The effect of the interosseous ligament and selected antebrachiocarpal ligaments on rotation of the radius during extension of the carpus.

OBJECTIVE: To evaluate the effect of the interosseous ligament and selected antebrachiocarpal ligaments on the internal rotation of the radius relative to the ulna, during carpal extension. STUDY DESIGN: Cadaveric study. SAMPLE POPULATION: Twenty-four cadaveric canine forelimbs. METHODS: Twenty-four forelimbs were disarticulated at the elbow joint and the antebrachia were prepared for testing. The forelimbs were divided to 6 groups, defined by the order in which ligaments were transected. All specimens were tested intact and after transecting each of the ligaments with the order defined by the group. Rotation of the radius relative to the ulna, caused by extension of the carpus, was measured using a sensor connected to the radius. RESULTS: The mean(±sd) maximum internal rotation of the radius (5.94° ± (1.23°)) with all the ligaments intact was significantly greater (p < 0.012) than the mean(±sd) maximum internal rotation of the radius (3.13° (± 1.13°)) after transecting the interosseus ligament. Transecting the interosseous ligament subsequent to one of the other ligaments caused a decrease in internal radial rotation (p = 0.629), while, transecting the short radial collateral ligament caused an increase in radial rotation (p = 0.629). Transecting the palmar radiocarpal and ulnocarpal ligaments had no effect on radial rotation. CONCLUSION: The interosseous ligament was stretched with internal rotation of the radius due to carpal extension. Carpal flexion resulted in external rotation of the radius. This effect was lost when the interosseus ligament was transected. CLINICAL SIGNIFICANCE: Rotation of the radius is associated with carpal extension, and is likely an intrinsic part of forelimb biomechanics.

Morphometric analysis of the intercarpal ligaments of the equine proximal carpal bones during simulated flexion and extension of cadaver limbs.

Despite many reported cases of carpal lameness associated with intercarpal ligament injuries in horses, the morphometry, movement pattern and general intrinsic biomechanics of the carpus are largely unknown. Using osteoligamentous preparation of the carpus prepared from 14 equine cadaver forelimbs (aged 9.62 ± 4.25 years), locomotory simulations of flexion and extension movements of the carpal joint were carried out to observed carpal biomechanics and, thereafter, the limbs were further dissected to obtain morphometric measurements of the medial and lateral collateral ligaments (MLC and LCL); medial and lateral palmar intercarpal ligaments (MPICL and LPICL); intercarpal ligaments between radial (Cr) and intermediate (Ci) carpal bones (Cr-Ci ICL); and intercarpal ligaments between Ci and ulnar (Cu) carpal bones (Ci-Cu ICL). The Cr, Ci, Cu and Ca are held together by a series of intercarpal ligaments and move in unison lateropalmarly during flexion, and mediodorsally during extension with a distinguishable proximo-distal sliding movement (gliding) of Cr and Ci against each other during movement. The mean length of MCL (108.82 ± 9.64 mm) was significantly longer (p = 0.042) than LCL (104.43 ± 7.65 mm). The Cr-Ci ICL has a dorsopalmar depth of 37.58 ± 4.14 mm and a midpoint width of 12.05 ± 3.09 mm and its fibres ran diagonally from the medial side of the Ci in a proximo-palmar disto-dorsal direction (i.e. palmarodistally) to the lateral side of the Cr. The specialized movement of the Cr-Ci ICL, which appeared to be further facilitated by a longer MCL suggest a biomechanical function by which carpal damage may be minimized in the equine carpus.

Kinematics of the Feline Antebrachiocarpal Joint from Supination to Pronation.

OBJECTIVE: Cats rely on their forelimb mobility for everyday activities including climbing and grooming. Supination and pronation of the forelimb in cats are considered to primarily involve the antebrachium, rather than the carpus. Therefore, our null hypothesis was that there would be no movement of the carpal bones (radial carpal bone, ulnar carpal bone and accessory carpal bone) relative to the ulna during supination and pronation. STUDY DESIGN: Eight feline cadaveric forelimbs were rotated from supination to pronation in a jig and computed tomography was performed in the neutral, supinated and pronated positions. The individual carpal bones were segmented from computed tomography images of the supinated and pronated scans in each of the eight specimens. A feline ulna coordinate system was established and used to quantify the translations and rotations between bones of the proximal carpal row and antebrachium. RESULTS: After the carpus was rotated from the initial supinated position into pronation, there was significant translation (x, y and z axes) and rotation (x and y axes) of the proximal row of carpal bones based on absolute magnitude values. Given the differences in translations and rotations of the proximal row of carpal bones, our null hypothesis was rejected. CONCLUSION: The proximal row of carpal bones translate and rotate independently from the ulna in the cat during pronation of the antebrachium. This may have future implications in the diagnosis and management of feline carpal injuries involving the antebrachiocarpal joint.

Force Distribution in the Canine Proximal Radio-Ulnar Joint on Extension of the Carpal Joint: A Cadaveric Study.

OBJECTIVE: The aim of this study was to measure the load on the lateral and medial aspects of the proximal radio-ulnar joint during extension of the carpus. STUDY DESIGN: This was an ex vivo biomechanical study. SAMPLE POPULATION: Twenty-two cadaveric Greyhound thoracic limbs were used. METHODS: Twenty-two paired thoracic limbs were used. The olecranon was attached to a custom jig with the foot resting on a stationary anvil. Load sensors were inserted into the proximal radio-ulnar joint, between the radial head and the lateral coronoid process, and between the radial head and the medial coronoid process. Specimens were tested under compression with measurements taken at 0, 4, 9 and 13.5 mm of axial displacement. Data collected at each point included forces on the specimen and medial and lateral coronoid processes as well as the angle of carpal joint extension. RESULTS: A linear mixed effects model relating load on the specimen and carpal joint extension angle had an R-squared value of 0.66, and load at the level of the medial coronoid process and angle of carpal extension had an R-squared value of 0.61. There was a significant difference in the loads measured on the lateral and medial coronoid processes at all angles (p < 0.0001). CONCLUSION: Extension of the carpus results in asymmetric loading of the proximal radio-ulnar joint. CLINICAL SIGNIFICANCE: The findings of this study show that loading of the medial coronoid process may be more complex than originally thought and supports the future investigation of novel management and therapeutic options for affected patients.

Carpal Extension Angles in Agility Dogs Exiting the A-Frame and Hurdle Jumps.

OBJECTIVES: The aim of this study was to determine the mean carpal extension angles in dogs participating in the A-frame and hurdle jumps, and to determine if the use of a carpal brace changed the carpal extension angle. STUDY DESIGN: Data from 13 healthy agility dogs were included. Approximately 1 cm square adhesive tape markers placed on both forelimbs served as anatomic landmarks for carpal angle measurement. Each dog was filmed landing after jumping over a bar and exiting the A-frame. Five valid trials on each obstacle were collected. The carpal braces were then applied and the dogs were allowed to navigate obstacles for 10 minutes. Once acclimated to the brace, an additional five valid trials were collected. Carpal extension was measured from the videos collected using a video analysis software. RESULTS: Without the carpal brace, the mean carpal extension angles ± standard deviations in dogs participating in the A-frame and hurdle jumps were 124.7 ± 11.9 degrees and 123.3 ± 6.3 degrees, respectively. With the carpal brace, the mean carpal extension angles ± standard deviations were 129.1 ± 11.4 degrees and 125.3 ± 7.3 for the A-frame and hurdle jumps, respectively. There was no clinically significant reduction as defined (>10 degrees) in carpal extension measurements with and without the brace. CLINICAL SIGNIFICANCE: The brace used in this study did not show a clinically significant reduction in carpal extension. However, multiple avenues for future research have been identified using these data.

Contribution of Palmar Radiocarpal and Ulnocarpal Ligaments to the Stability of the Canine Antebrachiocarpal Joint.

OBJECTIVE: The aim of this study was to evaluate the contribution of the palmar radiocarpal ligament and the palmar ulnocarpal ligament to canine antebrachiocarpal joint stability. MATERIALS AND METHODS: The right carpus of four dog cadavers, free of musculoskeletal pathology, was stripped of muscle. Each specimen was placed into a custom-made joint testing machine and tested at 15° extension, and 0° and 15° flexion. A single motion tracking sensor was fixed to the metacarpal bones. All specimens were tested with all ligaments intact and after transection of the palmar radiocarpal and ulnocarpal ligaments. A range of weights between 0.2 and 2.0 kg was used to test the carpi in three directions (axial, medial/lateral and cranial/caudal) and two moments (pronation/supination and valgus/varus). RESULTS: No differences were found between the translations and rotations of the manus relative to the radius and ulna with the ligaments intact and the ligaments transected at any of the carpal angles tested, except at 15° of flexion. Increasing the angle of flexion resulted in a significant increase in cranial and caudal translation of the manus relative to the radius and ulna both in the intact and transected specimens. CLINICAL RELEVANCE: Antebrachiocarpal joint position plays a more important role in craniocaudal antebrachiocarpal joint stability than the palmar radiocarpal and ulnocarpal ligaments.

Ulnar ostectomy decreases the stability of canine cadaver carpi as assessed with stress radiography.

Distal ulnar ostectomy may be performed palliatively in patients with distal ulnar osteosarcoma. Concurrent arthrodesis of the carpus has been proposed to counteract joint instability following transection of carpal ligaments associated with removal of the distal ulna. The objective of this prospective one group pretest, posttest study was to assess stability of the carpus following distal ulnar ostectomy using pre- and postoperative stress radiographic views in a group of canine cadaver limbs. Seven thoracic limbs from six canine cadavers weighing more than 20 kg were obtained. Lateral and dorsopalmar, extended lateral, medial stress, and lateral stress radiographs were made before and after distal ulnar ostectomy. Presurgical canine cadaver carpal angle measurements were as follows (mean ± standard deviation): extension 205.9° ± 5.4; medial stress 25.1° ± 5.7; and lateral stress 13.3° ± 5.2°. Cadaver limb joint angles exceeded those previously reported in live dogs. A significant increase in carpal angle was noted following ulnar ostectomy. The mean increases in carpal angle were as follows: (mean ± standard deviation (95% confidence interval)): extension 6.2° ± 4.9 (2.6-9.8) (P = 0.007); medial stress 3.2° ± 3.0 (1.0-5.5) (P = 0.015); lateral stress 6.2° ± 5.2 (2.4-10.1) (P = 0.010). Findings from this cadaver study support the use of supplementary stabilization for clinical patients undergoing distal ulnar ostectomy. Future studies are needed in clinical patients to evaluate changes in limb positioning and gait associated with distal ulnar ostectomy.

Evaluation of an indirect oscillometric blood pressure monitor in anaesthetised dogs at three different anatomical locations.

AIMS: To evaluate the agreement between invasive and non-invasive measurements of blood pressure (BP) using an oscillometer (PetTrust) at three different anatomical locations in anaesthetised dogs under different haemodynamic conditions. METHODS: Eight adult Greyhounds weighing 23.5-36.5 kg were anaesthetised with isoflurane and positioned in dorsal recumbency. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP) and mean arterial pressure (MAP) were measured invasively via a dorsal pedal artery and non-invasively using the oscillometer with cuffs placed above the carpus, above the tarsus and around the tail base. Phenylephrine was administered to induce vasoconstriction, dobutamine was used to increase cardiac output and increased end-tidal concentrations of isoflurane were used to induce vasodilation. Correlation between measurements was analysed by linear regression and agreement was analysed using Bland-Altman plots. RESULTS: Seventy two representative measurements were obtained. Mean differences (bias) between invasive and non-invasive measurements were <5 mmHg except for DAP measured on the tail, and SD (precision) were <15 mm Hg except for SAP measured at the pelvic limb. Correlation coefficients were >0.9 except for SAP on the pelvic limb and DAP on the tail. More than 50 and 80% of values measured using oscillometry lay within 10 and 20 mmHg, respectively, of values measured invasively except for SAP on the tail. SAP tended to be overestimated when measured non-invasively at low BP, and be underestimated at high BP. DAP was underestimated during low BP and overestimated during high BP. Hypotension (MAP <60 mmHg) was detected by the oscillometer with a sensitivity ≥83% and specificity ≥98% at all locations. CONCLUSIONS: This oscillometric device met the 2007 American College of Veterinary Internal Medicine guidelines for measurement of BP on the thoracic limb. There was good agreement between the oscillometer and invasive measurement of MAP at all locations. CLINICAL RELEVANCE: MAP is the driving pressure for tissue perfusion, thus MAP measurement is clinically essential. This oscillometric device yields reliable MAP measurements at three anatomical locations over a wide range of BP and can identify hypotension with high sensitivity and specificity.

A repeated-measures analysis of the effects of soft tissues on wrist range of motion in the extant phylogenetic bracket of dinosaurs: Implications for the functional origins of an automatic wrist folding mechanism in Crocodilia.

A recent study hypothesized that avian-like wrist folding in quadrupedal dinosaurs could have aided their distinctive style of locomotion with semi-pronated and therefore medially facing palms. However, soft tissues that automatically guide avian wrist folding rarely fossilize, and automatic wrist folding of unknown function in extant crocodilians has not been used to test this hypothesis. Therefore, an investigation of the relative contributions of soft tissues to wrist range of motion (ROM) in the extant phylogenetic bracket of dinosaurs, and the quadrupedal function of crocodilian wrist folding, could inform these questions. Here, we repeatedly measured wrist ROM in degrees through fully fleshed, skinned, minus muscles/tendons, minus ligaments, and skeletonized stages in the American alligator Alligator mississippiensis and the ostrich Struthio camelus. The effects of dissection treatment and observer were statistically significant for alligator wrist folding and ostrich wrist flexion, but not ostrich wrist folding. Final skeletonized wrist folding ROM was higher than (ostrich) or equivalent to (alligator) initial fully fleshed ROM, while final ROM was lower than initial ROM for ostrich wrist flexion. These findings suggest that, unlike the hinge/ball and socket-type elbow and shoulder joints in these archosaurs, ROM within gliding/planar diarthrotic joints is more restricted to the extent of articular surfaces. The alligator data indicate that the crocodilian wrist mechanism functions to automatically lock their semi-pronated palms into a rigid column, which supports the hypothesis that this palmar orientation necessitated soft tissue stiffening mechanisms in certain dinosaurs, although ROM-restricted articulations argue against the presence of an extensive automatic mechanism. Anat Rec, 297:1228-1249, 2014. © 2014 Wiley Periodicals, Inc.

Effect of Clostridium botulinum toxin type A injections into the deep digital flexor muscle on the range of motion of the metacarpus and carpus, and the force distribution underneath the hooves, of sound horses at the walk.

In the treatment of laminitis, reducing deep digital flexor muscle (DDFM) activity might diminish its pull on the distal phalanx, thereby preventing displacement and providing pain relief. Injection of Clostridium botulinum toxin type A into the DDFM of horses is potentially therapeutic. However, the effects of C. botulinum toxin type A on the gait characteristics of sound horses at the walk are not known. The aim of this study was to test if a reduced DDFM activity would lead to (1) alterations of the sagittal range of motion of the metacarpus (SROM) and range of motion of the carpal joint (CROM); (2) changes in the force distribution underneath the hoof (toe vs. heel region: balance index); and (3) changes in the force distribution between the treated and untreated limb (symmetry index). The DDFMs of the left forelimbs of seven sound Royal Dutch Sport Horses were injected with 200 IU C. botulinum toxin type A using electromyography and ultrasound guidance. Measurements using an inertial sensor system and dynamically calibrated pressure plate were performed before and after injections. The SROM and CROM of the treated limb were significantly increased after C. botulinum toxin type A injections. No significant changes were detected in the balance index or in the symmetry index, indicating that no lameness was induced. C. botulinum toxin type A injections into the DDFM of sound horses do not appear to result in substantial gait alterations at the walk.

The effect of extension and loading of the carpus on radial rotation.

OBJECTIVE: To describe the direction and magnitude of the rotation of the radius relative to the ulna during extension of the carpus and to describe the effect of carpal extension on internal and external rotation of the radius relative to the ulna. STUDY DESIGN: In vitro experiment. ANIMALS: Cadaveric canine thoracic limbs (n = 11). METHODS: Eleven thoracic limbs were collected from 6 healthy mixed breed dogs of medium build. Each specimen was radiographed to ensure that the carpal and elbow joints were free of pathology. The elbow joint was disarticulated and the distal thoracic limb was prepared for biomechanical testing. Each specimen was stripped of soft tissue, leaving the soft tissues around the proximal aspect of the radius and ulna intact. The interosseous ligament, pronator teres muscle, and all the soft tissues distal to the distal metaphysis of the radius were also left intact. In the 1st part of the study, the rotation of the radius relative to the ulna was measured while extending the carpal joint using a system of weights and pulleys attached to the manus. In the 2nd part of the study, the internal and external rotation of the radius relative to the ulna was performed by applying an internal and external rotational load to the radius using a system of weights and pulleys attached to the radius. The internal and external rotation of the radius was measured with the carpus unloaded and with the carpus extended by applying a load of 5 kg to the manus. RESULTS: Extension of the carpus resulted in internal rotation of the radius relative to the ulna. With the carpus extended under a maximum load of 2 kg, the mean (± SD) internal rotation of the radius was 4.3 ± 2.1° for all specimens. With the carpus unloaded, the mean internal and external rotation of the radius was 11.5 ± 2.9° and 22.5 ± 7.7° for all specimens, respectively. With the carpus loaded (extended under 5 kg load), the mean internal and external rotation of the radius was 3.3 ± 1.2° and 7.3 ± 2.0° for all specimens, respectively. The difference between internal and external rotation with the carpus loaded and unloaded was significant. CONCLUSION: Extending the carpus results in internal rotation, and proximal translation of the radius relative to the ulna. Loading the carpus in extension decreases the internal and external rotation of the radius relative to the ulna. A better understanding of the interaction between the carpus and the elbow may improve our understanding of the pathogenesis of elbow dysplasia.

The effect of previous conditioning exercise on diaphyseal and metaphyseal bone to imposition and withdrawal of training in young Thoroughbred horses.

This study recorded the response to training of the diaphysis of the proximal phalangeal bone and the third metacarpal bone (Mc3) and the Mc3 proximal metaphysis. Nineteen 2- and 3-year old horses in training were exposed either to spontaneous exercise at pasture (PASTEX group) or additional imposed exercise (CONDEX group) from a very young age. Quantitative computed tomography scans were analysed for bone mineral content, size, bone mineral density, periosteal and endosteal circumference, cortical thickness and an estimate of bone strength. The bones of the CONDEX horses were bigger and stronger than those of the PASTEX horses at the start of the observation period, and these differences were maintained after adjusting for training workload. Increase in the bone strength index was through size and not density increase. Density increased during training and decreased during paddock rest between the two training campaigns, during which time bone strength continued to increase because of the slow growth that was still occurring. The greatest variance in the response to the training exercise of diaphyseal bone mineral content, bone strength index or cortical thickness was associated with the cumulative workload index at the gallop, although statistically significant unexplained variances remained. There were no differences in bone response to training, with the exception of the endosteal circumference at 55% of the Mc3 length from the carpometacarpal joint space between CONDEX and PASTEX, which indicated that young horses may be able to be exercised slightly more vigorously than currently accepted.

The response of the rabbit subsynovial connective tissue to a stress-relaxation test.

The subsynovial connective tissue (SSCT) in the carpal tunnel may play a role in the etiology of carpal tunnel syndrome (CTS), yet the material properties of the SSCT remain unclear. Thus, we investigated the mechanical response of the SSCT in a rabbit model. Twenty-four rabbit cadaver paws were used for mechanical testing; two paws were used for scanning electron microscopy (SEM) imaging. After testing normal tendon excursion, the divided third digit flexor digitorum superficialis (FDS) tendon was pulled to displacements of 2, 3.5, 5, or 8 mm, maintained at that position until force decay, and then the process was repeated. Normal excursion of the FDS averaged 4.8 mm. The ratio of the second peak force to the first peak force in the 2 mm group was 0.98 (SD = 0.16), which was significantly higher than the other groups (3.5 mm: 0.74, 5 mm, 0.63, and 8 mm: 0.59; p < 0.05). SEM showed ruptured fibrils in the displaced specimen. The declining force ratio with displacements >2 mm suggests damage to the SSCT within the physiological tendon excursion. These data may be useful in understanding SSCT mechanics in CTS, which is associated with SSCT fibrosis.

Elbow loading promotes longitudinal bone growth of the ulna and the humerus.

Mechanical stimulation plays a critical role in bone development and growth. In view of recently recognized anabolic responses promoted by a joint-loading modality, we examined the effects of elbow loading on longitudinal growth of the ulna and the humerus. Using a custom-made piezoelectric loader, the left elbow of growing C57/BL/6 female mice was given daily 5-min bouts of dynamic loading for 10 days. The right forelimbs of those mice served as contralateral controls, and the limbs of non-treated mice were used as age-matched controls. The effects of elbow loading were evaluated through measurement of bone length, weight, bone mineral density (BMD), and bone mineral content (BMC), as well as mRNA expression levels of load-sensitive transcription factors such as c-fos, egr1, and atf3. The results revealed that the humerus was elongated by 1.2% compared to the contralateral and age-matched controls (both p < 0.001), while the ulna had become longer than the contralateral control (1.7%; p < 0.05) and the age-match control (3.4%; p < 0.001). Bone lengthening was associated with increases in bone weight, BMD and BMC. Furthermore, the mRNA levels of the selected transcription factors were elevated in the loaded ulna and humerus. Interestingly, the increase was observed not only at the elbow but also at the wrist and shoulder in the loaded limb. The present study demonstrates that joint loading is potentially useful for stimulating bone lengthening and treating limb length discrepancy.

Mechanical effect of rat flexor carpi ulnaris muscle after tendon transfer: does it generate a wrist extension moment?

The mechanical effect of a muscle following agonist-to-antagonist tendon transfers does not always meet the surgeon's expectations. We tested the hypothesis that after flexor carpi ulnaris (FCU) to extensor carpi radialis (ECR) tendon transfer in the rat, the direction (flexion or extension) of the muscle's joint moment is dependent on joint angle. Five weeks after recovery from surgery (tendon transfer group) and in a control group, wrist angle-moment characteristics of selectively activated FCU muscle were assessed for progressive stages of dissection: 1) with minimally disrupted connective tissues, 2) after distal tenotomy, and 3) after maximal tendon and muscle belly dissection, but leaving blood supply and innervations intact. In addition, force transmission from active FCU onto the distal tendon of passive palmaris longus (PL) muscle (a wrist flexor) was assessed. Excitation of control FCU yielded flexion moments at all wrist angles tested. Tenotomy decreased peak FCU moment substantially (by 93%) but not fully. Only after maximal dissection, FCU wrist moment became negligible. The mechanical effect of transferred FCU was bidirectional: extension moments in flexed wrist positions and flexion moments in extended wrist positions. Tenotomy decreased peak extension moment (by 33%) and increased peak flexion moment of transferred FCU (by 41%). Following subsequent maximal FCU dissection, FCU moments decreased to near zero at all wrist angles tested. We confirmed that, after transfer of FCU towards a wrist extensor insertion, force can be transmitted from active FCU to the distal tendon of passive PL. We conclude that mechanical effects of a muscle after tendon transfer to an antagonistic site can be quite different from those predicted based solely on the sign of the new moment arm at the joint.

A Wolff in sheep's clothing: trabecular bone adaptation in response to changes in joint loading orientation.

This study tests Wolff's law of trabecular bone adaptation by examining if induced changes in joint loading orientation cause corresponding adjustments in trabecular orientation. Two groups of sheep were exercised at a trot, 15 min/day for 34 days on an inclined (7°) or level (0°) treadmills. Incline trotting caused the sheep to extend their tarsal joints by 3-4.5° during peak loading (P<0.01) but has no effect on carpal joint angle (P=0.984). Additionally, tarsal joint angle in the incline group sheep were maintained more extended throughout the day using elevated platform shoes on their forelimbs. A third "sedentary group" group did not run but wore platform shoes throughout the day. As predicted by Wolff's law, trabecular orientation in the distal tibia (tarsal joint) were more obtuse by 2.7 to 4.3° in the incline group compared to the level group; trabecular orientation was not significantly different in the sedentary and level groups. In addition, trabecular orientations in the distal radius (carpal joint) of the sedentary, level and incline groups did not differ between groups, and were aligned almost parallel to the radius long axis, corresponding to the almost straight carpal joint angle at peak loading. Measurements of other trabecular bone parameters revealed additional responses to loading, including significantly higher bone volume fraction (BV/TV), Trabecular number (Tb.N) and trabecular thickness (Tb.Th), lower trabecular spacing (Tb.Sp), and less rod-shaped trabeculae (higher structure model index, SMI) in the exercised than sedentary sheep. Overall, these results demonstrate that trabecular bone dynamically adjusts and realigns itself in very precise relation to changes in peak loading direction, indicating that Wolff's law is not only accurate but also highly sensitive.

Effects of hypertonic dextrose injections in the rabbit carpal tunnel.

OBJECTIVE: This study investigated the effects of different doses of hypertonic dextrose injection on the carpal tunnel subsynovial connective tissue (SSCT) and median nerve in a rabbit model. METHODS: Thirty-eight New Zealand white rabbits weighing 4.0-4.5 kg were used. One forepaw carpal tunnel was randomly injected with one of five different treatments: saline-single injection; saline-two injections 1 week apart; 10% dextrose-single injection; 20% dextrose-single injection; or 10% dextrose-two injections 1 week apart. Animals were sacrificed at 12 weeks after the initial injection and were evaluated by electrophysiology (EP), SSCT mechanical testing and histology. RESULTS: There were significant increases in the energy absorption of the SSCT in the 10% dextrose-double injection group compared to the saline injection groups. SSCT stiffness was also significantly increased in the 10% dextrose-double injection group compared to the other groups. There was a significant increase in the thickness of the SSCT in the 10% dextrose-double injection group compared to the saline-single injection group and a significant decrease in the nerve short-long diameter ratio in the 10% dextrose-double injection group compared to the saline-single injection group. There were no changes in EP among the groups. CONCLUSIONS: SSCT fibrosis is present for up to 12 weeks after dextrose injection; multiple injections have bigger effects, including what appears to be a secondary change in nerve flattening. This model may be useful to study the effects of external fibrosis on nerve morphology and physiology, such as occurs clinically in carpal tunnel syndrome.

Mild exercise early in life produces changes in bone size and strength but not density in proximal phalangeal, third metacarpal and third carpal bones of foals.

Exercise or lack of it in early life affects chondro-osseous development. Two groups of horses were used to investigate the effects of age and exercise regimen on bone parameters of diaphyseal, metaphyseal, epiphyseal and cuboidal bones of the distal limb of Thoroughbreds. One group had exercised only spontaneously from an early age at pasture (PASTEX group), while the other group of horses were exposed to a 30% greater workload through additional defined exercise (CONDEX). Longitudinal data from peripheral quantitative computed tomography (pQCT) were obtained from eight scan sites of the left forelimb (proximal phalangeal (P(p); 1 site), third metacarpal (Mc3; six sites) and third carpal (C(3); one site) bones) of 32 Thoroughbred foals scanned five times from ∼3 weeks to 17 months of age. The primary outcome measures were bone mineral content (BMC), bone area (BA), and periosteal circumference (Peri C) in diaphyseal bone, with cortical thickness (CortTh), volumetric bone mineral density (BMD(v)) and a bone strength index (SSI) also being analysed. At the P(p) site within the model there was a significant effect (P=0.00-0.025) of conditioning exercise increasing bone parameters, except endosteal circumference (Endo C) and BMD(v). The BMC, BA, and SSI of P(p) were significantly greater in the CONDEX than PASTEX groups at 12 and 17 months (P=0.015-0.042) and CortTh at 17 months (P=0.033). At the M55 site of Mc3 BMC, BA and SSI (P=0.02-0.04), and at the M33 site, SSI (P=0.05) were higher in the CONDEX than PASTEX group. The adaptive responses, consistent with diaphyseal strengthening, were more marked in the diaphysis of P(p) than Mc3. In the Mc3, metaphysis, trabecular BMD(v) was less in the CONDEX than PASTEX group, associated with greater bone mineral accretion in the outer cortical-sub-cortical bone in the CONDEX group. There were no significant between-group differences in any epiphyseal or cuboidal bone parameter. Although the early imposed exercise regimen was not intensive, it had significant effects on diaphyseal bone strength, through change in size but not bone density.

The asymmetry of the carpal joint and the evolution of wing folding in maniraptoran theropod dinosaurs.

In extant birds, the hand is permanently abducted towards the ulna, and the wrist joint can bend extensively in this direction to fold the wing when not in use. Anatomically, this asymmetric mobility of the wrist results from the wedge-like shape of one carpal bone, the radiale, and from the well-developed convexity of the trochlea at the proximal end of the carpometacarpus. Among the theropod precursors of birds, a strongly convex trochlea is characteristic of Coelurosauria, a clade including the highly derived Maniraptora in addition to tyrannosaurs and compsognathids. The shape of the radiale can be quantified using a 'radiale angle' between the proximal and distal articular surfaces. Measurement of the radiale angle and reconstruction of ancestral states using squared-change parsimony shows that the angle was small (15 degrees) in primitive coelurosaurs but considerably larger (25 degrees) in primitive maniraptorans, indicating that the radiale was more wedge-shaped and the carpal joint more asymmetric. The radiale angle progressively increased still further within Maniraptora, with concurrent elongation of the forelimb feathers and the forelimb itself. Carpal asymmetry would have permitted avian-like folding of the forelimb in order to protect the plumage, an early advantage of the flexible, asymmetric wrist inherited by birds.