Abstract
Objective
To determine the ideal location of a medial tenoscopic portal in the equine carpal flexor tendon sheath (CFTS) using contrast computed tomography (CT).
Study design
Experimental cadaver study.
Animals
A total of 20 entire forelimbs from adult Standardbred horses.
Methods
Contrast media diluted in saline was injected into the CFTS from a lateral approach before manually flexing and extending the limb 20 times to disperse the contrast solution. The limbs were placed in lateral recumbency and a capped 21-gauge 1.5 inch needle was placed approximately 5 mm proximal and 32 mm caudal to the palpable distal medial radial physis into the medial aspect of the CFTS. Contrast CT was performed followed by tenoscopy using the conventional lateral approach. Gross dissection was then performed to determine if any damage was caused by needle placement. CT images were reviewed for impingement of intrathecal structures, the cephalic vein (CV) and the flexor carpi radialis tendon (FCRT).
Results
Neither intrathecal nor macroscopic superficial damage was caused by needle placement. Impingement of the FCRT and CV, identified on CT, occurred in seven specimens (35%) and one specimen (5%), respectively.
Conclusion
The location for a medial tenoscopic portal was identified in the current study.
Clinical significance
Establishment of the location of a medial tenoscopic portal may help surgeons improve triangulation, egress and visualization of structures within the carpal sheath.
