Carpal Injuries and Carpal Arthrodesis

Question 1

Nakladal, VCOT, 2013:

1. What was the most common cause of carpal joint injuries in cats?
2. Which carpal joint was predominantly injured in cats and what was the most common cause of the injury?
3. Which carpal joint is most frequently injured in falls from heights up to the 3rd floor?
4. What is the most common type of carpal joint injury in cats?

Answer 1

Nakladal, VCOT, 2013:

1. 73% of carpal joint injuries in cats were caused by a fall from a height
2. The antebrachiocarpal joint was predominantly injured (51% of cases) and was most commonly caused by falls from the 4th floor or higher
3. Falls from heights up to the 3rd floor predominantly injured the carpometacarpal joint in cats
4. The most common type of carpal joint injury in cats was luxation or subluxation (compared to hyperextension in dogs)

Question 2

Tomlinson and Manfredi, JAVMA, 2014:

Effect(s) of carpal brace applications for unilateral carpal ligament instability?

Answer 2

Tomlinson and Manfredi, JAVMA, 2014:

Improved stability and resolution or reduction in lameness were observed following carpal brace application for 12 weeks

Question 3

Castelli, Vet Surg, 2019:

1. Which provided better visualization of carpal ligaments - MRI or MRA?
2. Which provided better visualization - MRI and MRA or CT and CTA?
3. Did contrast arthrography improve the capabilities of MRI or CT for the visualization of canine carpal ligament?

Answer 3

Castelli, Vet Surg, 2019:

1. MRA provided better visualization of carpal ligaments and offered the best visualization overall
2. MRI and MRA offered better visualization compared to CT and CTA
3. Contrast orthography improved the capabilities of MRI but not CT

Question 4

Milgram, VCOT, 2019:

1. What effect did increasing the angle of flexion of the carpus have?
2. What plays a more important role in craniocaudal antebrachiocarpal joint stability - antebrachiocarpal joint position or the palmar radoiocarpal and ulnocarpal ligaments?

Answer 4

Milgram, VCOT, 2019:

1. Increasing the angle of flexion of the carpus resulted in increased cranial and caudal translation of the manus relative to the radius and ulna
2. Antebrachiocarpal joint position plays a more important role in craniocaudal joint stability

Question 5

Burton, VCOT, 2013:
Partial carpal arthrodesis - castless partial carpal arthrodesis (par-CA) plate vs T-plate vs cross pins

1. Advantages of the par-CA plate?
2. Differences in biomechanics?

Answer 5

Burton, VCOT, 2013:

1. The par-CA plate permits radial and ulnar carpal bone compression, a more distal location of the plate to limit impingement, and placement of screws in 2 metacarpal bones
2. The T-plate and par-CA plate were biomechanically similar but both were superior to cross pins in resisting micromotion

Question 6

Bristow, Vet Surg, 2015:
Pancarpal arthrodesis with a hybrid DCP (HDCP) vs castless arthrodesis plate (CLP)

1. Intra-op complication rates of HDCP vs CLP?
2. Most common intra-op complication for CLP?
3. Post-op complication rates of HDCP vs CLP?
4. Most common post-op complication for HDCP vs CLP?
5. Radiographic healing rates at 30-40 weeks post-op for HDCP vs CLP?
6. What % of HDCP vs CLP had no or mild lameness at median follow-up?

Answer 6

Bristow, Vet Surg, 2015:

1. Intra-op complication rate: 11% for HDCP vs 21% for CLP
2. Most common intra-op complication for CLP was metacarpal fracture/fissure
3. Post-op complication rate: 34% for HDCP vs 41% for CLP
4. Most common post-op complication: SSI (18% of cases)
5. Radiographic healing rates at 30-40 weeks post-op: 40% for HDCP vs 46% for CLP
6. 73% of HDCP cases and 83% of CLP cases had no or mild lameness at median follow-up

Question 7

Brown, Vet Surg, 2016:
Pancarpal arthrodesis for highly comminuted articular fractures of the distal antebrachium

1. Outcomes?
2. Risk of complications?
3. Prognosis for full functional outcome?

Answer 7

Brown, Vet Surg, 2016:

1. 38% full functional outcome, 38% acceptable outcome
2. High risk of complications
3. Guarded prognosis

Question 8

Ramirez and Macias, Vet Surg, 2016:
Pancarpal arthrodesis without rigid coaptation using the hybrid DCP

1. Minor complication rate?
2. Major complication rate?
3. Outcomes?

Answer 8

Ramirez and Macias, Vet Surg, 2016:

1. 23% minor complication rate
2. 17% major complication rate
3. 87% excellent outcome, 13% good outcome