Treatment of a second carpal bone fracture by removal under ultrasonographic guidance in a horse.

Summary

# Editorial Summary Second carpal bone fractures present a particular challenge in equine orthopaedics, especially when fragments are located on articular surfaces difficult to visualise arthroscopically; this case report demonstrates how ultrasonographic guidance can facilitate minimally invasive fragment removal in such scenarios. An 11-year-old Warmblood gelding presented with an unusual palmaromedial slab fracture spanning the full height of the second carpal bone, which the surgical team successfully located and extracted using ultrasound-guided needle demarcation followed by a small targeted arthrotomy, rather than relying on traditional arthroscopic visualisation alone. Despite concurrent pancarpal osteoarthritis and partial involvement of the medial collateral ligament, the horse returned to sound pleasure riding, suggesting reasonable long-term prognosis even in complicated cases. The key practical implication here is that ultrasonography offers an adjunctive tool for surgeons managing carpal fragments that may be poorly visualised arthroscopically, potentially reducing operative time and soft tissue trauma through precise pre-operative and intra-operative anatomical mapping. Whilst this remains a single case report with inherent limitations, the technique warrants consideration for practitioners managing non-standard carpal bone injuries where conventional arthroscopic approaches may prove inadequate.

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Key Findings

• •Ultrasonographically guided needle demarcation successfully identified and facilitated removal of a palmaromedial C2 slab fragment through minimally invasive arthrotomy
• •Horse achieved soundness and returned to previous level of pleasure riding activity post-operatively
• •Ultrasonographic guidance proved superior to arthroscopy alone for visualizing and accessing this unusual C2 articular fracture location

Conditions Studied