Topic:Carpal Joint
The carpal joint in horses, also known as the knee, is a complex structure composed of bones, cartilage, ligaments, and synovial fluid that facilitates movement and weight-bearing in the forelimb. It consists of three main articulations: the radiocarpal joint, the midcarpal joint, and the carpometacarpal joint. These articulations are supported by a series of ligaments and tendons that provide stability and flexibility. The carpal joint is susceptible to various conditions such as osteoarthritis, fractures, and synovitis, which can affect the horse's mobility and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, biomechanics, common disorders, diagnostic techniques, and treatment options related to the carpal joint in horses.
A comparison of methods for proximal palmar metacarpal analgesia in horses. Three techniques for inducing analgesia of the proximal metacarpal region were evaluated for the frequency of inadvertent injection into the middle carpal and carpometacarpal joints. Using methylene blue solution as a marker dye and 30 fresh cadaver specimens each, three clinicians performed either 30 infiltrations at the origin of the suspensory ligament (method A), 30 palmar and palmar metacarpal nerve blocks at the proximal end of the metacarpus (method B), or 30 palmar and palmar metacarpal nerve blocks at the distal aspect of the accessory carpal bone (method C). The frequency of inadvert...
Effect of subchondral drilling on repair of partial-thickness cartilage defects of third carpal bones in horses. Arthrotomies of middle carpal joints were done on 13 horses, and a 1-cm partial thickness, round defect was made on the radial facet of both third carpal bones. In one joint, 1-mm diameter 1-cm deep holes were drilled within the defect, and one joint was used as a control. horses were assigned to 2 groups--group 1 (n = 6 horses), 5 drill holes; group 2 (n = 7 horses), 11 drill holes. At 1 and 3 weeks after surgery, differences between joints in synovial fluid total protein values, WBC counts, or results of mucin precipitate tests were not significant (P = 0.005). Physically and radiographicall...
Changes in equine carpal joint synovial fluid in response to the injection of two local anesthetic agents. The effects of repeated arthrocentesis and injection of local anesthetic agents, lidocaine HCl or mepivacaine HCl on the equine middle carpal joint were investigated. Synovial fluid samples were evaluated before, and 12, 24 and 48 hours following, treatment. The greatest changes from pretreatment values occurred in synovial fluid cellularity. Repeated arthrocentesis caused a moderate increase in cell counts, while injection of local anesthetics caused a greater increase. Alterations in mucin clot quality, hyaluronic acid content, fluid viscosity, total protein and immunoglobulin G were general...
Communications and boundaries of the middle carpal and carpometacarpal joints in horses. To study communications and boundaries of the middle carpal and carpometacarpal joints of the horse, 50 forelimbs were obtained from fresh cadaver specimens. Blue latex solution (20 +/- 2.5 ml) was injected into the middle carpal joint, and the specimens were frozen in extension. Frozen specimens were cut into 1-cm sagittal sections from the middle of the radius to the middle of the metacarpus. The communications between the middle carpal and carpometacarpal joints and the presence, length, and position of the distopalmar outpouchings of the carpometacarpal joint were recorded. The middle carp...
Solitary osteochondroma of the radius in three horses. Osteochondroma of the distal portion of the radius was diagnosed in 3 horses with a history of lameness and distention of the common tendon sheath of the superficial and deep digital flexor tendons at the level of the carpal canal. In 2 horses, the exostosis was removed through an incision at the caudal border of the lateral digital extensor muscle above the carpal ligament.
Incidence, location and classification of 371 third carpal bone fractures in 313 horses. The medical records and radiographs of all horses with a third carpal bone fracture admitted to The Ohio State University Veterinary Hospital from 1979 to 1987 were reviewed. Three hundred and seventy-one fractures were found in 313 horses; 57 percent were Standardbreds, 41 per cent were Thoroughbreds, and only 1.6 per cent were Quarterhorses. All were young racehorses (average age = 3.1 years). Third carpal fractures occurred more frequently in the right limb (60 percent) than the left limb (40 percent); Thoroughbreds had a greater right-left disparity (67.5 percent R, 27.1 per cent L). Fract...
A clinical perspective on lameness originating in the carpus. Clinical experience continues to expand our understanding of the pathophysiology of pain and injury within the carpal joints. The anatomical and physiological capacity of the equine carpus to neutralise loading stress plays a significant role in the prevention of carpal injury. The ability of joint surfaces to dissipate axial force by transfer to the interosseous ligaments is the principal means by which carpal injury is avoided. In the medial aspect of the intercarpal joint and the dorsal aspect of the radial carpal joint, however, the effects of chronic maximal stress and isolated acute supr...
Slab fractures of the third carpal bone in standardbreds and thoroughbreds: 155 cases (1977-1984). Case records and radiographs of 155 horses with third carpal bone (C3) slab fractures were reviewed. Of these cases, race records were obtained for 72 Thoroughbreds and 61 Standardbreds. Three performance criteria were examined: ability to make 1 start, ability to make 10 starts or earn $2,000 (within 1 year of first start after the fracture), and earnings per start. Treatment distribution (lag screw fixation, fragment excision, or rest) was similar in both breeds. Significant differences between breeds were identified in age and sex distributions, fracture displacement, and postinjury perform...
Surgical reconstruction of a ruptured medial collateral ligament in a foal. An avulsed carpal medial collateral ligament was diagnosed by clinical and radiographic examination in a 1-day-old foal that was unable to bear weight on the affected limb. The foal had a valgus deviation originating at the carpus and medial to lateral instability of the affected carpus. The ligament was reconstructed with screws and suture tape. Surgical reconstruction is a viable alternative to long-term casting or splinting for treatment of a ruptured carpal medial collateral ligament in a foal.
Quantification of skin displacement near the carpal, tarsal and fetlock joints of the walking horse. A technique enabling simultaneous visualisation of skin and underlying bony structures in the walking horse was used to quantify skin displacements on the lateral surface of carpal, tarsal and fetlock joints. The technique employed implanted light-emitting-diodes (LEDs) for marking the bone, and self adhesive spot labels for marking the overlying skin. Photographic recordings were made. Skin displacement was measured in six Dutch Warmblood horses. Mean total displacements and mean displacement per degree of change of joint angle were calculated. Displacements at the level of the fetlock joints...
A technique for catheterization of the equine antebrachiocarpal joint. A 2.5-cm long, 0.8 mm in diameter catheter was placed percutaneously into the palmarolateral pouch of the antebrachiocarpal joint in 6 clinically normal horses. The catheter was affixed in place for 72 hours. Cytologic analysis was performed on synovial fluid specimens obtained through the catheter at postcatheterization hours (PCH) 0, 24, and 72. The horses were euthanatized at PCH 72, and macroscopic and microscopic examinations were performed on the dorsal portion of the joint capsule and the palmarolateral pouch of the catheterized and contralateral (noncatheterized) joint. Clinical, synov...
Severe Synovitis in Two Horses due to the Use of Irrigating Solutions Containing Methanol and Formaldehyde. Two horses were examined because of chronic lameness, which followed arthroscopy in one case, and tendon sheath lavage in a second case. Clinical investigations linked both cases to the use of irrigating fluids containing preservatives. The clinical signs were reproduced in a Shetland pony by injection and lavage of the carpal joints with the same fluid. Lameness was slow in onset and accompanied by profound periarticular fibrosis. Postmortem examination confirmed the presence of a severe, erosive, noninfectious arthritis that may have an immune-mediated component. Clinicians should read produ...
Arthroscopic surgery for the treatment of osteochondral chip fractures in the equine carpus. The technique and results of arthroscopic surgery for the removal of osteochondral fragments from 1,000 carpal joints in 591 horses are reported. Of the 591 horses, 580 were racehorses (including 349 Quarter Horses and 220 Thoroughbreds). The distal aspect of the radial carpal bone was the most commonly affected site, followed by the proximal aspect of the intermediate carpal bone and distolateral aspect of the radius. More than one carpal joint was simultaneously operated on in 58.9% of the Quarter Horses and in 37.4% of the Thoroughbreds. Marked differences in the amount of damage were noted...
Sagittal fractures of the third carpal bone in horses: 12 cases (1977-1985). Third carpal sagittal fractures were found to be related to racing injuries in 10 of 12 horses. These fractures occurred most commonly on the medial aspect of the bone. A dorsoproximal-dorsodistal view of the carpus was required to visualize the fracture in all cases. Healing of the fracture required periods of rest of up to one year. Conservative management of these fractures resulted in return to function in 7 of 12 horses.
Evaluation of the repair process of cartilage defects of the equine third carpal bone with and without subchondral bone perforation. To determine the effect of subchondral bone drilling (forage) on the cartilage repair process after injury has occurred, a cartilage defect (1 cm in diameter) was created on the radial facet of the proximal surface of each third carpal bone in 6 adult horses. In one of the third carpal bones (right or left thoracic limb) of each horse, a 1-cm cartilage defect was created, and 5 holes (1 mm in diameter and 10 mm deep) were drilled through the subchondral bone into the cancellous bone. In the other thoracic limb, an identical defect was created, but not drilled. Analyses of cell numbers and type...
Arthroscopic landmarks of the equine carpus. The radiocarpal and middle carpal joints of 4 clinically normal horses and 24 necropsy specimens were examined with an arthroscope to describe the topographic anatomy of these joints. The carpal bones of the radiocarpal joint had congruent articular surfaces in extension, but carpal flexion resulted in a stairstep between the radial and intermediate carpal bones. The variable surface anatomy, as well as the restricted synovial space and the technical limitations of the arthroscope, contributed to the need for more than one arthroscopic approach to the radiocarpal joint to ensure a thorough exa...
Prevalence of carpal fractures in thoroughbred and standardbred racehorses. The prevalence of carpal fractures was determined for 211 thoroughbred and 75 standardbred racehorses. Statistically significant differences were found in the location of fractures between the 2 breeds. In the thoroughbred and standardbred groups, total fractures (460) were distributed nearly equally between the left (224) and right (236) carpi. The most common site of fracture in the thoroughbred group was the distal aspect of the radiocarpal bone (112), whereas the most common site of fracture in standardbred horses was the proximal surface of the third carpal bone (61). Slab fractures were ...
Assessment of prognosis for racing after carpal surgery in 210 Thoroughbreds. The efficacy of treating carpal lesions by arthrotomy was evaluated in 210 Thoroughbred racehorses, using survival analysis to compare their racing performances and earnings with those of 840 control horses. The treated horses were significantly inferior with respect to races contested, and wins plus places (P less than 0.001) and races won (P less than 0.01). There was no difference with respect to earnings (P less than 0.1); after adjusting for other factors, arthritis, site of fracture and presence of a displaced chip had no effect on racing performance in horses with a single-site lesion i...
Slab fractures of the fourth and intermediate carpal bones in five horses. Fractures of the fourth carpal bone were diagnosed in 5 horses; 3 fractures were associated with fracture of the intermediate carpal bone. The diagnosis was delayed in all 5 horses, apparently because of the moderate nature of the clinical signs. Open surgical reduction with lag screw type fixation was used in all horses. Because of delayed treatment, transfixation of carpal bones (necessary for stability), and surgical trauma, degenerative joint disease with osteophyte formation occurred in all 5 horses. None of the 5 horses was able to begin or return successfully to work, although 4 of the ...
Technique for arthroscopic repair of third carpal bone slab fractures in horses. A technique involving internal fixation guided by arthroscopy was used to repair third carpal slab fractures in 23 horses. The technique allowed good reduction and compression of the fractures, with minimal surgical trauma. Ten of 17 horses with a 6-month or longer follow-up have returned to race successfully.
Arthroscopic anatomy of the intercarpal and radiocarpal joints of the horse. Arthroscopic anatomy of the equine intercarpal and radiocarpal joints was documented in six cadaver limbs and on observations made during surgical treatment of horses with carpal osteochondral fractures. Instrument positions and arthroscopic visualisation were recorded. The cadaver limbs were dissected and iatrogenic lesions recorded. A single arthroscopic portal examination was adequate in both joints; however, a second arthroscopic portal improved visualisation. The intercarpal joint was more easily examined than the radiocarpal joint because of anatomical differences. Iatrogenic lesions wer...
Periosteal transection and stripping for treatment of angular limb deformities in foals: radiographic observations. Radiographs of 23 foals (35 forelimbs) with carpal region angular limb deformities, which later were corrected by hemicircumferential transection of the periosteum and periosteal stripping, were evaluated as to geometric and morphologic abnormalities. Geometric evaluation included deviation angle and deviation pivot point. Morphologic abnormalities were categorized as: asymmetric width of the distal radial physis; asymmetric width of the distal radial epiphysis; carpal bone collapse or fracture; carpal bone hypoplasia; carpal bone displacement; and metacarpal bone displacement. Fifty-seven per...
Chondrosarcoma in the radius of a horse. An aged Thoroughbred stallion was examined because of progressive lameness, carpal swelling, and weight loss. Radiography revealed a destructive lesion in the caudomedial, distal portion of the radius. Chondrosarcoma was diagnosed by tumor-core biopsy. Gross and histologic evaluation of the neoplasm after necropsy revealed a locally invasive chondrosarcoma at the distal end of the radius that infiltrated the radiocarpal joint capsule and invaded the carpal bones. The malignant nature of this tumor was evident by its invasiveness and histologic features of cell pleomorphism and presence of mito...
Subluxation of the carpus in thirteen horses. The records of 13 horses of various breeds with subluxation of the radiocarpal, intercarpal or carpometacarpal joint, or combinations of these were reviewed. Subluxation was most common at the carpometacarpal joint (n = 10) and concomitant fractures of individual carpal bones or metacarpus II and IV were seen (n = 12).Treatment comprised of immobilization in a full leg plaster cast for from four to 18 weeks. Three animals were euthanized, two because of cast complications and one because of a request by the owner. The remaining ten were saved to function as breeding animals.