{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T17:28:52Z","timestamp":1790270932186,"version":"4.1.0"},"reference-count":26,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T00:00:00Z","timestamp":1649635200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Veterinary Surgery"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To describe the removal of palmar intermediate carpal bone (ICB) fracture fragments using a transthecal approach through the carpal flexor tendon sheath.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study design<\/jats:title><jats:p>Case series.<\/jats:p><\/jats:sec><jats:sec><jats:title>Animals<\/jats:title><jats:p>Four horses with fractures of the palmar aspect of the ICB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Two horses were injured when falling and two during recovery from general anesthesia. Three horses underwent MRI to supplement conventional imaging. Three horses had concurrent fractures of the radial and\/or accessory carpal bones. Conventional proximolateral carpal sheath arthroscope and instrument portals were used, supplemented with a medial instrument portal through the carpal flexor retinaculum to access the palmar carpal ligament. Optimized dissection through the latter was facilitated by needle guidance and radiography. The fragment was dissected from the soft tissue attachments and the palmar ICB fragments retrieved through the carpal sheath in all horses. Surgery time was 85 to 142\u2009min.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Limitations of this technique include a long surgery time and the potential for hemorrhage to impair visibility during surgery. All four horses were discharged 3 to 8\u2009days postoperatively. Three horses returned to full athletic work within 9\u00a0months postoperatively and one horse was euthanized due to persistent lameness.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>A tenoscopic transthecal carpal flexor tendon sheath approach provides access for removal of palmar ICB fracture fragments but should be viewed as an advanced arthroscopic procedure.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical significance<\/jats:title><jats:p>A transthecal approach through the carpal flexor tendon sheath offers an alternative technique for removal of palmar ICB fracture fragments.<\/jats:p><\/jats:sec>","DOI":"10.1111\/vsu.13813","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T09:59:34Z","timestamp":1649671174000},"page":"929-939","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath"],"prefix":"10.1111","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1156-6523","authenticated-orcid":false,"given":"Charlotte L.","family":"Hewitt\u2010Dedman","sequence":"first","affiliation":[{"name":"The University of Edinburgh Royal (Dick) School of Veterinary Studies Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henry D.","family":"O'Neill","sequence":"additional","affiliation":[{"name":"Donnington Grove Equine Hospital Newbury UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce M.","family":"Bladon","sequence":"additional","affiliation":[{"name":"Donnington Grove Equine Hospital Newbury UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,4,11]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.2001.219.801"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7234-3693-5.00004-7"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.228.10.1551"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.2006.00141.x"},{"issue":"4","key":"e_1_2_7_6_1","doi-asserted-by":"crossref","first-page":"553","DOI":"10.2460\/javma.1993.203.04.0553","article-title":"Removal of a fracture fragment from the palmar aspect of the intermediate carpal bone in a horse","volume":"203","author":"Dabareiner RM","year":"1993","journal-title":"J Am Vet Med Assoc"},{"issue":"2","key":"e_1_2_7_7_1","first-page":"301","article-title":"The anatomy of the carpal tendon sheath of the horse","volume":"133","author":"Leach D","year":"1981","journal-title":"J Anat"},{"issue":"8","key":"e_1_2_7_8_1","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.2460\/javma.1997.210.8.1166","article-title":"Lateral approach for endoscopic removal of solitary osteochondromas from the distal radial metaphysis in three horses","volume":"210","author":"Southwood LL","year":"1997","journal-title":"J Am Vet Med Assoc"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-3306.2011.00438.x"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7234-3693-5.00012-6"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/jvet.1999.0099"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.2042-3306.1997.tb03159.x"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-950X.1998.tb00112.x"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/evj.12203"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.2746\/042516403775696294"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.2746\/0425164054223804"},{"key":"e_1_2_7_17_1","first-page":"415","article-title":"Anatomical features of the carpal flexor retinaculum of the horse. 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