Arthroscopic approaches to the palmar aspect of the equine carpus.
Authors: Cheetham Jonathan, Nixon Alan J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Palmar carpal pathology has historically presented diagnostic and therapeutic challenges due to limited arthroscopic access to these structures. Cheetham and Nixon mapped feasible arthroscopic portals to the palmar aspects of both the antebrachiocarpal and middle carpal joints using 16 cadaveric specimens and 8 live horses, developing distinct medial and lateral approach sites for each joint compartment. Through systematic arthroscopic exploration, they demonstrated that separate medial and lateral portals allow visualisation of the palmar surfaces of the radial, second, third, fourth and ulnar carpal bones, portions of the caudodistal radius, and the dorsal aspect of the accessory carpal bone—regions previously difficult to assess under direct visualisation. These palmar approaches enable clinicians to remove fracture fragments from the palmar carpal surface and directly assess the medial palmar intercarpal ligaments, conditions that frequently affect performance horses yet demand precise diagnosis and targeted intervention. For practitioners managing carpal injuries, this work provides the anatomical framework necessary to select appropriate surgical approaches and anticipate which structures can be effectively examined and treated arthroscopically rather than relying on imaging or exploratory techniques alone.
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Practical Takeaways
- •Surgeons can now access and treat fractures and soft tissue injuries on the palmar carpal surface that were previously difficult to visualize arthroscopically
- •The described medial and lateral portal approaches provide complementary views of different carpal bone surfaces, allowing more complete arthroscopic evaluation
- •This technique expands the scope of arthroscopic carpal surgery, potentially reducing the need for invasive open approaches in selected cases
Key Findings
- •Medial and lateral arthroscopic portals to palmar AC and MC joints were successfully developed and characterized in 24 equine carpi
- •Palmar approaches allow visualization of radial, ulnar, second, third, and fourth carpal bones plus caudodistal radius and accessory carpal bone dorsal surface
- •Technique enables assessment of medial palmar intercarpal ligaments and removal of fracture fragments from previously inaccessible carpal regions