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马的腕掌关节融合术后继发第二腕骨板骨折及腕中关节半脱位

Second carpal bone slab fracture and subluxation of the middle carpal joint in a horse subsequent to arthrodesis of the carpometacarpal joint.

作者信息

MacKay Angela V, Panizzi Luca, Sparks Holly D, Barber Spencer M

机构信息

Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.

出版信息

Vet Surg. 2015 Feb;44(2):242-5. doi: 10.1111/j.1532-950X.2014.12282.x. Epub 2014 Sep 25.

Abstract

OBJECTIVE

To report complications of arthrodesis of the carpometacarpal (CMC) joint using a drilling technique in an adult horse.

STUDY DESIGN

Case report.

ANIMALS

Horse (n = 1).

METHOD

A 12-year-old Quarter Horse mare with CMC osteoarthritis (CMC-OA) had arthrodesis under general anesthesia in right lateral recumbency. Under fluoroscopic guidance, a 4.5 mm drill bit was inserted at 3 drilling sites 5-6 cm into the CMC joint and was fanned 30-45° in the plane of the joint and 5-10° in the long axis of the limb to destroy articular cartilage and expose the subchondral bone.

RESULTS

The horse presented 2 weeks after surgery for severe lameness of the operated limb. A slab fracture of the 2nd carpal bone (C2) and subluxation of the middle carpal (MC) joint was diagnosed. The horse was humanely euthanatized due to poor prognosis.

CONCLUSION

The fanning technique of arthrodesis of the CMC joint may lead to fracture of carpal bones, joint instability, and MC joint subluxation. A balance between articular surface destruction and maintenance of joint stability should be achieved when using this technique.

摘要

目的

报告成年马使用钻孔技术进行腕掌关节(CMC)关节融合术的并发症。

研究设计

病例报告。

动物

马(n = 1)。

方法

一匹12岁的四分之一马母马患有腕掌关节骨关节炎(CMC - OA),在全身麻醉下右侧卧进行关节融合术。在荧光透视引导下,将一个4.5毫米的钻头插入CMC关节内3个钻孔部位,深度为5 - 6厘米,并在关节平面内呈30 - 45°扇形展开,在肢体长轴方向呈5 - 10°扇形展开,以破坏关节软骨并暴露软骨下骨。

结果

术后2周,该马出现手术肢体严重跛行。诊断为第2腕骨(C2)的片状骨折和中腕关节(MC)半脱位。由于预后不良,对该马实施了安乐死。

结论

CMC关节融合术的扇形展开技术可能导致腕骨骨折、关节不稳定和MC关节半脱位。使用该技术时应在关节面破坏和维持关节稳定性之间取得平衡。

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