Presentation
Presents with right thoracic limb lameness.
Patient Data
The distal right radial physis is closed and there is distal displacement of the proximal radius from the humeral condyle resulting in humeroradial subluxation. This has resulted in carpal varus of the right forelimb.
There is a small mineral fragment visible cranial to the ulna on the lateral projection which is most likely a fragmented coronoid process. There is mild subtrochlear sclerosis of the ulna and mild periosteal proliferation at the proximal aspect of the anconeal process. There is mild periarticular osteophytosis of the proximal radius. The distal ulnar physis is still open.
premature closure of the right distal radius
carpal varus
humeroradial subluxation
fragmented cornoid process
Case Discussion
The premature closure of the right distal radius has led to secondary changes including elbow incongruity, fragmented coronoid process, and carpal varus. The shortened bone leads to abnormal weight bearing within the elbow joint. Fragmented coronoid process was confirmed at arthroscopy. The left elbow was normal.
Premature closure of the physis is often due to trauma resulting in damage to the physeal cartilage and early transition to bone. If the trauma occurs on one side of the physis, and the other side continues to grow, an angular limb deformity will result. In this case, it appears that the medial side of the distal radial physis closed early, causing carpal varus. Carpal valgus would occur if the lateral side closed early. Premature closure of the entire distal radial physis results in a shortened and straightened radius with a possibly shortened ulna as well, and elbow subluxation.
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