34th Annual Scientific Meeting proceedings

Objectives:

Management of carpal fracture is challenging and required accurate diagnosis of the affected structures. Radiography is the first-lined examination for fracture but has well recognized limitations. Computed tomography have been found to detect a higher frequency of carpal fractures than radiographs, making it the diagnostic test of choice. Carpal arthrodesis is the surgical option in case of severe carpal injury but the choice of the technique has to be properly discussed with the owner considering the risk of complications. Our purpose was to report a partial carpal arthrodesis using two Locking Compression Plates (LCP) for the treatment of a complex traumatic comminuted fracture and subluxation of the fourth carpal bone (C4) associated with an angular limb deformity.

Methods:

A one-month-old Paint filly was diagnosed with a dorso-laterodistal subluxation of C4 associated with avulsion fractures of C3 and C4 and rupture of intercarpal ligaments. A CMC arthrodesis was performed using a lateral LCP T-plate and a medial short narrow LCP associated with mediocarpal arthroscopic exploration, debridement and CMC osteostixis to enhance fusion. An external coaptation was maintained for 6 weeks.

Results:

No complication was reported and the filly was sound the day after surgery. Radiographic follow-up was available several weeks after surgery showing an intact construct and a complete fusion of the lateral part of the joint at 14 weeks postoperatively. The filly was sound on pasture without angular deformity by 4 months after surgery.

Conclusions:

Carpal fracture and subluxation of C4 was successfully stabilized by two LCP and an external coaptation device, leading to pasture soundness.