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Tearing of the medial palmar intercarpal ligament in the equine midcarpal joint
Author(s) -
McILWRAITH C. W.
Publication year - 1992
Publication title -
equine veterinary journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.82
H-Index - 87
eISSN - 2042-3306
pISSN - 0425-1644
DOI - 10.1111/j.2042-3306.1992.tb02857.x
Subject(s) - tearing , medicine , ligament , carpal joint , lameness , joint effusion , arthroscopy , anatomy , effusion , surgery , wrist , radiology , materials science , magnetic resonance imaging , composite material
Summary Tearing of the medial palmar intercarpal ligament is described in 45 intercarpal (midcarpal) joints in 42 horses (37 racehorses, 5 non‐racehorses). Of the 37 racehorses, there were 20 Quarter Horses, 14 Thoroughbreds and 3 Standardbreds. The patients had been referred for arthroscopic surgery for removal of osteochondral chip fragments that had been diagnosed radiographically or diagnostic arthroscopy of a persistent carpal problem. The problem was unilateral in 39 horses and bilateral in 3. The presenting clinical signs were lameness and/or persistent synovial effusion. In one instance, the presenting complaint was haemarthrosis. Osteochondral chip fragments were present in the joint affected with tearing in 23 horses. In 6 horses in which osteochondral fragments were present in other joints, the degree of synovial effusion was greatest in the midcarpal joint with ligamentous tearing. In most of the 22 midcarpal joints where carpal chip fragmentation and ligamentous tearing were present concomitantly, the degree of clinical compromise was greater than normally seen with that degree of osteochondral fragmentation. A ligament was designated as torn when a defect was present in the ligament. This usually took the form of frayed fibres suspended in the irrigating solution, presenting a transverse type of defect in the dorsal aspect of the lateral portion of ligament. However, longitudinal tearing was present in 1 case and tearing was noted in the palmar aspect of the ligament in 2 other cases. The shredded fibres were trimmed in most cases and this allowed better definition of the amount of ligament considered to be torn. The degree of damage ranged from 10% to 100% of the width considered to be torn. A total loss of integrity was diagnosed in 2 cases. The degree of tearing was estimated at 70–90% in 6 joints, 50% in 11 joints, 30% in 7 joints, 20–25% in 7 joints, and 10–15% in 9 joints. Long‐term follow‐up was obtained for 31 horses and 17 had successful and 14 unsuccessful results. Of the horses with successful results, 13 were estimated as having 30% or less damage to the ligament and 3 horses with 50% damage to the ligament raced successfully after treatment with intra‐articular corticosteroids. One horse with >30% damage was considered to be successful without the use of intra‐articular corticosteroids. In the 14 horses with unsuccessful results, all but 2 had 50% or more estimated damage to the medial palmar intercarpal ligament. Of the 2 exceptions, 1 had 30% damage but also had a sagittal fracture of the third carpal bone and the second horse's lack of success was considered to be unrelated to the carpus.