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Carpal Trauma/Breakdown 145

TREATMENT

VetBooks.ir Treatment Overview Diseases and Disorders
The disease is self-limited, and conservative
therapy is appropriate.
Acute and Chronic Treatment
• Enforced rest and exercise have been recom-
mended, with similar results.
• Refractory cases might benefit from a
bandage extending from the elbow to the
paw and with the limb in normal stance
position, maintained for 1 to several weeks.
Nutrition/Diet
Provide a balanced diet; avoid caloric excess
and mineral/vitamin supplementation.

PROGNOSIS & OUTCOME
Even in severe cases, improvement occurs within
a few days to 2 weeks, and recovery is complete
CARPAL FLEXURAL DEFORMITY Severe procurvatum and varus deformity at all levels of the carpus. by the second to fourth week.
PEARLS & CONSIDERATIONS

and with varied severity. Severely affected • One possibility is lack of synchrony between Comments
puppies may stumble when walking. growth of the radius/ulna and the FCU. • Tenotomy of one or both heads of the tendon
• Affected FCU muscle contains more type I of the FCU is therapeutic excess, even in
PHYSICAL EXAM FINDINGS fibers than normal; this may predispose to severely affected animals.
• Characteristic appearance: carpal hyperflexion the condition. • The disorder is remarkable by the contrast
and varus deviation/supination of the manus, between the severity of the deformity
sometimes with weight bearing on the DIAGNOSIS apparent on physical exam and the benign,
lateropalmar surfaces of the digits self-resolving course of the disease process.
• Lameness of varied severity; often worsens with Diagnostic Overview
exercise. In severe cases, affected animals tend Diagnosis is based on signalment, history, and Technician Tips
to lean on the lateral surfaces of the digits. physical findings; radiographs are normal. Reserve bandaging for cases in which improve-
• In mild cases, carpal deviation may be evoked ment has not occurred within 2 weeks. In such
by wheelbarrowing the puppy. Differential Diagnosis cases, check every 5-7 days to reduce risk of
• Carpal effusion and crepitus are absent. Distal radius and ulna deformities (p. 66); carpal hyperextension.
Manipulation of the carpus does not cause ligamentous injury or bone deformity within
pain. The carpus can usually be extended, the carpus SUGGESTED READING
albeit with some difficulty and with increased Çetinkaya MA, et al: Carpal laxity syndrome in
tension within the flexor tendons. Initial Database forty-three puppies. Vet Comp Orthop Traumatol
Radiographs of the antebrachium and carpus: 20:126-130, 2007.
Etiology and Pathophysiology bones, growth plates, and level of mineralization
• Flexor carpi ulnaris (FCU) muscle contrac- should be normal. AUTHOR: Massimo Petazzoni, MV
EDITOR: Kathleen Linn, DVM, MS, DACVS
ture produces the deformity, but its cause is
unknown.

Video
Carpal Trauma/Breakdown Client Education Available
Sheet

BASIC INFORMATION Epidemiology RISK FACTORS

Definition SPECIES, AGE, SEX Racing, agility, or other intense activities; distal
Carpal trauma includes ligamentous (sprain), Dogs > cats; usually adult animals forelimb trauma; obesity; erosive polyarthropathy
fibrocartilaginous (hyperextension), fracture, Clinical Presentation
and shearing injuries. GENETICS, BREED PREDISPOSITION
• Racing greyhounds: radial and accessory DISEASE FORMS/SUBTYPES
Synonyms carpal bone fractures • Sprains
Palmar carpal breakdown, carpal hyperextension • Boxers: radial carpal bone fracture • Fractures

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