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1.
Fifty-six carpal arthrodeses were carried out in 50 dogs. Six of these had bilateral arthrodeses. A dynamic compression plate (DCP; Straumann Great Britain Ltd), placed on the dorsal aspect of the carpus, was used for fixation in all cases. The main indication for pancarpal arthrodesis was a hyperextension injury of the radiocarpal joint. Forty-three pancarpal arthrodeses were performed in 40 dogs (a bilateral procedure was performed in three). Hyperextension injuries of the intercarpal and carpometacarpal joints were treated by partial carpal arthrodesis in 10 dogs; three of these had bilateral procedures. Seventy-four per cent of dogs treated by pancarpal arthrodesis regained full limb function. Only 50 per cent of cases treated by partial carpal arthrodesis had a similar result. 相似文献
2.
Carpal arthrodesis using a minimally invasive approach and locking compression plates: Three cases 
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下载免费PDF全文 O. Brandenberger F. Rossignol S. Bartke T. Van Bergen A. Vitte 《Equine Veterinary Education》2018,30(5):229-236
Three horses with carpal instability due to comminuted second carpal bone fractures (Cases 1 and 3), fracture of the head of the second metacarpal bone (Case 1) or comminuted fractures of the fourth carpal bone, ulnar and intermediate carpal bones (Case 2) were treated by minimally invasive approach for partial (Cases 1 and 3) or pancarpal (Case 2) joint arthrodesis, using locking compression plates. The joint cartilage was removed by either an arthroscopic approach (middle carpal joint and antebrachiocarpal joint) or a percutaneous drilling technique (carpometacarpal joint). Two or 3 locking compression plates were contoured to the dorsolateral, dorsomedial and dorsoaxial aspects of the carpal joints using a custom‐made tunnelling tool and a minimally invasive tunnelling technique, and the screws were positioned through stab incisions. All cases recovered well, were lame free at the walk, were able to trot and gallop and could be used for leisure and pasture activities (partial carpal arthrodesis) and breeding (pancarpal arthrodesis). Post‐operative x‐rays showed progressive joint fusion after 12 months (Case 1), 5 months (Case 2) and 10 months (Case 3). Case 2 with a pancarpal arthrodesis showed a mechanical lameness at the walk due to the inability to flex the carpus. Carpal flexion after carpometacarpal and middle carpal arthrodesis in Case 1 was calculated to be 42.6° and 44° in Case 3. 相似文献
3.
S J Langley-Hobbs M H Hamilton J N J Pratt 《Veterinary and comparative orthopaedics and traumatology》2007,20(4):324-330
Lameness associated with carpal varus deformity was recognised in 10 dogs, eight of which were Dobermann Pinschers. The dogs had a mean age of seven years and nine months. Carpal varus was usually bilateral with concurrent carpal hyperflexion and pronation. Carpal varus was present prior to the onset of lameness in four cases. With stress radiography the median angle of varus deviation in all carpi was 14.6 degrees , and an increase in the size of the ulnar /ulnar carpal bone joint space was seen in six of the seven dogs. Radiographic changes included: enthesophyte formation at the proximolateral aspect of metacarpal V, periarticular soft tissue swelling, especially lateral, bone proliferation at the carpometacarpal joint I and enthesophyte formation at metacarpophalangeal joint V. Four dogs were admitted for problems other than carpal varus and lameness was not treated. Five dogs were treated with nonsteroidal anti-inflammatory drugs, but lameness was not completely resolved and became exacerbated with exercise. One dog was successfully treated by pancarpal arthrodesis. 相似文献
4.
Partial arthrodesis was performed for carpal hyperextension injury in a dog. T-plate application for middle carpal and carpometacarpal arthrodesis was associated with low patient morbidity and allowed normal pet activity without clinical lameness. Radiography revealed bony healing of arthrodesed joints, reactive bone formation over the dorsal aspect of the plate, and periarticular osteophyte formation. A guarded prognosis is advised for degenerative joint disease that may lead to decreased range of motion of the antebrachiocarpal joint. 相似文献
5.
DIANA L. JONES bs dvm mvsc SPENCER M. BARBER dvm Diplomate acvs CECIL E. DOIGE dvm PhD 《Veterinary surgery : VS》1993,22(6):524-530
Changes in synovial fluid and clinical variables after arthroscopic partial synovectomy of the middle carpal joint were studied in 12 normal horses. A 7 mm motorized synovial resector was inserted into each middle carpal joint; one middle carpal joint of each horse was randomly selected to have arthroscopic synovectomy (treated) and the opposite joint was lavaged (control). Lameness examinations and synovial fluid analyses were performed before operation and at 8, 14, 21, and 28 days after operation. Lameness variables did not differ between treated and control legs. Middle carpal and carpometacarpal joint circumference measurements were increased for 4 weeks. Synovial fluid specific gravity, pH, total protein, albumin concentration, and alpha-1-, beta- and gamma-globulin concentrations, at 8 and 14 days were significantly higher than before operation in both treated and control middle carpal joints. No significant differences were found between treated and control middle carpal joints at any time for color, clarity, pH, mucin clot formation, total protein, albumin, and globulin fractions. Arthroscopic partial synovectomy and lavage did not cause significant lameness and resulted in a synovitis indistinguishable from synovitis related to arthroscopic lavage alone. 相似文献
6.
TROY S. FORD DVM MICHAEL W. ROSS DVM DiplomateACVs PAUL G. ORSINI DVM 《Veterinary surgery : VS》1989,18(2):146-150
Three techniques for inducing analgesia of the proximal metacarpal region were evaluated for the frequency of inadvertent injection into the middle carpal and carpometacarpal joints. Using methylene blue solution as a marker dye and 30 fresh cadaver specimens each, three clinicians performed either 30 infiltrations at the origin of the suspensory ligament (method A), 30 palmar and palmar metacarpal nerve blocks at the proximal end of the metacarpus (method B), or 30 palmar and palmar metacarpal nerve blocks at the distal aspect of the accessory carpal bone (method C). The frequency of inadvertent injection into the distal carpal joints was 37, 17, and 0% for methods A, B, and C, respectively. The association between method and injection into the joints was significant (p less than 0.01). Infiltration of the distal carpal joints occurred with injection distances from the carpometacarpal joint of 1.5 to 4.5 cm. Although there was no joint injection with method C, the carpal synovial sheath was inadvertently infiltrated in 68% of the specimens. Injection into the distal carpal joints can occur when deep injections are made into the proximal palmar aspect of the metacarpus because of the distopalmar outpouchings of the carpometacarpal joint between the axial surfaces of the second and fourth metacarpal bones and the abaxial surface of the suspensory ligament. 相似文献
7.
Carpal Joint Arthrodesis as a Treatment for Chronic Septic Carpitis in Calves and Cattle 总被引：1，自引：0，他引：1
X. VAN HUFFEL DMV M. STEENHAUT DMV J. IMSCHOOT DMV F. VERSCHOOTEN DMV F. GASTHUYS DMV P. DESMET DMV A. De Moor DMV 《Veterinary surgery : VS》1989,18(4):304-311
Chronic septic carpitis in 72 calves and adult cattle was treated by arthrodesis of the carpus (n = 24), proximal or distal carpal row resection with arthrodesis (n = 31), or resection of both the proximal and distal carpal bones and radio-metacarpal arthrodesis (n = 17). Painfree arthrodesis permitting full weight-bearing was obtained in 69% of the cases. Arthrodesis without resection of carpal bones was successful in 87% of the cases. With resection of one carpal row, 72% of the cases were treated successfully. Radio-metacarpal arthrodesis with removal of both carpal rows resulted in fusion in 35% of the animals. 相似文献
8.
To study communications and boundaries of the middle carpal and carpometacarpal joints of the horse, 50 forelimbs were obtained from fresh cadaver specimens. Blue latex solution (20 +/- 2.5 ml) was injected into the middle carpal joint, and the specimens were frozen in extension. Frozen specimens were cut into 1-cm sagittal sections from the middle of the radius to the middle of the metacarpus. The communications between the middle carpal and carpometacarpal joints and the presence, length, and position of the distopalmar outpouchings of the carpometacarpal joint were recorded. The middle carpal and carpometacarpal joints always communicated between os carpale III (C3) and os carpale IV (C4). An additional communication between the joints existed in 17 (34%) of the specimens, 10 on the palmar aspect of C4, and 3 on the palmar aspect of os carpale II (C2). When os carpale I (C1) was present (n = 5), communication between C1 and C2 was observed in 4 of the 5 specimens. In all specimens, medial and lateral distopalmar outpouchings of the carpometacarpal joint were observed and were located between the axial surface of os metacarpale II (MC2) and os metacarpale IV (MC4) and the abaxial surface of the suspensory ligament. There was no significant difference between the lengths of the lateral (2.3 +/- 0.54 cm) or medial (2.6 +/- 0.75 cm) distopalmar outpouchings. Small extensions from the distopalmar outpouchings were seen and extended axially into the fibers of the suspensory ligament or between the suspensory ligament and the distal accessory ligament of the deep digital flexor tendon.(ABSTRACT TRUNCATED AT 250 WORDS) 相似文献
9.
MARK B. HURTIG DVM PETER B. FRETZ VMD DiplomateACVS CECIL E. DOIGE dvm PhD JONATHAN NAYLOR BVSc PhD DiplomateACVS 《Veterinary surgery : VS》1985,14(2):93-98
The equine carpal joint was used to evaluate arthroscopic diagnosis of lesions created in joints obtained from horses euthanized for reasons other than lameness. Full-thickness articular defects were made in 13 sites within the antebrachiocarpal joint and middle carpal joint approximating those found in diseased carpal joints. Arthroscopic evaluation of the lesions included location, depth, and size of the defects. The joints were subsequently examined grossly. Results showed that, when compared to gross evaluation, arthroscopy is capable of accurately identifying subtle changes in articular cartilage and bone. A statistically significant increase in error rate was found for lesions at the medial aspect of the proximal radial carpal bone. Other sites with limited arthroscopic access were the proximal ulnar carpal bone, the proximal fourth carpal bone, and the distal intermediate carpal bone. The accuracy of arthroscopic identification of lesions improved significantly during the study as experience with the technique was gained. 相似文献
10.
W G Keller J N Chambers 《Journal of the American Veterinary Medical Association》1989,195(10):1382-1384
Congenital malformation of the carpal joint in a young dog resulted in a progressive lameness. Traumatic disruption of the carpus in another dog resulted in carpal bone necrosis, infection, and chronic instability. Radial metacarpal arthrodesis was performed in both dogs. The diseased carpal bones were excised, sparing the accessory carpal bone in both dogs. Radial metacarpal arthrodeses were then performed, using bone plate fixation. In the dog with the malformed limb, the gait had improved, but intermittent lameness was still present 8 months later because of an associated malarticulation of the cubital joint. The dog with the traumatized carpus had little or no lameness associated with normal activity for 32 months. 相似文献
11.
OBJECTIVE: To report treatment of a unilateral comminuted fourth carpal bone (C4) fracture associated with carpal instability by partial carpal arthrodesis (PCA) of the middle carpal joint (MCJ) and carpometacarpal joint (CMCJ). STUDY DESIGN: Case Report. ANIMALS: An 8-month-old Arabian filly. METHODS: A C4 slab fracture was diagnosed radiographically; however, fracture comminution was conclusively diagnosed after computed tomographic (CT) imaging. PCA of the MCJ and CMCJ was performed with 2 narrow dynamic compression plates. RESULTS: PCA provided appropriate carpal stability and correct limb alignment immediately after surgery. Complete bony fusion with substantial carpal flexion and no lameness at walk or light trot was observed 8 months after surgery. CONCLUSIONS: Carpal CT was successfully used to define fracture configuration after standard radiographic examination failed to delineate comminution. PCA was selected because of joint instability and lateral carpal collapse of MCJ and CMCJ and can be successfully used to treat comminuted C4 slab fractures associated with carpal instability. Moderate MCJ osteoarthritis without radiocarpal joint involvement allows pain-free, substantial carpal flexion and thus, return to low-level pleasure riding may be possible. CLINICAL RELEVANCE: CT imaging may more adequately characterize traumatic carpal bone injury, particularly, when carpal bone fracture configuration cannot be determined on standard radiographs. Early PCA of the MCJ and CMCJ is an useful alternative to treat comminuted C4 slab fractures that cannot be reconstructed. 相似文献
12.
A 9‐year‐old Warmblood gelding underwent magnetic resonance (MR) imaging of the carpal and proximal metacarpal regions for evaluation of prolonged right forelimb lameness. Magnetic resonance findings were indicative of desmopathy of the right lateral carpometacarpal ligament and the interosseous ligament between the third and fourth metacarpal bones. Based on the MR findings and lack of response to conservative therapy, surgery using a drilling technique was performed to facilitate fusion of the right carpometacarpal joint. After surgery and a 6‐month rest and rehabilitation programme, the horse returned to soundness. This case report describes a unique combination of lateral carpal/proximal metacarpal soft tissue injuries that resulted in prolonged lameness and were treated with facilitated arthrodesis of the carpometacarpal joint. These soft tissue injuries should be considered as a differential diagnosis in horses with lameness localised to the proximal metacarpal/distal carpal region. 相似文献
13.
ALICIA L. BERTONE DVM MS PhD DiplomateACVS HARVEY L. SCHNEITER DVM A. SIMON TURNER BVSC MS DiplomateACVS R. STUART SHOEMAKER DVM 《Veterinary surgery : VS》1989,18(5):353-359
Two mares with multiple carpal bone fractures, malarticulation and degenerative joint disease were successfully treated with unilateral arthrodeses of the antebrachiocarpal, middle carpal, and carpometacarpal joints. Arthrodesis was achieved by removal of articular cartilage, autogenous cancellous bone graft, and double dynamic compression plating. In one horse, wedge ostectomy corrected the severe, acquired angular limb deformity. External coaptation supplemented the internal fixation. Postoperative complications were limited to cast sores that healed with treatment, although protracted in one horse. Both mares adapted to the "peg leg" condition and ambulated without pain by 3 months. The first mare treated survived for at least 2 1/2 years after surgery and has had at least one foal. The most recently treated mare will be bred next year. 相似文献
14.
SPENCER M. BARBER DVM Diplomate ACVS LUCA PANIZZI Dr Med Vet HAYLEY M. LANG 《Veterinary surgery : VS》2009,38(8):1006-1011
Objective— To evaluate arthrodesis as a treatment for carpometacarpal joint osteoarthritis (CMC‐OA). Study Design— Case series. Animals— Horses (n=12) with CMC‐OA. Methods— Arthrodesis was facilitated by insertion and fanning of a drill bit into the CMC joint at several (3–5) locations in 15 limbs. Follow‐up radiographs were obtained for 7 horses (9 limbs). Outcome was determined by telephone survey of owners based on postoperative pain, return to use, appearance of the limb, and success of treatment. Results— Postoperative pain was slight or moderate in 10 of 12 (83%) horses during the first 30 days, and 11 of 12 (92%) horses were markedly improved by 6 months and capable of returning to work. Radiographically 6 CMC joints had a bony ankylosis at follow‐up whereas 3 did not (mean 8.7 months). On long‐term follow‐up (mean 28.6 months) all horses had reduced severity of lameness, 10 of 12 (83%) were considered “sound,” 8 (67%) returned to their original activity, and all owners considered arthrodesis highly successful as a treatment. Conclusion— A drilling technique that produced CMC arthrodesis, allowed most horses to return to their original activity and was considered successful by all clients. Clinical Relevance— Arthrodesis of the CMC joint should be considered a treatment option for CMC‐OA. 相似文献
15.
J.W. FOLAND DVM MS C.W. MCILWRAITH BVSc PhD FRCVS Diplomate ACVS G.W. TROTTER DVM MS Diplomate ACVS B.E. POWERS DVM PhD Diplomate ACVP C.H. LAMAR DVM PhD 《Veterinary surgery : VS》1994,23(5):369-376
Osteochondral fragments were created arthroscopically on the distal aspect of both radial carpal bones in 12 horses. On day 14 after surgery, one middle carpal joint of each horse was injected with 2.5 mL Betavet Soluspan (3.9 mg betamethasone sodium phosphate and 12 mg betamethasone acetate per milliliter) and the contralateral joint was injected with 2.5 mL saline as a control. Intra-articular treatments were repeated on day 35. On day 17, six horses began exercising 5 days per week on a high-speed treadmill. The other six horses were kept in box stalls throughout the study as nonexercised controls. On day 56, all horses were examined clinically and radiographically and then were euthanatized. Samples were obtained for histological, his-tochemical, and biochemical evaluation. Mild lameness was observed in five of the six exercised horses at day 56; four horses were lame in the control limb and one horse was lame in the treated limb. Of the five nonexercised horses evaluated for lameness, two were lame in the control limb, two were lame in the treated limb, and one was lame in both the control and the treated limb. No differences were noted on radiographs or palpation of steroid treated limbs versus control limbs. Firm reattachment of the osteochondral fragment to the radial carpal bone occurred in all but three joints. Gross cartilage damage was not different between steroid-treated joints and joints injected with saline. Histologically, there were no significant detrimental effects of betamethasone with or without exercise, but there was a tendency for more pathological change in treated joints. There was a trend toward decreased glycosaminoglycan staining in steroid treated joints of rested horses, whereas exercised horses had similar glycosaminoglycan staining in treated and control joints. No significant difference in the water content or uronic acid concentration was detected between treated and control joints. Intra-articular betamethasone administration in this carpal chip model was not associated with any significant detrimental effects in either rested or exercised horses. 相似文献
16.
An 8‐year‐old Paint Horse gelding was evaluated for a persistent left forelimb lameness (grade 4/5), with a hard swelling at the dorsomedial aspect of the carpometacarpal joint, due to osteoarthritis. Previous systemic and local anti‐inflammatory therapy had only a temporary effect. Partial carpal arthrodesis was suggested, but the owner elected for conservative treatment. The horse was confined to a small paddock and received phytotherapeutic supplementation with Harpagophytum procumbens. The lameness gradually resolved but a similar hard swelling developed on the right carpus. Radiographic follow‐up 1.5 years later revealed a spontaneous bilateral ankylosis of the carpometacarpal joint. 相似文献
17.
Li A Bennett D Gibbs C Carmichael S Gibson N Owen M Butterworth SJ Denny HR 《The Journal of small animal practice》2000,41(2):74-79
Between 1977 and 1992, 15 adult dogs were presented to the Universities of Bristol, Glasgow, Liverpool and London with fractures of the radial carpal bone which had occurred without a known episode of violent trauma. Eleven of the dogs were boxers and the other breeds affected were a Pharaoh hound, rottweiler, springer spaniel and a greyhound. The condition was bilateral in three cases. Eleven dogs were treated surgically by cast immobilisation (four cases), fragment removal (one case), lag screw fixation (three cases), pan-carpal arthrodesis (one case) and lag screw reduction followed by pan-carpal arthrodesis (two cases). The remaining four dogs were treated conservatively with rest and tactical use of non-steroidal anti-inflammatory drugs. Follow-up periods ranged from two months to 11 years. Varying degrees of lameness, which tended to be exacerbated by exercise, persisted in all cases. The radial carpal bone appears to have at least three separate centres of ossification which eventually fuse; their planes of fusion correspond approximately to the two main fracture lines. These areas of fusion could be weak points within the radial carpal bone. 相似文献
18.
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. 相似文献
19.
Pancarpal Arthrodesis in the Dog: A Review of Forty-five Cases 总被引：1，自引：0，他引：1
ROBERT B. PARKER D.V.M. S. GARY BROWN D.V.M. ALIDA P. WIND D.V.M. † 《Veterinary surgery : VS》1981,10(1):35-43
This report describes an open surgical technique for pancarpal arthrodesis and its efficacy in 45 canine cases. Indications for carpal arthrodesis include hyperextension injuries, severe fracture/luxations, end-stage arthritis, and selected neurologic deficits. Chronic joint instability was the major indication for surgery (76%). Degenerative joint disease (18%) and neurologic deficits (6%) accounted for the other cases. In a subjective owner survey, 97% of the owners reported that their animals' gait improved following arthrodesis, and 74% stated that their animals walked and ran normally. 相似文献