surgery, limb function was excellent in 26 (67%), good in 12 (31%) cases and acceptable in one (2.5%) case. Frame tolerance was reported as good in 24 (62%), acceptable in 14 (36%) cases and poor in one (2.5%) case. Limb appearance was reported as straight in 25 (64%) cases and mildly rotated in 14 (36%) cases. In five cases that were evaluated, post-operative frontal and sagittal plane alignment ranged from 0–3.1° and 9.1–12.2°, respectively, and distal CORA was corrected to <6.1°. These were within the normal reported reference ranges. Pin tract infections were reported in seven (18%) casesCONCLUSIONS AND CLINICAL RELVANCE: This study suggests that the described technique may be an effective practice for the correction of AARLD that provides good clinical results, based on client assessment. The effectiveness of this technique was further supported by the five cases that underwent objective radiographic assessment. The technique is simpler than techniques that use extensive pre-operative planning, uses a smaller inventory and is easily applicable in companion animal practice.

Evaluation of application of a carpal brace as a treatment for carpal ligament instability in dogs: 14 cases (2008–2011)

To determine whether carpal brace application is a viable treatment for dogs with unilateral carpal ligament instability. Retrospective case series. 14 client-owned athletic dogs. Medical records were reviewed to identify dogs treated with a brace for unilateral carpal valgus or varus instability between August 2008 and August 2011. Treatment included passive motion and isometric strengthening exercises during brace application. Of the 14 dogs, 11 were considered to have returned to normal function; 11 of 12 dogs returned to agility competition. Carpal measurements before treatment indicated the affected limb had significantly greater valgus measurements (median, 30°; range, 30° to 35°), significantly greater varus measurements (median, 15°; range, 15° to 25°), and significantly less flexion (median, 37.5°; range, 30° to 45°), compared with results for the contralateral carpus. Long-term monitoring revealed no differences in measurements between affected and contralateral limbs. Valgus measurements of the affected carpus at brace removal (median, 15°; range, 15° to 20°) and at the end of long-term monitoring (median, 15°; range, 15° to 20°) were significantly lower than measurements before treatment (median, 30°; range, 30° to 35°). Dogs had significantly lower lameness scores (assessed on a scale of 0 to 5) at brace removal (median, 0; range, 0) and at the end of monitoring (median, 0; range, 0 to 2), compared with scores before treatment (median, 3; range, 1 to 3). Application of a carpal brace resulted in improved stability and resolution or reduction in lameness in dogs with carpal ligament instability.

Transfixation Pinning and Casting of a Comminuted Metacarpal Fracture in a 870 kg Bull

To report metacarpal fracture repair in a bull. Clinical report. Simmental bull (n = 1; 870 kg). A comminuted right metacarpal fracture was repaired using 2 transfixation pins (6 mm diameter) through the distal metaphysis and diaphysis of the radius and a full limb synthetic resin cast. Slight bending of both pins occurred 1 day after surgery. Both pins were loose and removed at 31 days and a full-limb cast reapplied. The cast was changed at approximately -4 week intervals. On day 50, the right carpus had moderate overextension and a valgus deformity. An exercise program was started on day 62, and on day 110, the cast was replaced with a Robert-Jones-bandage. At 130 days there was circumferential callus formation and the bull was discharged. At 6.5 months, overextension of the right carpus had resolved and carpal valgus had improved. The bull returned to at 7.5 months after surgery, and was successfully used for 4 years. For highly valuable cattle like this breeding bull, a surgical treatment of such a fracture should be attempted despite a primarily poor prognosis.

Longitudinal development of equine forelimb conformation from birth to weaning in three different horse breeds

There is limited published data on conformational changes in the forelimbs of growing foals. This study was designed to describe the changes in conformation of the carpus and distal forelimb from birth to weaning in foals of three different breeds. Evaluation of the conformation of the carpus, fetlock, pastern and foot was carried out in 134 Thoroughbreds, 162 French Trotters and 98 Selle Français (French Warmblood) within 1month of age and then at approximately 2month intervals until weaning at approximately 6months of age. The prevalence of limb deviations decreased from birth to weaning. Angular limb deformities were the predominant conditions in the first month (63.6% of all observed limb deviations) and flexural limb deformities were the most common abnormalities at weaning. The most frequent congenital abnormalities were carpal valgus (42.1% of the foals), fetlock valgus (31.2%), over-at-the-knee (30.8%) and dropped fetlocks (13.0%), with French Trotters and Thoroughbred foals being more affected than Selle Français foals. During the study period, the carpal and fetlock conformation became less valgus. The predominant abnormalities at weaning were fetlock valgus (19.1%), club feet (13.0%) and fetlock varus (11.2%). These observations show that carpal, fetlock and foot conformations changed substantially from birth and weaning. There were significant conformational differences between the three breeds, especially in the first months of life. An understanding of the peculiarities of specific breeds may be useful for the evaluation of individual foal conformation.

Clinical Use of Extracorporeal Shockwave Therapy (ESWT) for the Treatment of Carpus Valgus Deformities in Young Foals: A Retrospective Study of 64 Cases (2006-2009)

The purpose of this study was to report the use and assess the effects of extracorporeal shockwave therapy (ESWT) for the treatment of carpal joint valgus deformities (CJVDs) in young foals. Only foals with CJVDs greater than 5° were included in the study. Foals were assigned to 3 treatment groups based on their degree of CJVD measured during the initial evaluation: valgus deformity (VD) of 5° to 8.9° (Group 1), VD of 9° to 11.9° (Group 2) and VD greater than or equal to 12° (Group 3). ESWT was applied on the convex side of the angular deformity immediately following the initial radiographic evaluation. Foals were subsequently evaluated clinically and radiologically followed by treatment every 10 days until resolution of the VD, with resolution defined as a deviation less than 5 degrees. Each treatment group received specific exercise, hoof trimming and hoof/shoe extension recommendations. Sixty-four (64) foals were included in the study; ages ranged from 8 to 60 days old at inclusion in the study with a mean age of 26.7 days. Of the 28 foals included in Group 1, 10 had bilateral CJVD. There were 21 in Group 2, and 15 in Group 3. Treatment success was defined as a VD angle less than 5°, and was reached in all foals in Groups 1 and 2. Five (5) foals in Group 3 completed the study with a VD angle of 5° to 6.7° at the last radiographic assessment. No major complications were observed during the study. In conclusion, ESWT in conjunction with controlled exercise, hoof trimming and hoof/shoe extensions corrected severe CJVDs in young foals. The use of ESWT eliminates possible negative side effects of general anesthesia and surgical techniques to treat VDs. Future studies should include a control population, more severe cases, other types of angular limb deformities, and older foals.