Felis ISSN 2398-2950

Arthrodesis: pancarpal

Contributor(s): Joseph Harari, Sorrel Langley-Hobbs

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 the most common treatment method, although medial bone plating and external fixation have also been described.
  • See: arthrodesis overview  Arthrodesis: pancarpal for all detail except procedure.

Uses

  • Hyperextension injury with severe palmar ligament and fibrocartilage damage leading to instability and subluxation:

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 is 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 good. Following arthrodesis cats do not jump as high and they show a reluctance in their willingness to jump or climb.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Guerrero T G, Kalchofner K, Scherrer N et al (2014) The advanced locking plate system (ALPS): a retrospective evaluation in 71 small animal patients. Vet Surg 43 (2), 127-135 PubMed.
  • Calvo I, Farrell M, Chase D, Aisa J, Rayward S, Carmichael S, Keely B et al (2009) Carpal arthrodesis in cats. Vet Comp Ortho Traumatol 22 (6), 498 Link Opens in New Tab.
  • Pucheu B & Duhautois B (2007) Ulnocarpal arthrodesis in a cat. JSAP 48 (9), 518-521 Link Opens in New Tab.
  • Gemmill T J, Clarke S P & Carmichael S (2004) Carpal agenesis in a domestic short haired cat. Vet Comp Ortho Traumatol 17 (3), 163-166 Link Opens in New Tab.
  • Simpson D & Goldsmid S (2000) Pancarpal arthrodesis in a cat: a case report and antomical study. Vet Comp Ortho Traumatol 13 (3), 149-153 Link Opens in New Tab.
  • Okin R (1982) Carpal arthrodesis in a cat with radial nerve damage. Fel Pract 18-20 Link Opens in New Tab.

Other sources of information

  • Voss K, Montavon P M, Langley-Hobbs S J (2009) The Carpus. In:Feline Orthopedics and Musculoskeletal Disease. Montavon P M, Voss K, Langley-Hobbs S J (eds). Saunders Elsevier. pp 385-396.


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