Canis ISSN: 2398-2942

Arthrodesis: pancarpal

Introduction

  • To immobilize all 3 levels of the carpal joint by bone fusion, using internal or external fixation, thereby eliminating painful movement.
  • Utilizing a dorsal compression bone plate is treatment of choice (although palmar carpal plating and external fixation have also been described), unless a shear injury is present.
  • See: arthrodesis overview Arthrodesis: overview for all detail except procedure.

Uses

Advantages

  • The presence of infection does not obviate the use of this technique.
    Infection must be controlled in conjunction with surgery.
  • Open injuries with extensive bone and soft tisssue loss can be managed after arthrodesis with the use of external fixators Fracture fixation: external skeletal fixator.

Disadvantages

  • Palmar plating would be more biomechanically sound (tension side of carpus) but technically more difficult than dorsal due to surgical approach through soft tissue elements (muscles, tendons, nerves, blood vessels).
  • Cross pins placed under power → heat necrosis and pin loosening.
  • No access for open wound management with dorsal compression plate because it is necessary to cast limb post-operatively.
  • External skeletal fixation permits access for post-operative wound management but bones are difficult to stabilize.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Generally very good - 74% regain full limb function within 4 months (97% gait improvement) - even when bilateral.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Queen J (2005) Pancarpal arthodesis in the dog. UK Vet 10, 33-41.
  • Li A, Gibson N, Carmicheal S et al (1999) Thirteen pancarpal arthrodeses using 2.7/3.5 mm hybrid dynamic compression plates. Vet Comp Ortho Traum 12 (3), 102-107 VetMedResource.


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