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Prevalence and response to surgical treatment of lateral palmar intercarpal ligament avulsion in horses: 37 cases (1990–2001)

Dr. Christopher P. BeinlichDepartment of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
Present address is Valley View Animal Hospital, 2167 Progress St, Dover, OH 44680.

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 DVM, MS
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Dr. Alan J. NixonDepartment of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

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 BVSc, MS, DACVS

Abstract

Objective—To clarify the diagnosis of avulsion of the lateral palmar intercarpal ligament (LPICL), correlate avulsion of this ligament with lameness, determine the prevalence of avulsion of the LPICL in a hospital population, and evaluate the response to surgical removal of the avulsion fragment in horses.

Design—Retrospective study.

Animals—37 horses with avulsion of the LPICL.

Procedure—Medical records and radiographs of horses with avulsion of the LPICL were reviewed; follow-up information was obtained from race records and from owners via a telephone survey.

Results–Of 6,418 horses evaluated for forelimb lameness from March 1, 1990, to December 31, 2001, 37 (0.5%) had avulsion of the LPICL; each horse had a discrete fragment associated with avulsion of the ligament origin from the ulnar carpal bone. Twenty-six horses underwent arthroscopic fragment removal; 20 of 22 (91%) horses for which follow-up information was available returned to work. Of 9 horses treated conservatively, 5 returned to work. Odds ratio calculations indicated that horses treated surgically were 8 times as likely to return to work than those not treated surgically. Twelve horses had LPICL avulsion without concurrent osteochondral fragmentation in the same or additional joints; follow-up information was available for 9 of those horses, of which 8 returned to athletic work.

Conclusions and Clinical Relevance—In horses, discrete avulsion of the LPICL can be a cause of lameness and arthroscopic debridement may be the treatment of choice. Prognosis for return to work of horses with avulsion of the LPICL is good. (J Am Vet Med Assoc 2005;226:760–766)

Abstract

Objective—To clarify the diagnosis of avulsion of the lateral palmar intercarpal ligament (LPICL), correlate avulsion of this ligament with lameness, determine the prevalence of avulsion of the LPICL in a hospital population, and evaluate the response to surgical removal of the avulsion fragment in horses.

Design—Retrospective study.

Animals—37 horses with avulsion of the LPICL.

Procedure—Medical records and radiographs of horses with avulsion of the LPICL were reviewed; follow-up information was obtained from race records and from owners via a telephone survey.

Results–Of 6,418 horses evaluated for forelimb lameness from March 1, 1990, to December 31, 2001, 37 (0.5%) had avulsion of the LPICL; each horse had a discrete fragment associated with avulsion of the ligament origin from the ulnar carpal bone. Twenty-six horses underwent arthroscopic fragment removal; 20 of 22 (91%) horses for which follow-up information was available returned to work. Of 9 horses treated conservatively, 5 returned to work. Odds ratio calculations indicated that horses treated surgically were 8 times as likely to return to work than those not treated surgically. Twelve horses had LPICL avulsion without concurrent osteochondral fragmentation in the same or additional joints; follow-up information was available for 9 of those horses, of which 8 returned to athletic work.

Conclusions and Clinical Relevance—In horses, discrete avulsion of the LPICL can be a cause of lameness and arthroscopic debridement may be the treatment of choice. Prognosis for return to work of horses with avulsion of the LPICL is good. (J Am Vet Med Assoc 2005;226:760–766)