TECHNIQUE

Surgical Correction of Angel Wing (Disease Investigation & Control - Treatment and Care)

Summary Information
Type of technique Health & Management / Disease Investigation & Control / Treatment & Care / Techniques:
Synonyms and Keywords Surgical Correction of: Valgus Carpal Deformity / Carpometacarpal Deformity in Birds
Description The following description outlines the procedure as described by Yeisley, 1993 (P4.1993.w2). N.B. Measurements given are for "young Canada geese"; adjustment for size of bird should be made as appropriate.
  • Anaesthetise.
  • Place in ventral recumbency.
  • Remove feathers from dorsal and cranial aspect of carpometacarpus and carpal joint area, except primary flight feathers and alulae.
  • Surgically prepare site and drape (transparent adherent surgical drape usually used).
  • Incise skin starting just over the distal end of of the radial carpal bone and extending approximately 5cm distally along the lateral aspect of the major metacarpal bone (metacarpal III).
  • Identify and isolate the branches of the radial and ulnar arteries and veins as they cross over the proximal metacarpus, to avoid damaging these.
  • Bluntly dissect connective tissue to expose the periosteum of the major metacarpal bone.
  • Incise periosteum lengthways for two to three centimetres, centring the incision just proximal to the origin of the minor metacarpal bone (metacarpal IV), on the craniolateral aspect of the major metacarpal bone.
  • Elevate and reflect periosteum to expose the major metacarpal bone in this region.
  • Using an osteotome, cut through the major metacarpal bone, and smooth the edges with a bone rongeur as necessary.
  • Make initial insertion of a 1/8 or 3/32 inch pin into the cortex of the major metacarpal bone, approximately three centimetres distal to the osteotomy site, in the craniolateral aspect of the major metacarpal bone.
  • Measure the pin to be placed (3/32 inch or smaller), and produce a small bend (approximately 20 degrees) where the pin will end distally at the entry point.
  • Place the pin normograde from the distal bone fragment towards the carpus.
  • Hold the carpus in flexion and seat the pin in the cortex of the proximal fragment, with the bones in correct alignment.
  • Cut the pin as close as possible to the bone surface.
  • Close periosteum using 3-0 Vicryl.
  • Close skin using 3-0 Vicryl.
  • Take post-operative radiographs.
  • Apply figure of eight bandage to hold wing flexed.
  • Ten days of prophylactic antibiotic cover (e.g. trimethoprim-sulpha) should be given.
  • Change bandages regularly and apply gentle physical therapy every three days for four to six weeks
  • Radiograph every two weeks to monitor healing and pin position
  • Remove bandage once radiography shows a stable bridging callus, and keep bird in a small enclosure to restrict exercise.
  • Remove pin when radiography indicates bony union (e.g. six to ten weeks post-operative), and move to a larger enclosure, allowing more exercise and an opportunity to observe the position and functional use of the wing.

(P4.1993.w2).

Appropriate Use (?) Cosmetic correction should be achieved and full flight capability may occur also (P4.1993.w2).
Notes  
Complications/ Limitations / Risk
  • Return to full flight capability cannot be guaranteed (P4.1993.w2).
  • Most suitable for larger birds (B14).
Equipment / Chemicals required and Suppliers Surgical set suitable for small animal exotics/avian surgery, orthopaedic pin pack including osteotome and bone rongeurs (P4.1993.w2).
Expertise level / Ease of Use Veterinary procedure. Procedure should only be undertaken by an individual with appropriate clinical training and practical experience; this would usually be a veterinarian.
Cost/ Availability May be quite expensive: cost of general anaesthesia and substantial surgical operation.
Legal and Ethical Considerations In some countries there may be legislation restricting the use of this type of technique to licensed veterinarians. For example in the UK: "The Veterinary Surgeons Act 1966 (Section 19) provides, subject to a number of exceptions, that only registered members of the Royal College of Veterinary Surgeons may practice veterinary surgery."(see: LCofC1 - RCVS Guide to Professional Conduct 2000 - Treatment of Animals by Non-Veterinary Surgeons).).
Author Debra Bourne
Referee  
References P4.1993.w2, B14

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