Development of an ultrasound-guided proximo-medial approach for injection of the carpal flexor tendon sheath in horses and comparison with the conventional proximo-lateral ´blind` technique

IF 1.3 3区 农林科学 Q2 VETERINARY SCIENCES
C.A. Dörner , V. Vargas , C.H. Castellón
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引用次数: 0

Abstract

The aim of this prospective case-control study was to describe and implement a reliable, accurate, and straightforward ultrasound-guided proximo-medial approach technique for injecting the carpal flexor tendon sheath in horses. The proximo-medial ultrasound-guided approach for intrathecal access to the carpal canal, as described in this study, was firstly developed on ten cadaveric limbs using an undiluted ionic iodinated contrast medium. Landmarks were identified, and the access point was established. Subsequently, the technique was validated in ten horses, and its efficacy was compared with the proximo-lateral ´blind` technique. For each injection, the following was recorded: successful injection (contrast within the carpal canal), number of attempts, and whether a structure other than the carpal sheath was penetrated. The ´blind` technique had a total accuracy of 70 % (7/10; 95 % confidence interval [CI]: CI 35 %-93 %), with inadvertent injection into the dorso-palmar pouch of the radiocarpal joint, carpal canal surrounding soft tissue, and intravenous injection being the most common issues associated with this approach. In contrast, the ultrasound-guided approach achieved an accuracy of 100 % (10/10; 95 % confidence interval [CI]: 69 %-100 %) for intrasynovial administration of the contrast medium. The ultrasound-guided proximo-medial approach for injecting the carpal sheath is an accurate and technically straightforward technique. This approach should be considered for synoviocentesis of the carpal sheath, particularly in horses with no evident effusion.
超声引导下马腕屈肌腱鞘注射近内侧入路的发展,并与传统的近外侧“盲”技术进行比较。
本前瞻性病例对照研究的目的是描述和实施一种可靠、准确、直接的超声引导近内侧入路技术,用于马腕屈肌腱鞘注射。如本研究所述,近内侧超声引导下鞘内入路进入腕管,首先在10具尸体肢体上使用未稀释的离子碘化造影剂。确定了地标,建立了接入点。随后,在10匹马身上验证了该技术,并将其与近侧“盲”技术进行了比较。对于每次注射,记录以下内容:注射成功(腕管内对比),尝试次数,以及是否穿透腕鞘以外的结构。“盲”技术的总准确率为70% (7/10;95%可信区间[CI]: CI 35%-93%),不小心注射到桡腕关节掌背袋、腕管周围软组织和静脉注射是与该入路相关的最常见问题。相比之下,超声引导入路的准确率为100% (10/10;95%可信区间[CI]: 69%-100%)用于脑内注射造影剂。超声引导的近内侧入路注射腕鞘是一种准确且技术上简单的技术。对于腕鞘滑膜穿刺术,特别是没有明显积液的马,应考虑采用这种方法。
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来源期刊
Journal of Equine Veterinary Science
Journal of Equine Veterinary Science 农林科学-兽医学
CiteScore
2.70
自引率
7.70%
发文量
249
审稿时长
77 days
期刊介绍: Journal of Equine Veterinary Science (JEVS) is an international publication designed for the practicing equine veterinarian, equine researcher, and other equine health care specialist. Published monthly, each issue of JEVS includes original research, reviews, case reports, short communications, and clinical techniques from leaders in the equine veterinary field, covering such topics as laminitis, reproduction, infectious disease, parasitology, behavior, podology, internal medicine, surgery and nutrition.
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