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New perineural injection technique for the lateral palmar nerve in horses
Perineural injection is commonly indicated in the diagnosis of lameness in horses. Unfortunately, the perineural injection of the lateral palmar nerve can lead to inadvertent injection into the carpal synovial sheath, even by experienced veterinarians. This new technique seems to be much safer!

This prospective experimental study was performed on 30 equine cadaver forelimbs.

Each of 3 clinicians injected 0.5 mL of a 1% aqueous solution of new methylene blue as a marker at the medial aspect of the accessory carpal bone of 10 limbs.

Immediately after each injection, the lateral palmar nerve was identified by dissection of and inspected for proximity of dye, and the carpal synovial sheath was inspected for the presence of dye.

Results: New methylene blue solution was observed to surround the nerve (29 limbs) or to lie within 2 mm of it (1 limb). Dye was not found in the carpal synovial sheath of any specimen.

Conclusions: Using this technique, perineural injection of the lateral palmar nerve can be consistently achieved, and the carpal synovial sheath is unlikely to be penetrated by the needle during the procedure.

Thus, the technique described provides an accurate and simple method for perineural injection of the lateral palmar nerve proximal to the origin of its deep branch.

This technique can be used to anesthetize the lateral palmar nerve for diagnosis of pain originating in the palmaroproximal aspect of the metacarpus without risk of inadvertently desensitizing structures within the carpal synovial sheath.


Source: CASTRO, FERNANDO A., SCHUMACHER, JAMES S., PAUWELS, FREDERIK & BLACKFORD, JAMES T. (2005): A New Approach for Perineural Injection of the Lateral Palmar Nerve in the Horse. In: Veterinary Surgery 34 (6), 539-542.





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EQUINE

CT diagnosis of fatigue fracture of Mt 3 in young adult horsesmembers
Two young adult endurance horses were presented for investigation of sudden-onset forelimb lameness during competition. Clinical examination revealed a severe forelimb lameness and pain on palpation of the proximal palmar metacarpal area. Initial radiographic survey of the affected forelimb was unremarkable in both cases. A week of box rest resulted in only a mild improvement in the lameness. A second radiographic examination did not reveal any significant abnormalities. The history is very suspicious for a fracture, especially a fatigue fracture. How was it diagnosed and treated finally?

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