Ex vivo evaluation of carpal flexion after partial carpal arthrodesis in horses.
Authors: Tulloch Patty J, Johnston James D, Barber Spencer M, Gellert Candace L, Lang Hayley M, Panizzi Luca
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Carpal Arthrodesis and Range of Motion in Horses When managing chronic carpal joint disease, surgeons must balance disease stabilisation against functional preservation—a decision complicated by limited data on how different arthrodesis approaches affect limb mechanics. Tulloch and colleagues conducted an ex vivo biomechanical study on nine equine forelimbs, performing three partial carpal arthrodesis techniques using locking compression plates and measuring resulting carpal flexion angles under standardised loading conditions with a protractor methodology. Isolated carpometacarpal (CMC) arthrodesis preserved nearly normal carpal flexion (149° versus 150° in controls; P = .21), whilst middle carpal/CMC (MC/CMC) combined arthrodesis reduced flexion dramatically to 43° and antebrachiocarpal (ABC) arthrodesis to just 25°, with ABC showing significantly greater restriction than MC/CMC arthrodesis (P < .001 for both). For practitioners, these findings suggest that CMC-only procedures offer a valuable option for distal carpal pathology where preserving proximal carpal motion is desirable, whilst ABC involvement or combined middle carpal disease necessitates accepting substantial flexion loss as an inevitable consequence of stabilisation—important information for prognosticating post-operative movement quality and managing owner expectations.
Read the full abstract on PubMed
Practical Takeaways
- •If preserving carpal flexion is important, CMC-only arthrodesis is preferable as it maintains normal range of motion without functional compromise
- •MC/CMC and ABC arthrodesis should be reserved for cases where severe carpal instability requires these techniques, as both substantially restrict joint mobility
- •Surgical planning must weigh the biomechanical benefit of stability against the loss of functional flexion, particularly in performance horses
Key Findings
- •CMC arthrodesis alone does not significantly reduce carpal flexion (149° ± 9° vs 150° ± 8° control, P = 0.21)
- •MC/CMC arthrodesis markedly reduces flexion to 43° ± 7.6° (P < 0.001)
- •ABC arthrodesis produces greatest restriction with flexion of only 25° ± 6.3° (P < 0.001)
- •ABC arthrodesis significantly reduces flexion more than MC/CMC arthrodesis (P < 0.001)