The carpal joints as a whole act as a ginglymus (hinge) joint stabilized by short extra-articular and intra-articular ligaments, an articular disc (sometimes known as the radioulnar ligament that connects the radius to the ulna), palmar fibrocartilage, and the joint capsule. The intercarpal joints exist between the individual bones of each row. The metacarpophalangeal joint exists between the distal row of carpal bones and the joint surface of the base of the metacarpal bones. The middle carpal joint exists between the proximal and distal rows of carpal bones. 29 The antebrachiocarpal joint occurs between the distal radius and ulna and the proximal row of carpal bones. The carpus is a composite joint composed of all the articulations to which the seven carpal bones contribute. General fracture repair techniques are presented in other chapters, but techniques unique to the carpus, metacarpus, and digits will be addressed in this chapter. In general, fractures that involve joint surfaces, ligament injuries that cause significant instability, and shearing injuries are approached surgically using the same principles applied when those injuries occur in other parts of the skeleton. Although these studies highlight diverse treatment options and theorize causation of the injuries, many questions remain regarding the best clinical approach for treating many of these conditions. The scientific literature regarding treatment options consists primarily of observational studies and biomechanical laboratory studies. Yet the mechanism of injuries to these structures and best treatment options for those injuries in the dog and cat are poorly understood. 29 The manus has a complex anatomy that is well documented and studied. The manus of the canine thoracic limb consists of the carpus, metacarpal bones, phalanges, and associated sesamoid bones. Kapatkin, Tanya Garcia-Nolen and Kei Hayashi Your surgeon will discuss with you which option is best for your fracture.Amy S. There are pros and cons to all treatment options.
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