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palmar intercarpal ligament

The horse must be restricted to stall rest for at least 2 to 3 weeks.Although most horses with intraarticular fracture of the carpus display acute-onset clinical signs, the damage is chronic in nature, at least in racehorses, and occurs at consistent sites in the dorsal aspect of the joints. The degree of radiographic change does not always correlate with the degree of pain or lameness, and radiographic changes may sometimes be advanced at the time of lameness onset, so predicting onset and degree of lameness from radiographic examination is difficult.Osteoarthritis in the antebrachiocarpal joint is observed most commonly in flat-track racehorses and is usually caused by repetitive overloading injury of the articular osteochondral structure.Periarticular osteophytes are most commonly detected on the dorsal aspect, particularly of the radial and intermediate carpal bones, but may also be observed on the palmar aspect of the joint (see,Osteoarthritis in the middle carpal joint occurs in a manner similar to the antebrachiocarpal joint (see.Osteoarthritis of the carpometacarpal joint occurs much less commonly than does osteoarthritis of the two proximal articulations and occurs largely in middle-aged to older horses.Osteoarthritic change is generally characterized by narrowing or collapse of the joint space, frequently focal or confined to either the medial or lateral side only, involving the articulation with either the second or fourth metacarpal bones.Horses with septic arthritis usually become severely lame within 24 hours of infection, with heat and swelling of the carpal region. Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado 80523, USA.Use the link below to share a full-text version of this article with your friends and colleagues.Tearing of the medial palmar intercarpal ligament is described in 45 intercarpal (midcarpal) joints in 42 horses (37 racehorses, 5 non‐racehorses). Of the 37 racehorses, there were 20 Quarter Horses, 14 Thoroughbreds and 3 Standardbreds.

The concern here is that the horses may be predisposed to postoperative synovial sepsis; however, this has not been shown to be of major concern.Arthroscopic treatment for osteochondral damage, including osteochondral fragmentation and slab fractures, is best described elsewhere.Comminuted fractures require internal fixation or arthrodesis to restore axial stability to the limb and to give the horse a chance to become pasture sound.Postoperative care of arthroscopically treated carpal joints has been completely described elsewhere.In addition to rehabilitation, most surgeons will often recommend some form of intraarticular therapy to reduce inflammation and speed healing, especially of articular cartilage.
This primarily occurs in older Standardbred racehorses because of chronic stress-induced disease within the subchondral bone.Standard of care now dictates that any osteochondral damage should be arthroscopically removed to optimize the horse’s chances of soundness and athletic potential. Degeneration of articular cartilage and bone have been graded for severity and correlated with outcome.Grade 1: Minimal fibrillation or fragmentation at the edge of the defect left by the fragment, extending no more than 5 mm from the fracture line.Grade 2: Articular cartilage degeneration extending more than 5 mm back from the defect and including up to 30% of the articular surface of that bone.Grade 3: Loss of 50% or more of the articular cartilage from the affected carpal bone.Grade 4: Significant loss of subchondral bone (usually distal radial carpal bone lesions).Osteochondral fragments are removed and if the lesions are severe, then augmentative therapy such as microfracture or various intraarticular medications can be used. A lateral instrument portal is then made 10 to 15 mm proximal to the accessory carpal bone. They consist of two thin layers of tissue that cross each other and insert on the proximal palmar tuberosities of the proximal phalanx. A common example is SLIL reconstruction via a dorsal capsulodesis utilizing the dorsal intercarpal ligament.

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