Carpus Hyper Extension

Clinical Intent

This protocol addresses dogs with carpal hyperextension injuries, a condition resulting from failure of the palmar carpal support system, including the palmar radiocarpal ligaments, palmar fibrocartilage, accessory carpal ligament complex, and associated carpal flexor musculotendinous structures. Loss of resistance to terminal stance extension leads to excessive carpal extension during weight-bearing and altered limb mechanics.

Clinical management focuses on protecting injured ligamentous and soft tissue structures, controlling inflammation, and restoring controlled stance stability while preventing progression to structural instability. Conservative rehabilitation emphasizes stabilization of the carpus with a custom orthotic device, gradual restoration of weight-bearing tolerance, and progressive strengthening of the dynamic muscular support system of the thoracic limb.

Clinical evaluation includes assessment of stance stability, gait mechanics, and carpal range of motion, along with systematic palpation of the carpus, distal antebrachium, and carpal flexor musculature to identify associated soft tissue injury or compensatory dysfunction. Diagnostic tools such as stress radiographs and musculoskeletal ultrasound may be used to evaluate ligament integrity, determine injury severity, and guide treatment planning.

This protocol provides a structured, phase-based conservative rehabilitation approach for dogs with Grade I or select Grade II carpal hyperextension injuries and includes an evidence-based orthotic wearing schedule designed to protect healing tissues while allowing gradual progression of functional limb loading during rehabilitation. Structural instability or severe ligament disruption should prompt surgical consultation.