If the foals are getting too old, surgery may need to be added to the therapeutic plan in order to achieve the best results. Cast application - Cast application is most beneficial in cases of cuboidal bone collapse or collateral ligament laxity. Casting is not indicated in cases of pure physeal abnormalities. It is important to use a tube cast in order to decrease the incidence of flexor ligament laxity. Because of the rapid growth of foals at this age, the cast should be changed every 2-3 weeks, and may need to be reset multiple times.
Radiographs are necessary to determine if the bones have gone on to ossify normally.
Surgical Options - Surgery becomes necessary in some cases if the best possible outcome is desired. There are different surgical options, some depending on the severity of the angulation, and others on the surgeons preference. Periosteal Stripping - Periosteal stripping is performed on the concave surface of the limb, just proximal to the affected growth plate. Periosteal stripping is only beneficial in cases where the angular deformity is coming from an active growth plate. The exact mechanism that improves angular deformities after periosteal stripping is unknown.