Fractures of the Carpus

McIlwraith, C. Wayne

doi:10.1002/9781119431749.ch24

Cited by 5 publications

(14 citation statements)

References 59 publications

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“…Conversely, in this population, 33% of all C3 slab fractures repaired involved both radial and intermediate facets and the majority were displaced. While left carpal injuries seem more common in the UK, a higher prevalence of C3 slab fractures occurring in the right carpus in Thoroughbred and Quarter Horses in the USA has been recognised 9,11 . The dominance of right forelimb injuries is not clearly understood but is likely attributed to breed and regional racetrack demographics.…”

Section: Discussionmentioning

confidence: 99%

“…C3 slab fractures involving both radial and intermediate facets were frequently collapsing and resulted in avulsion of the MPICL, the reason hypothesised to be fractures occurring more palmad than routine C3 slab fractures and/or consequent instability 11 . There are two palmar intercarpal ligaments: the MPICL located medially and another lateral.…”

Section: Discussionmentioning

confidence: 99%

“…C3 slab fractures involving both radial and intermediate facets can be nondisplaced or displaced and promote joint collapse 11 . Collapsing C3 slab fractures are particularly problematical as the radial carpal bone displaces distad to the fracture line and, without fixation, axial instability and joint collapse into varus deformity occurs 12 .…”

Section: Introductionmentioning

confidence: 99%

“…Collapsing C3 slab fractures are particularly problematical as the radial carpal bone displaces distad to the fracture line and, without fixation, axial instability and joint collapse into varus deformity occurs 12 . Repair strategies for C3 slab fractures of both radial and intermediate facets (particularly collapsing fractures), warrant additional considerations than routine slab fractures 11,12 . While the surgical technique for repair of these slab fractures has been reported, 11 specific features of treatment and outcomes following surgical repair in racing Quarter Horses are lacking.…”

Section: Introductionmentioning

confidence: 99%

“…Repair strategies for C3 slab fractures of both radial and intermediate facets (particularly collapsing fractures), warrant additional considerations than routine slab fractures 11,12 . While the surgical technique for repair of these slab fractures has been reported, 11 specific features of treatment and outcomes following surgical repair in racing Quarter Horses are lacking. The objectives of this study were to describe the pre‐ and intraoperative characteristics of C3 slab fractures of both radial and intermediate facets in racing Quarter Horses and to report on long‐term outcomes after arthroscopic‐guided internal fixation.…”

Section: Introductionmentioning

confidence: 99%

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Slab fractures of the third carpal bone involving both radial and intermediate facets and outcomes after surgical repair in racing Quarter Horses

Nelson

Lawless

McIlwraith

2021

Equine Veterinary Journal

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Background: Characteristics and outcomes after surgical repair of third carpal bone (C3) slab fractures involving both radial and intermediate facets in racing Quarter Horses are unknown. Objectives: To describe the pre-and intraoperative characteristics of C3 slab fractures of both radial and intermediate facets in Quarter Horses and to report on the long-term outcomes after internal fixation. Study design: Retrospective case series. Methods: Case records were collected from racehorses with C3 slab fractures between 2008 and 2020. Inclusion criteria required arthroscopic-guided repair of C3 slab fractures involving both radial and intermediate facets in Quarter Horses. Routine C3 slab fractures (single facet), fractures in other breeds or those repaired with other techniques were excluded. Outcomes were obtained by standardised questionnaire. Data were presented as mean ± SD or as proportions with 95% confidence interval (CI).Results: Of 22 Quarter Horses with C3 slab fractures involving both radial and intermediate facets, 91% (CI 79%-100%; n = 20) were collapsing and 91% (CI 79%-100%; n = 20) had avulsion of the medial palmar intercarpal ligament. Articular cartilage erosion and osteochondral fracture of the radial carpal bone was observed in 91% (CI 79%-100%; n = 20) and 41% (CI 20%-62%; n = 9) cases respectively. At 5.5 ± 3.9 years after surgery, 86% (CI 72%-100%; n = 19) were alive and used for breeding or retirement. Of 18 horses with follow-up >1 year, 39% (CI 16%-61%; n = 7) resumed some athletic activity.Main limitations: Cases were referred specifically for surgical repair and horses with fractures considered too severe for surgical intervention or euthanasia at owner request were not included. Questionnaire responses are susceptible to recall bias. Conclusions:Horses with C3 slab fractures of both radial and intermediate facets that are repaired have a favourable prognosis for retirement, breeding and potentially low-level athletic activity.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Slab fractures of the third carpal bone involving both radial and intermediate facets and outcomes after surgical repair in racing Quarter Horses

Nelson

Lawless

McIlwraith

2021

Equine Veterinary Journal

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Distal forelimb radiographic bone morphology in Thoroughbred foals during the first 10 months post‐partum. Part 1: Carpus

Son,

De Paz,

Kim

et al. 2024

Veterinary Medicine & Sci

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BackgroundThe risk of carpal injury in racehorses may be related to the morphology, yet whether carpal morphologies are set from birth or change through growth remains unclear.ObjectiveTo quantify carpal bone changes through growth.MethodTwenty privately owned Thoroughbred foals born between January 2022 and May 2023 were radiographed bimonthly from birth to 10 months of age. Imprint training was used to take radiographs safely without chemical restraints. Fifteen individual and 11 relative angular carpal parameters were measured using ImageJ on dorsopalmar radiographs of the carpus at zero degrees of vertical and horizontal rotation. Associations with age (growth), sex and the differences between left and right limbs were analysed separately using a linear mixed effects model.ResultsSix individual carpal parameters changed with age (radial carpal joint [RCJ], Prx.dor. radial carpal [Cr], Prx.Cu, Dis.dor. third carpal [C3], Dis.pal.C3 and Dis.pal. intermediate carpal), and one was influenced by side, that is higher in the left carpus (Dis.pal.Cr). Seven relative parameters changed with age, and one relative parameter was influenced by side, that is higher in the left (Ra.met‐RCJ). The proximo‐dorsal bone surface angle of Cr and disto‐dorsal bone surface angle of C3 became flatter over time, which may be associated with the re‐direction of the load towards the sagittal carpal plane. Sex did not influence any of the carpal parameters, nor did the combined effect of age, side of the limb and sex.ConclusionSpecific individual and relative angular carpal parameters changed significantly over time and some differed between the left and right limb, whereas other parameters did not change. The steeper carpal bone angles achieved proximally with the parameters that did change may improve stability by redirecting the load more medially through the carpus and the proximal and distal bones.

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Accessory carpal bone fracture repair by means of computer‐assisted orthopaedic surgery in a Warmblood stallion

Preux

Vekens

Racine

et al. 2021

Equine Veterinary Education

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Summary A 10‐year‐old, 595 kg Irish Warmblood stallion used for showjumping was presented with a marked right forelimb lameness at walk. The horse sustained a dorsal plane fracture of the accessory carpal bone (ACB) when falling with both carpi in flexion. The fracture was repaired by means of computer‐assisted orthopaedic surgery (CAOS) using two cortex screws placed in lag fashion. In a second CAOS procedure, a dorsoproximal fragment of the ACB was removed after further proximal displacement had become apparent. Both surgical procedures were facilitated by the application of a fibreglass cast to immobilise the carpus in extension and to allow for the placement of the patient tracker distant from the surgical site. One year after surgery, the horse had returned to full athletic activity. Neither the antebrachiocarpal joint nor the carpal sheath were distended. Control radiographs and standing cone beam computed tomography showed complete osseous union of the fracture and osteophyte formation on the caudal aspect of the radius and the proximal border of the ACB.

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Fractures of the Carpus

Cited by 5 publications

References 59 publications

Slab fractures of the third carpal bone involving both radial and intermediate facets and outcomes after surgical repair in racing Quarter Horses

Slab fractures of the third carpal bone involving both radial and intermediate facets and outcomes after surgical repair in racing Quarter Horses

Distal forelimb radiographic bone morphology in Thoroughbred foals during the first 10 months post‐partum. Part 1: Carpus

Accessory carpal bone fracture repair by means of computer‐assisted orthopaedic surgery in a Warmblood stallion

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