Vet Comp Orthop Traumatol 2022; 35(02): 112-118
DOI: 10.1055/s-0041-1736381
Clinical Communication

Hemiepiphysiodesis for the Correction of Distal Femoral Valgus in Growing Dogs

Luca Vezzoni
1   Surgical Department, Clinica Veterinaria Vezzoni, Cremona, Italy
Ida Forzisi
2   Surgical Department, Clinica Veterinaria Gina, Annicco, Cremona, Italy
Antonio Ferretti
3   Surgical Department, Clinica Veterinaria Ferretti, Legnano, Italy
1   Surgical Department, Clinica Veterinaria Vezzoni, Cremona, Italy
› Author Affiliations
Funding None.


Objectives The aim of this study was to describe hemiepiphysiodesis for the treatment of distal femoral valgus in immature dogs and to evaluate its effect on the anatomical lateral distal femoral angle (aLDFA).

Methods Skeletally immature dogs with distal femoral valgus deformities that had undergone hemiepiphysiodesis between November 2012 and March 2020 at two private veterinary practices were included. Criteria for inclusion in the study were a preoperative aLDFA below the previously published reference range (94 ± 3.3 degrees) and radiographs of the femur taken preoperatively and at growth plate closure.

Results A total of 11 dogs fulfilled the inclusion criteria, and a total of 17 limbs were treated. The mean aLDFA was 82.1 ± 3.2 degrees (range: 76–87 degrees) preoperatively and 93.1 ± 5 degrees (range: 76–99 degrees) at the final re-evaluation. The mean difference between the preoperative and final aLDFA was +11 degrees, which was significant. Undercorrection occurred in 2/17 cases, whereas overcorrection was not recorded. The implants were removed in 12/17 cases, and rebound growth occurred in 3 of these.

Clinical Significance Hemiepiphysiodesis for the treatment of distal femoral valgus is a technique that allows for increase in aLDFA and should be considered as an early treatment in affected immature dogs. Monitoring for possible overcorrection using serial radiography is important. Implant removal when the desired aLDFA has been achieved is recommended because the incidence of rebound growth is uncommon in dogs.

Authors' Contributions

L.V. contributed to the study conception, study design, acquisition of data, data analysis and interpretation, drafting or revising of the manuscript, approval of the submitted manuscript and is publicly accountable for relevant content. A.F. and A.V. contributed to the study conception, study design, data analysis and interpretation, drafting or revising of the manuscript, approval of the submitted manuscript and is publicly accountable for relevant content. I.F. contributed to the acquisition of data, data analysis and interpretation, drafting or revising of the manuscript, approval of the submitted manuscript and is publicly accountable for relevant content.

Supplementary Material

Publication History

Received: 02 March 2021

Accepted: 08 September 2021

Article published online:
23 November 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

  • References

  • 1 Piermattei D, Flo GL, DeCamp C. Brinker, Piermattei and Flo's Handbook of Small Animal Orthopedics and Fracture Repair. Correction of Abnormal Bone Growth and Healing.. 4th edition.. St. Louis: Saunders Elsevier; 2006: 747-770
  • 2 Ramadan RO, Vaughan LC. Disturbance in the growth of the tibia and femur in dogs. Vet Rec 1979; 104 (19) 433-435
  • 3 Paley D. Principles of Deformity Correction. 1st edition.. Berlin, Germany: Springer-Verlag; 2003
  • 4 Slocum B, Slocum TD. Patellar luxation algorithm. In: Bojrab M. ed. Current Techniques in Small Animal Surgery. 4th edition.. Baltimore: The Williams & Wilkins Co; 1998: 1222-1231
  • 5 Vaughan LC. Growth plate defects in dogs. Vet Rec 1976; 98 (10) 185-189
  • 6 Witte PG, Scott HW. Treatment of lateral patellar luxation in a dog by femoral opening wedge osteotomy using an interlocking nail. Vet Rec 2011; 168 (09) 243
  • 7 Kalff S, Butterworth SJ, Miller A, Keeley B, Baines S, McKee WM. Lateral patellar luxation in dogs: a retrospective study of 65 dogs. Vet Comp Orthop Traumatol 2014; 27 (02) 130-134
  • 8 Shaver SL, Mayhew KN, Sutton JS. et al. Complications after corrective surgery for lateral patellar luxation in dogs: 36 cases (2000-2011). J Am Vet Med Assoc 2014; 244 (04) 444-448
  • 9 Mehlman CT, Araghi A, Roy DR. Hyphenated history: the Hueter-Volkmann law. Am J Orthop 1997; 26 (11) 798-800
  • 10 Frost HM. A chondral modeling theory. Calcif Tissue Int 1979; 28 (03) 181-200
  • 11 Bowen JR, Leahey JL, Zhang ZH, MacEwen GD. Partial epiphysiodesis at the knee to correct angular deformity. Clin Orthop Relat Res 1985; (198) 184-190
  • 12 Stevens PM. Guided growth for angular correction: a preliminary series using a tension band plate. J Pediatr Orthop 2007; 27 (03) 253-259
  • 13 Burghardt RD, Herzenberg JE, Standard SC, Paley D. Temporary hemiepiphyseal arrest using a screw and plate device to treat knee and ankle deformities in children: a preliminary report. J Child Orthop 2008; 2 (03) 187-197
  • 14 Goyeneche RA, Primomo CE, Lambert N, Miscione H. Correction of bone angular deformities: experimental analysis of staples versus 8-plate. J Pediatr Orthop 2009; 29 (07) 736-740
  • 15 Witte S, Hunt R. A review of angular limb deformities. Equine Vet Educ 2009; 21: 378-387
  • 16 Fretz PB, Turner AS, Pharr J. Retrospective comparison of two surgical techniques for correction of angular deformities in foals. J Am Vet Med Assoc 1978; 172 (03) 281-286
  • 17 Olsen AM, Vezzoni L, Ferretti A, Palmer RH, Vezzoni A, Duerr F. Hemiepiphysiodesis for the correction of proximal tibial valgus in growing dogs. Vet Comp Orthop Traumatol 2016; 29 (04) 330-337
  • 18 Denny HR. A Guide to Canine and Feline Orthopaedic Surgery. 3th edition.. Oxford: Blackwell Scientific Publications; 1993: 344-345
  • 19 Tomlinson J, Fox D, Cook JL, Keller GG. Measurement of femoral angles in four dog breeds. Vet Surg 2007; 36 (06) 593-598
  • 20 Peterson JL, Torres BT, Hutcheson KD, Fox DB. Radiographic determination of normal canine femoral alignment in the sagittal plane: a cadaveric pilot study. Vet Surg 2020; 49 (06) 1230-1238
  • 21 Johnson KA. Piermattei's Atlas of Surgical Approaches to the Bones and Joints of the Dog and Cat. 5th edition.. St. Louis: Elsevier Saunders; 2013: 396-399
  • 22 Leveille LA, Razi O, Johnston CE. Rebound deformity after growth modulation in patients with coronal plane angular deformities about the knee: who gets it and how much?. J Pediatr Orthop 2019; 39 (07) 353-358
  • 23 Zuege RC, Kempken TG, Blount WP. Epiphyseal stapling for angular deformity at the knee. J Bone Joint Surg Am 1979; 61 (03) 320-329
  • 24 McBrien Jr CS, Vezzoni A, Conzemius MG. Growth dynamics of the canine proximal tibial physis. Vet Surg 2011; 40 (04) 389-394
  • 25 Blount WP, Clarke GR. Control of bone growth by epiphyseal stapling; a preliminary report. J Bone Joint Surg Am 1949; 31A (03) 464-478
  • 26 Park KH, Oh CW, Kim JW, Park IH, Kim HJ, Choi YS. Angular deformity correction by guided growth in growing children: eight-plate versus 3.5-mm reconstruction plate. J Orthop Sci 2017; 22 (05) 919-923
  • 27 Kumar A, Gaba S, Sud A, Mandlecha P, Goel L, Nayak M. Comparative study between staples and eight plate in the management of coronal plane deformities of the knee in skeletally immature children. J Child Orthop 2016; 10 (05) 429-437
  • 28 Brower BE, Kowaleski MP, Peruski AM. et al. Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs. Vet Comp Orthop Traumatol 2017; 30 (01) 20-27
  • 29 DeTora MD, Boudrieau RJ. Complex angular and torsional deformities (distal femoral malunions). Preoperative planning using stereolithography and surgical correction with locking plate fixation in four dogs. Vet Comp Orthop Traumatol 2016; 29 (05) 416-425
  • 30 Swiderski JK, Palmer RH. Long-term outcome of distal femoral osteotomy for treatment of combined distal femoral varus and medial patellar luxation: 12 cases (1999-2004). J Am Vet Med Assoc 2007; 231 (07) 1070-1075
  • 31 Panichi E, Cappellari F, Olimpo M. et al. Distal femoral osteotomy using a novel deformity reduction device. Vet Comp Orthop Traumatol 2016; 29 (05) 426-432
  • 32 Petazzoni M, Palmer RH. Femoral angular correction and lengthening in a large-breed puppy using a dynamic unilateral external fixator. Vet Surg 2012; 41 (04) 507-514