Fractures of the palmar aspect of the carpal bones in horses: 10 cases (1984–2000)

Wilke, Markus; Nixon, Alan J.; Malark, J A; Myhre, Grant

doi:10.2460/javma.2001.219.801

Cited by 23 publications

(53 citation statements)

References 6 publications

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“…Knowledge of the extent of the palmar lateral outpouching of the middle carpal joint and its arthroscopically accessible structures could help predict which palmar carpal osteochondral fragments can be removed via this approach. Owing to the ease of manipulation within the pouch and the reportedly improved outcome obtained after removal of palmar carpal osteochondral fragments, 8,10 arthroscopic removal of fragments in the palmar lateral outpouching of the middle carpal joint should be considered in patients.…”

Section: Discussionmentioning

confidence: 99%

“…The arthroscopic techniques for their removal and the intra‐articular anatomy of the dorsal aspect of the equine carpus have been described 4,5 . Carpal osteochondral fractures occur primarily in the dorsal aspect of the affected joint 6,7 ; however, palmarly located carpal osteochondral fragments do occur 8–11 . We know of no comprehensive description of the magnetic resonance (MR) imaging anatomy of the palmar aspect of the equine carpus.…”

Section: Introductionmentioning

confidence: 99%

“…It has been shown that palmar carpal osteochondral fragments occur most commonly in the palmar lateral outpouching of the middle carpal joint 9,10 . Horses with palmarly located carpal osteochondral fragments have an improved outcome if these fragments are surgically removed 8,10 . It has been our impression that although the arthroscopic approach to the palmar lateral outpouching of the middle carpal joint is technically easy, the anatomy can be confusing.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Magnetic Resonance Contrast Arthrography and Arthroscopic Anatomy of the Equine Palmar Lateral Outpouching of the Middle Carpal Joint

Getman

McKnight

Richardson

2007

Vet Radiology Ultrasound

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The objective of this report was to provide an anatomic description of the equine palmar lateral outpouching of the middle carpal joint by comparing its arthroscopic and magnetic resonance (MR) contrast arthrography appearance and to define the structures within the palmar lateral outpouching of the middle carpal joint that can be assessed arthroscopically. MR contrast arthrography was performed on seven cadaveric limbs; images were compared with those obtained during arthroscopic exploration of the palmar lateral outpouching of the middle carpal joint. Gross dissection was performed to confirm identification of intra-articular structures. The MR images compared well with the arthroscopic and gross appearance of the palmar lateral outpouching of the middle carpal joint. Portions of the ulnar carpal bone, fourth carpal bone, fourth metacarpal bone, lateral palmar intercarpal ligament, and lateral collateral ligament of the carpus were identified within the palmar lateral outpouching of the middle carpal joint in all limbs. In addition, in three limbs areas of the third carpal bone and intermediate carpal bone could be seen. MR arthrography was a useful tool for helping to define the anatomy of the palmar lateral outpouching of the middle carpal joint. The arthroscopic approach to the palmar lateral outpouching of the middle carpal joint is technically easy, but the intra-articular anatomy can be confusing. Use of a motorized arthroscopic blade to remove excess synovial tissue is necessary to view all of the structures within the palmar lateral outpouching of the middle carpal joint. Arthroscopic removal of osteochondral fragments from this location may be facilitated by the information obtained from this study.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Comparison of Magnetic Resonance Contrast Arthrography and Arthroscopic Anatomy of the Equine Palmar Lateral Outpouching of the Middle Carpal Joint

Getman

McKnight

Richardson

2007

Vet Radiology Ultrasound

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“…The fall onto its flexed carpal joints could also have caused fractures of the small carpal bones or accessory carpal bone as has been described in horses falling on their carpi during training or during recovery from general anesthesia. 4 Carpal bone fractures may cause a nonspecific carpal swelling, depending on their anatomic location, especially because these injuries are rare and often not recognized until several days later.…”

Section: Commentsmentioning

confidence: 99%

What Is Your Diagnosis?

Vidal

Valdés‐Martínez²,

Bueno³

2006

javma

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HistoryA 12-year-old Thoroughbred Quarter Horse cross gelding was evaluated because of a grade 4/5 lameness 1 of the right forelimb. The horse had fallen at a jump during a show jumping training session and collapsed onto its carpi. The referring veterinarian suspected a flexor tendon rupture because of significant soft tissue swelling in the palmar proximal metacarpal area and immediately treated the horse with hydrotherapy, corticosteroids, and flunixin meglumine. A splint was applied over the dorsal aspect of the distal portion of the limb to support the injured limb during transport.Abnormalities detected on physical examination included focal swelling around the deep digital flexor tendon at the level of the proximal portion of the metacarpus and generalized swelling over the medial aspect of the carpus, which did not elicit signs of pain during palpation. Complete rupture of the superficial or deep digital flexor tendons could not be confirmed after palpation of the swollen area. No abnormalities were detected on CBC count and serum biochemical analyses. No abnormalities were detected on radiographs of the right carpus and proximal portion of the third metacarpal bone. Ultrasonography of the medial aspect of the carpus distal to the chestnut and the palmar aspect (zone 2B) 2 of the proximal portion of the third metacarpal bone was performed (Figure 1).Determine whether additional imaging studies are required, or make your diagnosis from Figure 1-then turn the page * * Figure 1-Transverse (A) and longitudinal (B) ultrasonographic images of the medial aspect of the distal portion of the right antebrachium, and transverse (C) ultrasonographic image of the palmar aspect of the metacarpal region 14 cm distal to the accessory carpal bone in a 12-year-old horse evaluated because of a grade 4/5 lameness of the right forelimb. In images A and B, cranial and proximal, respectively, are on the right side of the image. In image C, lateral is on the left side of the image. Images were obtained by use of a 7.5-MHz linear array transducer with a stand-off pad at a displayed depth of 5 cm.

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“…Removal of a fracture fragment from the palmar aspect of the intermediate carpal bone using arthrotomy was successfully described in 1 showjumper 11 . Fractures of the palmar aspect of the radial carpal bone, associated with fractures of the ulnar or intermediate carpal bones and distal radius, treated by means of arthroscopy or arthrotomy, have been associated with a poor prognosis 6 …”

Section: Introductionmentioning

confidence: 99%

Treatment of a Second Carpal Bone Fracture by Removal Under Ultrasonographic Guidance in a Horse

Piccot-Crézollet¹,

Cauvin²

2005

Veterinary Surgery

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Fractures of the palmar aspect of the carpal bones in horses: 10 cases (1984–2000)

Abstract: Results suggest that fractures of the palmar aspect of the carpal bones are uncommon in horses. The prognosis appears to be poor for affected horses but may be better for horses that undergo arthroscopic removal of intra-articular fragments.

Cited by 23 publications

References 6 publications

Comparison of Magnetic Resonance Contrast Arthrography and Arthroscopic Anatomy of the Equine Palmar Lateral Outpouching of the Middle Carpal Joint

Comparison of Magnetic Resonance Contrast Arthrography and Arthroscopic Anatomy of the Equine Palmar Lateral Outpouching of the Middle Carpal Joint

What Is Your Diagnosis?

Treatment of a Second Carpal Bone Fracture by Removal Under Ultrasonographic Guidance in a Horse

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