Jonathan Cheetham1, Alan J Nixon. 1. Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853, USA.
Abstract
OBJECTIVE: To identify sites for arthroscopic access to the palmar aspects of the antebrachiocarpal (AC) and middle carpal (MC) joints, and describe visible carpal bone surfaces for each approach. STUDY DESIGN: Prospective experimental study. ANIMALS: Equine carpi: 16 cadavers, 8 live horses. METHODS: A latex model was used to identify possible sites for arthroscopic access to the palmar aspects of the AC and MC joints. Carpi (n = 24) were examined arthroscopically and arthroscopic access sites and visible carpal bone surfaces were described. RESULTS: Arthroscopic approaches and instrument portals were developed for the medial and lateral aspects of the palmar pouches of the AC and MC joints. The palmar surface of the radial carpal bone and radius, and the dorsal articular surfaces of the accessory carpal bone, could be viewed using palmar approaches to the AC joint. The palmar aspect of the radial, third and second carpal bones (medially) and ulnar and fourth carpal bones (laterally) could be observed using a palmar approach to the MC joint. CONCLUSIONS: Arthroscopic access, using separate medial and lateral portals to the AC and MC joints, allowed assessment of portions of the caudodistal radius, the palmar surfaces of the radial, ulnar, second, third and fourth carpal bones, and the dorsal aspect of the accessory carpal bone. CLINICAL RELEVANCE: Arthroscopic approaches to the palmar aspect of the carpus could be used to remove fracture fragments, and to assess the medial palmar intercarpal ligaments.
OBJECTIVE: To identify sites for arthroscopic access to the palmar aspects of the antebrachiocarpal (AC) and middle carpal (MC) joints, and describe visible carpal bone surfaces for each approach. STUDY DESIGN: Prospective experimental study. ANIMALS: Equine carpi: 16 cadavers, 8 live horses. METHODS: A latex model was used to identify possible sites for arthroscopic access to the palmar aspects of the AC and MC joints. Carpi (n = 24) were examined arthroscopically and arthroscopic access sites and visible carpal bone surfaces were described. RESULTS: Arthroscopic approaches and instrument portals were developed for the medial and lateral aspects of the palmar pouches of the AC and MC joints. The palmar surface of the radial carpal bone and radius, and the dorsal articular surfaces of the accessory carpal bone, could be viewed using palmar approaches to the AC joint. The palmar aspect of the radial, third and second carpal bones (medially) and ulnar and fourth carpal bones (laterally) could be observed using a palmar approach to the MC joint. CONCLUSIONS: Arthroscopic access, using separate medial and lateral portals to the AC and MC joints, allowed assessment of portions of the caudodistal radius, the palmar surfaces of the radial, ulnar, second, third and fourth carpal bones, and the dorsal aspect of the accessory carpal bone. CLINICAL RELEVANCE: Arthroscopic approaches to the palmar aspect of the carpus could be used to remove fracture fragments, and to assess the medial palmar intercarpal ligaments.