The effect of plate fixation on supination and pronation of the feline antebrachium: a model of pancarpal arthrodesis.

BACKGROUND: Pancarpal arthrodesis is purported to limit supination and pronation of the feline antebrachium. The objective of this study was to investigate whether plate fixation of the radius to the carpus and metacarpus limits supination and pronation of the ulna relative to the radius as a model for pancarpal arthrodesis in the cat. Eight feline cadaveric forelimbs were rotated from supination to pronation in a testing jig and CT (computed tomography) was performed in the neutral, supinated and pronated positions. A locking plate was then secured dorsally to the radius, radial carpal bone and metacarpal III of each of the limbs. CT was repeated in each of the testing positions following plate application. The radius and ulna of the control specimens, and the radius, ulna and plate of the plated specimens were then segmented using software. Alignment of the bones to the radius in the control specimens, and to the plate in the plated specimens was used to compare the changes in degrees of movement of the ulna relative to the radius in dorsal, sagittal and transverse planes. RESULTS: Based on the results of the paired t test, there was no significant difference in degrees of movement, or total range of motion between control and plated specimens in supinated and pronated testing conditions. CONCLUSION: The results of this ex-vivo study indicate that under the testing conditions employed, plate fixation of the radius to the carpus and metacarpus does not limit supination and pronation of the feline antebrachium.

Return to racing after surgical management of third carpal bone slab fractures in thoroughbred and standardbred racehorses.

OBJECTIVE: To determine the prognosis for racing of horses surgically treated for slab fractures of the third carpal bone (C3). STUDY DESIGN: Retrospective case study. ANIMALS: Horses (n = 125) surgically treated for C3 slab fractures. METHODS: Medical records of horses surgically treated for dorsal or sagittal C3 fractures were reviewed for age, sex, breed, limb, fracture type, degree of cartilage damage, and surgical treatment. Radiographs were evaluated to determine fracture depth, width, and displacement. Osteophytes, C3 lysis, and fragmentation were scored. Racing performance was obtained from online databases. Univariable and multivariable analyses were used to determine associations between independent variables and outcomes. RESULTS: Fifty-four (43%) horses raced postoperatively. Among thoroughbreds, 35% (30/86) with dorsal fractures and 63% (17/27) with sagittal fractures raced postoperatively. Among standardbreds, 77% (10/13) with dorsal fractures and 0% (0/2) with sagittal fractures raced postoperatively. Fracture displacement, C3 lysis, and cartilage damage affected the likelihood of racing postoperatively. Placement of 3.5-mm screws vs 4.5-mm screws and the placement of fewer screws were associated with improved likelihood of racing. CONCLUSION: The prognosis for postoperative racing of thoroughbreds with dorsal C3 fractures was less favorable than that previously reported. Concurrent joint pathology, such as cartilage damage at time of surgery, affected the ability of the horse to race postoperatively. CLINICAL SIGNIFICANCE: Although internal fixation of C3 slab fractures is required to restore joint congruity, return to racing should be expected in only 42% of thoroughbreds and 67% of standardbreds.

Palmar arthroscopic approach and intra-articular anatomy of the bovine carpal joints.

OBJECTIVE: To describe the palmar arthroscopic approaches to the bovine carpus and document the visible intra-articular structures in each approach. STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Thirty fresh cadaveric bovine forelimbs. METHODS: Computed tomography (CT) and gross dissection were performed on 4 carpi. Latex models were produced from 6 carpi to define the gross anatomy and arthroscopic portals to the palmar carpal pouches. Ultrasonography and arthroscopy were performed on 20 carpi to document visualization of the local anatomy. RESULTS: A single palmar pouch was present on both sides of each joint on gross dissection and evaluation of latex models. The relationship between pouches and palmar structures was observed by CT. Small anechoic areas identified on ultrasonography increased after joint distension. Palmar arthroscopy of the antebrachiocarpal joint enabled visualization of the palmar surfaces of radial, intermediate, and ulnar carpal bones; distal radius; ulnar styloid process; palmar radiocarpal ligament; and articulation of accessory and ulnar carpal bones. Palmar arthroscopy of the middle carpal joint enabled inspection of the palmar aspects of ulnar, intermediate, radial, fused second and third and fourth carpal bones, palmar carpometacarpal ligament, and the short lateral collateral ligament. Palmar aspects of the fourth and fifth metacarpal bones were explored through the palmarolateral approach to the middle carpal joint. Instrument portals for each pouch were created under arthroscopic guidance. CONCLUSION: Palmar arthroscopy of the adult bovine carpus enabled visualization of the clinically relevant palmar intra-articular structures. CLINICAL SIGNIFICANCE: Palmar carpal arthroscopy should be considered as an adjunct to dorsal approach for the diagnosis and treatment of bovine carpal diseases.

Effect of bandaging techniques on sub-bandage pressures in the equine distal limb, carpus, and tarsus.

OBJECTIVE: To determine the influence of 3 types of bandages on sub-bandage pressures over the distal limb, carpus, and tarsus. STUDY DESIGN: Observational study. ANIMALS: Eight healthy horses. METHODS: Each of the 6 following bandages was applied on each horse in randomized order: (1) distal limb compression bandage (DLC), (2) double layer bandage (DL), (3) inner sanctum bandage (IS), (4) carpal compression bandage (CC), (5) tarsal compression bandage (TC), and (6) adhesive elastic carpal bandage (C-ELA). Sub-bandage pressures were measured with the Picopress compression measuring system (Microlab Electonica, Nicolo, Italy) after bandage application. Carpal and tarsal bandage pressures were assessed before and after walking the horses approximately 50 m. TC pressures were also measured after creating a slit over the calcaneus. A generalized linear model was used to test the association of pressure with sensor location, bandage type, time, and potential interactions (P < .05). RESULTS: DLC (165 mmHg) and IS (167 mmHg) generated greater mean combined pressures compared with DL (146 mmHg; P = .0166). At application, CC (154 mmHg) created higher mean combined sub-bandage pressure compared with C-ELA (70 mmHg; P < .001). Pressures resulting from CC and TC decreased after walking (P < .001), whereas those associated with C-ELA were not affected. CONCLUSION: Variations to the standard DLC construct did not increase sub-bandage pressures. CC and TC pressures rapidly decreased with ambulation, whereas C-ELA pressures in healthy horses were not affected by walking. CLINICAL SIGNIFICANCE: Variations to the standard DLC offer no additional benefit in regards to increasing sub-bandage pressures. Carpal elastic bandages maintain sub-bandage pressures during ambulation and may be more appropriate for long term bandaging in ambulating horses. Creating a slit over the calcaneal tuber in TC bandages is discouraged due to rapid decreases in sub-bandage pressure.

Pancarpal and partial carpal arthrodesis with 3 locking compression plates in 6 horses.

OBJECTIVE: To report the outcome of horses after pancarpal or partial carpal arthrodesis with 3 locking compression plates (LCP). STUDY DESIGN: Case series. ANIMALS: Six horses ranging in age from 8 months to 16 years and weighing 227-580 kg with severe carpal pathology including acute fractures, chronic osteoarthritis, and chronic angular limb deformity. METHODS: Pancarpal or partial carpal arthrodesis was performed with 3 LCP. Autologous cancellous bone grafts were used in 5 of 6 cases to facilitate joint arthrodesis. RESULTS: External coaptation was maintained for 4 to 6 weeks after surgery. Radiographic follow-up was available in all 6 cases, all of which reached arthrodesis and pasture soundness by 4-5 months postoperatively. One case required implant removal at 6 months because of implant exposure through the skin but returned to pasture soundness after removal. CONCLUSION: Carpal instability due to acute fractures or chronic disease was successfully stabilized with 3 short LCP, leading to pasture soundness in all 6 horses. CLINICAL SIGNIFICANCE: The use of 3 short LCP should be considered as a strategy to facilitate pancarpal or partial carpal arthrodesis by providing superior stability without placement of implants in the diaphysis of the radius and third metacarpus.

Pancarpal Arthrodesis Without Rigid Coaptation Using the Hybrid Dynamic Compression Plate in Dogs.

OBJECTIVE: To describe the complications, short- and long-term outcomes, and owner satisfaction for dogs treated with pancarpal arthrodesis (PCA) using the 2.7/3.5 mm locking and dynamic compression plate (DCP) hybrid pancarpal arthrodesis plate (hybrid DCP [HDCP]) without rigid coaptation in the postoperative period. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with carpal injuries requiring PCA (n=15). METHODS: Records (May 2007-October 2013) of dogs that had PCA using 3.5/2.7 mm HDCP (1 or 2 plates) and a Robert-Jones bandage were reviewed to determine intra- and post-operative complications and overall limb function. Follow-up was obtained by clinical evaluation at our institution and telephone interview of owners. RESULTS: Fourteen dogs had PCA stabilized with a single HDCP and 1 giant breed dog had PCA stabilized with 2 HDCP on the dorsal aspect of the carpus secured onto the 3rd and 4th metacarpal bones. Two dogs presented with bilateral injuries. Thirteen owners (87%) judged the results of surgery as excellent and 2 (13%) judged the results of surgery as good. Minor complications (4 limbs; 23%) were occasional episodes of mild lameness in 3 dogs and 3 episodes of discharging sinus tracts in a single dog. Major complications (3 limbs; 17%) included 1 surgical site infection and implant failure in a 43 kg dog with an active leishmaniasis infection and a concurrent bilateral sacro-iliac luxation. Two dogs developed episodes of discharging sinus tract and pain over the most distal screw that eventually necessitated plate removal. CONCLUSION: PCA without rigid coaptation can successfully be performed using the HDCP.

Augmentation of arthrodesis in dogs using a free autogenous omental graft.

A technique for using free autogenous omental grafting with arthrodesis in dogs is described and radiographic osseous union and complications after surgery are evaluated. This retrospective study matched body weight and procedure type for 8 cases of pancarpal arthrodesis, 4 cases of pantarsal arthrodesis, and 2 cases of partial tarsal arthrodesis in dogs with omental and cancellous bone autograft (OBG group) and with cancellous bone autograft alone (BG group). Radiographs were reviewed 9 to 12 weeks after surgery to compare scores of radiographic osseous union and it was found that the OBG group had higher scores than the BG group. The BG group had significantly more major complications that required re-operation for implant removal or treatment of a deep infection compared to the OBG group. Overall, free autogenous omental grafts may be used to augment arthrodesis in dogs without significant morbidity and further investigation of its use to reduce major complications and speed bone healing are warranted.

Augmentation de l'arthrodèse chez les chiens en utilisant une greffe omentale autogène libre. Cette étude décrit une technique de l'utilisation d'une greffe omentale autogène avec une arthrodèse chez les chiens et elle évalue l'union osseuse radiographique et les complications après la chirurgie. L'étude rétrospective a jumelé le poids corporel et le type d'intervention pour 8 cas d'arthrodèse pancarpienne, 4 cas d'arthrodèse pantarsienne et 2 cas d'arthrodèse partielle du tarse chez des chiens avec une autogreffe de l'os spongieux (groupe OBG) et avec une autogreffe de l'os spongieux seulement (groupe BG). On a évalué les radiographies de 9 à 12 semaines après la chirurgie pour comparer les notes d'union osseuse radiographique et on a constaté que le groupe OBG avait des notes supérieures à celles du groupe BG. Il s'est produit un nombre significativement supérieur de complications majeures dans le groupe BG qui ont exigé une nouvelle opération pour l'enlèvement de l'implant ou le traitement d'une infection profonde comparativement au groupe OBG. En général, les greffes omentales autogènes libres peuvent être utilisées pour augmenter l'arthrodèse chez les chiens sans morbidité significative et de nouvelles études de leur utilisation pour réduire les complications majeures et accélérer la guérison osseuse sont justifiées.(Traduit par Isabelle Vallières).

Diagnostic endoscopy of the navicular bursa using a needle endoscope by direct or transthecal approach: A comparative cadaver study.

OBJECTIVES: To compare the practicability, visualization of structures, and iatrogenic damage of direct and transthecal approaches to the navicular bursa for diagnostic needle endoscopy. STUDY DESIGN: Descriptive study. SAMPLE POPULATION: Equine cadaver forelimbs (n = 30). METHODS: Direct and transthecal approaches for insertion of a needle endoscope into the navicular bursa were performed. Video recordings of endoscopic procedures were assessed to determine all structures visualized within the navicular bursa. Number of attempts to gain access to the navicular bursa and total time for insertion and examination were recorded. Distribution and severity of iatrogenic lesions were assessed and scored after dissection. RESULTS: There were no statistical differences for number of attempts or time needed for insertion and examination between direct and transthecal approaches. The direct approach offered significantly increased visibility of the ipsilateral abaxial and proximal margins of the navicular bone, and ipsilateral collateral sesamoidean ligament. Iatrogenic lesions were superficial and focal, regardless of approach taken, or whether a blunt or sharp trocar tip was used. CONCLUSIONS: The direct approach provided significantly better visualization of the ipsilateral structures within the navicular bursa compared to the transthecal approach. Needle endoscopy offers a reliable technique to evaluate the navicular bursa and may complement or replace other diagnostic modalities in horses with lameness localized to the navicular region.

Clinical comparison of the hybrid dynamic compression plate and the castless plate for pancarpal arthrodesis in 219 dogs.

OBJECTIVE: To describe and compare a large population of dogs that had pancarpal arthrodesis (PCA) using either a hybrid dynamic compression plate (HDCP) or a CastLess Plate (CLP). STUDY DESIGN: Multicenter, retrospective, cohort study. ANIMALS: Dogs (n = 240; 261 PCA). METHODS: Medical records (2000-2012) from 12 UK orthopedic centers were reviewed for dogs that had PCA to document signalment, diagnosis, arthrodesis method, and complication rates. Follow-up data were used to compare outcome (lameness evaluation and radiographic healing) after use of HDCP and CLP plates. RESULTS: PCA was performed with HDCP in 125 cases, CLP in 105, and by other techniques in 31. Carpal hyperextension injury was the most common diagnosis in HDCP and CLP groups. Surgical site infection (18.3%) was the most common postoperative complication. There was no difference in intra- (11% HDCP, 21% CLP) or postoperative (34% HDCP, 41% CLP) complication rates. Use of external coaptation did not affect postoperative complication rates or outcome. External coaptation related complications occurred in 32% HDCP and 18% CLP (P = .02). At median follow-up, most dogs were classified as having no or mild lameness (73% HDCP, 83% CLP) and there was radiographic healing in 40% HDCP and 46% CLP (P = .8) cases. CONCLUSIONS: CLP and HDCP may both be used successfully to achieve pancarpal arthrodesis. Adjunctive external coaptation does not appear to have a measurable clinical benefit but is associated with morbidity.

Ex vivo evaluation of carpal flexion after partial carpal arthrodesis in horses.

OBJECTIVE: To determine degrees of flexion after arthrodesis of the antebrachiocarpal (ABC) joint, middle carpal (MC), and carpometacarpal (CMC) joints combined (MC/CMC), and carpometacarpal (CMC) joint alone. STUDY DESIGN: Ex vivo study. ANIMALS: Forelimbs (n = 9) from 2- to 10-year-old Quarter Horses (5), Thoroughbred (2), and American Paint Horse (2). METHODS: Using 2 locking compression plates, 3 partial carpal arthrodesis techniques were performed. Cables and deadweights were connected to limbs and each angle of flexion determined 3 times using a protractor and then averaged. Control measurements were obtained before and after arthrodesis, the techniques randomized with Latin square design. Descriptive data were analyzed with Levene's test, Q-Q plots, ANOVA, and Bonferroni test. RESULTS: Mean ± SD carpal flexion results were: controls 150° ± 8°, CMC arthrodesis 149° ± 9°, MC/CMC arthrodesis 43° ± 7.6°, and ABC arthrodesis 25° ± 6.3°. There was no significant reduction in flexion after a CMC arthrodesis compared with controls (P = .21), but there was after ABC (P < .001) and MC/CMC arthrodesis (P < .001), with the ABC arthrodesis significantly reduced compared with an MC/CMC arthrodesis (P < .001). CONCLUSIONS: Whereas CMC arthrodesis does not affect carpal flexion, CMC/MC and ABC arthrodesis markedly reduce the degree of carpal flexion.

Second carpal bone slab fracture and subluxation of the middle carpal joint in a horse subsequent to arthrodesis of the carpometacarpal joint.

OBJECTIVE: To report complications of arthrodesis of the carpometacarpal (CMC) joint using a drilling technique in an adult horse. STUDY DESIGN: Case report. ANIMALS: Horse (n = 1). METHOD: A 12-year-old Quarter Horse mare with CMC osteoarthritis (CMC-OA) had arthrodesis under general anesthesia in right lateral recumbency. Under fluoroscopic guidance, a 4.5 mm drill bit was inserted at 3 drilling sites 5-6 cm into the CMC joint and was fanned 30-45° in the plane of the joint and 5-10° in the long axis of the limb to destroy articular cartilage and expose the subchondral bone. RESULTS: The horse presented 2 weeks after surgery for severe lameness of the operated limb. A slab fracture of the 2nd carpal bone (C2) and subluxation of the middle carpal (MC) joint was diagnosed. The horse was humanely euthanatized due to poor prognosis. CONCLUSION: The fanning technique of arthrodesis of the CMC joint may lead to fracture of carpal bones, joint instability, and MC joint subluxation. A balance between articular surface destruction and maintenance of joint stability should be achieved when using this technique.

Improvement in Bilateral Carpal Valgus Deviation in 9 Foals After Unilateral Distolateral Radial Periosteal Transection and Elevation.

OBJECTIVES: To evaluate the effect of periosteal transection and elevation in foals with naturally occurring carpal valgus deviation. STUDY DESIGN: Prospective clinical study. ANIMALS: Foals (n = 9) with bilateral carpal valgus. METHODS: Foals with bilateral carpal valgus had distolateral radial periosteal transection and elevation (PE) including distal ulnar transection on 1 limb. Foals were stall confined until the skin incisions healed, and then allowed free exercise in a small paddock or round pen. Dorsopalmar carpal radiographs were obtained at 14 day intervals to determine the carpal valgus angle (CVA) until it was <5°. RESULTS: All limbs had a reduction in CVA and there was no significant difference in total carpal valgus angular correction or the rate at which the correction occurred between the surgical and control limb. CONCLUSIONS: Unilateral distolateral radial PE had no effect on carpal angulation in 9 foals with naturally occurring bilateral carpal valgus deviation when performed between 19 and 43 days.

Carpal valgus in llamas and alpacas: Retrospective evaluation of patient characteristics, radiographic features and outcomes following surgical treatment.

This study evaluated outcomes of surgical treatment for carpal valgus in New World camelids and correlated successful outcome (absence of carpal valgus determined by a veterinarian) with patient characteristics and radiographic features. Univariable and multivariable analyses of retrospective case data in 19 camelids (33 limbs) treated for carpal valgus between 1987 and 2010 revealed that procedures incorporating a distal radial transphyseal bridge were more likely (P = 0.03) to result in success after a single surgical procedure. A greater degree of angulation (> 19°, P = 0.02) and younger age at surgery (< 4 months, P = 0.03) were associated with unsuccessful outcome. Overall, 74% of limbs straightened, 15% overcorrected, and 11% had persistent valgus following surgical intervention. To straighten, 22% of limbs required multiple procedures, not including implant removal. According to owners, valgus returned following implant removal in 4 limbs that had straightened after surgery.

Valgus carpien chez les lamas et les alpagas : évaluation rétrospective des caractéristiques des patients, des radiographies et des résultats après un traitement chirurgical. Cette étude a évalué les résultats du traitement chirurgical pour le valgus carpien chez des camélidés du nouveau monde et a établi une corrélation entre les résultats fructueux (absence de valgus carpien déterminée par un vétérinaire) et les caractéristiques du patient et des radiographies. Des analyses à variable unique et à variables multiples des données de cas rétrospectifs chez 19 camélidés (33 jambes) traités pour le valgus carpien entre 1987 et 2010 ont révélé que les procédures intégrant un pont radial distal transphyséal présentaient une plus grande probabilité de succès (P = 0,03) après une seule intervention chirurgicale. Une déviation supérieure (> 19°, P = 0,02) et un jeune âge à la chirurgie (< 4 mois, P = 0,03) étaient associés à des échecs. Dans l'ensemble, 74 % des jambes ont été redressés, 15 % ont été corrigées et 11 % présentaient un valgus persistant après l'intervention chirurgicale. Pour le redressement, 22 % des jambes ont nécessité des procédures multiples, ce qui n'incluait pas l'enlèvement de l'implant. Selon les propriétaires, le valgus est réapparu après l'enlèvement de l'implant dans 4 jambes qui avaient été redressées après la chirurgie.(Traduit par Isabelle Vallières).

Owner satisfaction and prognosis for return to work after pancarpal arthrodesis in working dogs in the United Kingdom: a retrospective study (2011-2020).

BACKGROUND: Pancarpal arthrodesis (PCA) is a commonly performed procedure in the UK. However, it is not known whether working dogs in the UK and other European countries with carpal injuries that have undergone unilateral PCA are able to return to working ability as determined by the owner. Medical records from a referral hospital in the UK were reviewed retrospectively for cases of working dogs treated using unilateral PCA. Case files and radiographs were retrospectively analysed for cause of injury, diagnosis, and complications. The ability of the dog to work after surgery and owner satisfaction with the outcome were assessed using telephone questionnaire. RESULTS: 50% (5/10, 50%) owners stated their dog could perform normal duties, 4/10 (40%) could perform most duties with some allowances. Outcome was not as good for dogs working on steep, uneven fell terrain. 80% (8/10, 80%) owners rated the level of post-operative lameness as unaffected with a normal gait. 90% (9/10, 90%) owners were either very satisfied or satisfied with the outcome of the procedure, and 90% owners stated the financial investment was worthwhile. CONCLUSIONS: Unilateral PCA carries a good prognosis for working dogs with high owner satisfaction. Caution should be advised for dogs expected to work on steep, uneven fell terrain.

Successful surgical management of a Salter-Harris type I fracture of the accessory carpal bone in a dog.

OBJECTIVE: To describe the successful surgical management of a previously unreported Salter-Harris type I fracture of the accessory carpal bone in a dog. ANIMAL: An 11-week-old intact female Golden Retriever-Poodle cross presented with a history of a marked left forelimb lameness following a suspected fall from a height. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: On physical examination, the patient demonstrated a severe left forelimb lameness and pain on palpation and range of motion of the left carpus. Orthogonal radiographs of the distal left forelimb demonstrated a type I Salter-Harris fracture of the accessory carpal bone with proximal displacement of the palmar fragment. TREATMENT AND OUTCOME: The patient underwent open reduction and internal fixation wherein the fracture was reduced and stabilized with two 1.1-mm Kirschner wires. Postoperatively, the patient was initially managed with a carpal flexion bandage for 2 weeks and then a soft padded bandage was maintained until 4 weeks postoperatively. The patient recovered well and was walking and weight-bearing comfortably following removal of the carpal flexion bandage. Repeat radiographs performed 4 and 8 weeks postoperatively demonstrated adequate fracture healing but showed mild proximocaudal implant displacement. Implant removal was not performed, as the patient was doing well at home and the implant migration appeared static and was not causing clinical morbidity. CLINICAL RELEVANCE: To the authors' knowledge, this was the only reported case of a Salter-Harris fracture of the accessory carpal bone in a dog and the only described case of successful surgical stabilization.

The use of small (2.7 mm) screws for arthroscopically guided repair of carpal chip fractures.

REASONS FOR PERFORMING THE STUDY: Removal of large chip fractures of the carpal bones and the osteochondral deficits that result, have been associated with a worse prognosis than removal of small fragments in similar locations. HYPOTHESIS: Reducing the articular defects by repair of large osteochondral fragments may have advantages over removal. METHODS: Horses with osteochondral chip fractures that were of sufficient size and infrastructure to be repaired with small (2.7 mm diameter) AO/ASIF cortex screws were identified and repair effected by arthroscopically guided internal fixation. RESULTS: Thirty-three horses underwent surgery to repair 35 fractures of the dorsodistal radial carpal bone (n = 25), the dorsal margin of the radial facet of the third carpal bone (n = 9) and the intermediate facet of the distal radius (n = 1). There were no surgical complications and fractures healed satisfactorily in 26 of 28 horses and 23 horses returned to racing performance. CONCLUSION: Arthroscopically guided repair of carpal chip fractures with small diameter cortex screws is technically feasible and experiences with 33 cases suggest that this may have advantages over fragment removal in managing such cases. POTENTIAL RELEVANCE: Surgeons treating horses with large chip fractures of the carpal bones should consider arthroscopically guided internal fixation as an alternative to removal.

Evaluation of a minimally invasive arthrodesis technique for the carpometacarpal joint in horses.

OBJECTIVE: To evaluate a minimally invasive technique for arthrodesis of the carpometacarpal (CMC) joint in horses. STUDY DESIGN: Experimental study. ANIMALS: Healthy horses (n=6). METHODS: A 5.5 mm, 3-drill tract arthrodesis technique was evaluated in 1 randomly selected CMC joint in each of 6 normal horses. Peak vertical ground reaction force (GRF) values were recorded before surgery and at 6, 8, and 12 months thereafter. Radiographic and clinical lameness scores were assigned at regular intervals until 12 months after surgery when the horses were euthanatized. Gross and histologic examinations were performed on the treated CMC joints. RESULTS: After surgery, all horses were lame. Clinical resolution of lameness occurred in 2 by 12 months. Mean peak vertical GRF values significantly differed between treated and nontreated limbs at all recorded time points after surgery. Radiographic scores significantly differed from day 0 at all times after surgery, but did not change significantly after 4 months. Intraarticular bony ankylosis only occurred in 2 horses, based on gross, histologic, and microradiographic examination of sagittal sections of the operated CMC joints. CONCLUSION: The 5.5 mm, 3-drill tract arthrodesis technique was considered successful in only 2 of 6 normal CMC joints treated. Greater articular damage may be necessary to achieve arthrodesis in normal horses. Better results may be achieved by technique modification or in horses affected by CMC osteoarthritis.

Carpal canal lipoma causing lameness in a dog.

Carpal canal syndrome, or carpal tunnel syndrome, is the most common entrapment neuropathy in humans and is caused by compression of the median nerve as it courses through the carpal canal. A similar condition has been reported in horses, however there have not been any reported cases of a dog showing lameness secondary to compression within the carpal canal. This report describes the case of a dog exhibiting lameness secondary to a lipoma within the carpal canal. Lameness improved after surgical removal of the mass. This case highlights the need to consider compression of the tendons and nerves in the carpal canal as a cause of forelimb lameness in dogs when pain is localised to the carpus.

[Pancarpal arthrodesis using a "CastLess Plate" in dogs and cats]. / Pankarpale Arthrodese unter Verwendung einer "CastLess Plate" bei Hunden und Katzen.

OBJECTIVE: Description of clinical experience with a new implant for dorsal plating in pancarpal arthrodesis. MATERIAL UND METHODS: Retrospective analysis (June 2008 - May 2009) of clinical records from a heterogenous group of dogs and cats which where treated by pancarpal arthrodesis using a PCA-plate ("CastLess-plate", Orthomed®, UK). RESULTS: In 15 dogs and three cats, a total of 20 pancarpal arthrodesis (complete fusion of carpal joints) using a PCA-plate were performed. External coaptation by cast was not used in the postoperative period. In two out of 17 arthrodesis in 15 dogs serious postoperative complications (plate deformation, wound infection) occurred which required a revision surgery. Fistula formation (8-16 weeks post surgery) was seen in six arthrodesis. They all resolved after medical therapy. In cats, all three arthrodesis showed postoperative complications (bone resorption under the plate n=1, paw swelling n=2). Long-term evaluation by telephone interview with the owners (17 owners, 6-21 months after surgery, one case lost in follow-up) revealed good or very good results for 17 of 19 arthrodesis. CLINICAL RELEVANCE: Pancarpal arthrodesis in dogs can be performed successfully using the "CastLess Plate" without additional external coaptation. Due to the size of the available implants complications have to be expected in cats.