Tenoscopic release of the equine carpal canal.
Authors: Textor Jamie A, Nixon Alan J, Fortier Lisa A
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Tenoscopic Release of the Equine Carpal Canal Carpal canal syndrome in horses results from compression within the carpal sheath, traditionally managed through open surgical division of the carpal flexor retinaculum—a procedure with inherent tissue trauma and recovery considerations. Textor and colleagues developed and validated a minimally invasive tenoscopic technique using a proximolateral approach to the carpal sheath, systematically evaluating the method across 12 cadaveric limbs followed by in vivo assessment in four clinically normal and two affected horses, combining anatomical dissection, histological evaluation, and clinical follow-up data. The tenoscopic approach successfully divided the inner layer of the carpal retinaculum without iatrogenic damage to adjacent structures, achieving permanent decompression with negligible post-operative morbidity; both affected horses showed resolution of effusion, and the one case with extended follow-up demonstrated complete resolution of lameness. For practitioners managing carpal canal syndrome, this technique offers a genuinely minimally invasive alternative to traditional open surgery, potentially reducing soft tissue trauma, hospitalisation time, and recovery complications whilst maintaining the same therapeutic outcome. The evidence suggests that endoscopic release warrants consideration as a first-line surgical approach where carpal canal decompression is indicated.
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Practical Takeaways
- •Tenoscopic carpal retinaculum release offers a minimally invasive alternative to open surgery for horses with carpal canal syndrome, allowing faster recovery and reduced post-operative complications.
- •The procedure successfully resolves carpal effusion and associated lameness when surgical decompression is indicated.
- •This arthroscopic approach requires specialized training but can be performed with confidence given the anatomical safety demonstrated in this study.
Key Findings
- •Tenoscopic division of the carpal flexor retinaculum successfully decompressed the carpal canal in 12 cadaveric limbs with no iatrogenic damage to surrounding structures.
- •In 2 clinically affected horses, tenoscopic release resolved carpal effusion and lameness resolved in 1 horse with long-term follow-up.
- •The technique achieved adequate and permanent division of the retinaculum with negligible clinical morbidity in 4 normal horses and 2 affected horses.