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Home / Equine Research Bank / Vet Surg / Arthroscopic removal of palmar intermediate carpal bone frac...
Veterinary surgery : VS2022; 51(6); 929-939; doi: 10.1111/vsu.13813

Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath.

Abstract: To describe the removal of palmar intermediate carpal bone (ICB) fracture fragments using a transthecal approach through the carpal flexor tendon sheath. Methods: Case series. Methods: Four horses with fractures of the palmar aspect of the ICB. Methods: Two horses were injured when falling and two during recovery from general anesthesia. Three horses underwent MRI to supplement conventional imaging. Three horses had concurrent fractures of the radial and/or accessory carpal bones. Conventional proximolateral carpal sheath arthroscope and instrument portals were used, supplemented with a medial instrument portal through the carpal flexor retinaculum to access the palmar carpal ligament. Optimized dissection through the latter was facilitated by needle guidance and radiography. The fragment was dissected from the soft tissue attachments and the palmar ICB fragments retrieved through the carpal sheath in all horses. Surgery time was 85 to 142 min. Results: Limitations of this technique include a long surgery time and the potential for hemorrhage to impair visibility during surgery. All four horses were discharged 3 to 8 days postoperatively. Three horses returned to full athletic work within 9 months postoperatively and one horse was euthanized due to persistent lameness. Conclusions: A tenoscopic transthecal carpal flexor tendon sheath approach provides access for removal of palmar ICB fracture fragments but should be viewed as an advanced arthroscopic procedure. Conclusions: A transthecal approach through the carpal flexor tendon sheath offers an alternative technique for removal of palmar ICB fracture fragments.
© 2022 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2022-04-11 PubMed ID: 35403724PubMed Central: PMC9544275DOI: 10.1111/vsu.13813Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This study describes the use of an advanced arthroscopic procedure for the removal of palmar intermediate carpal bone (ICB) fracture fragments from horses via a transthecal approach through the carpal flexor tendon sheath.

Research Methodology

  • The researchers investigated a case series involving four horses that had fractures of the palmar aspect of the ICB.
  • Two of the horses were injured from falling, while the other two were injured during recovery from general anesthesia.
  • Three of the four horses underwent MRI scans in addition to conventional imaging to better visualize the fracture
  • Three of the horses also had concurrent fractures of their radial and/or accessory carpal bones.
  • Conventional proximolateral carpal sheath arthroscope and instrument portals were used for the operation, supplemented with a medial instrument portal through the carpal flexor retinaculum to access the palmar carpal ligament.
  • Optimized dissection was facilitated by needle guidance and radiography, with surgery times ranging from 85 to 142 minutes.

Results and Findings

  • All four horses successfully had their palmar ICB fragments removed through the carpal sheath in this surgery.
  • Limitations of this technique include a lengthy surgery time and the risk of hemorrhage impairing visibility during the operation.
  • Post operation, horses were discharged between 3 to 8 days, and three out of four horses returned to full athletic work within 9 months.
  • One horse had to be euthanized due to persistent lameness, indicating the technique may not be successful in all cases.

Conclusions

  • The researchers concluded that a transthecal carpal flexor tendon sheath approach provides access for removal of palmar ICB fracture fragments in horses.
  • Despite its advantages, this technique is considered as an advanced arthroscopic procedure due to its complexity and the challenges faced during surgery.
  • Despite certain limitations, the transthecal approach through the carpal flexor tendon sheath could still be viewed as an alternative technique for the removal of palmar ICB fracture fragments.

Cite This Article

APA
Hewitt-Dedman CL, O'Neill HD, Bladon BM. (2022). Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath. Vet Surg, 51(6), 929-939. https://doi.org/10.1111/vsu.13813

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 51
Issue: 6
Pages: 929-939

Researcher Affiliations

Hewitt-Dedman, Charlotte L
  • The University of Edinburgh Royal (Dick) School of Veterinary Studies, Edinburgh, UK.
O'Neill, Henry D
  • Donnington Grove Equine Hospital, Newbury, UK.
Bladon, Bruce M
  • Donnington Grove Equine Hospital, Newbury, UK.

MeSH Terms

  • Animals
  • Arthroscopes
  • Arthroscopy / methods
  • Arthroscopy / veterinary
  • Carpal Bones / surgery
  • Fractures, Bone / surgery
  • Fractures, Bone / veterinary
  • Horse Diseases / surgery
  • Horses
  • Tendons / surgery

Conflict of Interest Statement

The authors declare no conflicts of interest related to this study.

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