Arthroscopic approaches to the palmar aspect of the equine carpus.

This study explores arthroscopic techniques for reaching the palmar aspects of the antebrachiocarpal and middle carpal joints in horses, describing the views attainable for each approach and its use in assessing or removing fracture fragments from these joints.

Methods

• Initial trials were performed using a latex model to identify potential access points for arthroscopy to these joint aspects of equine carpi.
• Following this, a set of 24 carpi (collected from 16 cadavers and 8 live horses) were examined extensively using arthroscopy. The researchers detailed the access sites used, and observed and recorded the visible carpal bone surfaces for each exploration method.

Results

• Successful arthroscopic approaches were developed to the medial and lateral flanks of the palmar pouches of both the antebrachiocarpal (AC) and middle carpal (MC) joint. The chosen instrument portals allowed for a comprehensive examination of the said joints.
• When approached through the AC joint, the palmar surface of the radial carpal bone and the radius could be examined, along with the dorsal articular surfaces of the accessory carpal bone.
• A palmar approach to the MC joint allowed for observation of the palmar aspect of the radial, second and third carpal bones on the medial side, and the ulnar and fourth carpal bone on the lateral side.

Conclusions

• The researchers concluded that arthroscopic access to these joints, when performed using separate medial and lateral portals to the AC and MC joints, permits an evaluation of the caudodistal radius, palmar surfaces of the radial, ulnar, second, third and fourth carpal bones, as well as the dorsal aspect of the accessory carpal bone.
• The arthroscopic approaches practiced in this study to the palmar aspect of the carpus can be used to evaluate the medial palmar intercarpal ligaments, and even to remove any scattered fracture fragments from these joints.