# Case Report: Staged bilateral pancarpal arthrodesis using 3D-printed patient specific guides and customized hybrid plate for severe carpal joint instability associated with chronic inflammatory demyelinating polyneuropathy in a miniature dachshund

## TL;DR

A miniature dachshund with a neurological condition and severe carpal joint instability was successfully treated with 3D-printed surgical guides and a customized plate.

## Contribution

This case report introduces the use of 3D-printed patient-specific guides and a customized hybrid plate for staged bilateral pancarpal arthrodesis in a miniature breed.

## Key findings

- Staged bilateral PCA using 3D-printed guides and a customized plate successfully treated severe carpal instability.
- The procedure resulted in good to excellent functional recovery and quality of life for the patient.
- 3D-printed tools reduced surgical time and improved construct stability in a chondrodystrophic breed.

## Abstract

This clinical case report aims to describe the surgical treatment of a severe bilateral multilevel and multidirectional carpal joint instability associated with chronic inflammatory demyelinating polyneuropathy (CIDP) with staged bilateral pancarpal arthrodesis (PCA) using 3D-printed patient specific guides and customized hybrid plate in a nine-year-old female neutered Dachshund. The dog was presented due to a progressive acute onset of generalized weakness. Neurological examination, blood work, electromyography, muscle, nerve biopsies and treatment responsiveness led to a diagnosis of CIDP. Medical treatment of the CIDP resulted in resolution of muscle weakness, but did not improved the carpal hyperextension, that ultimately ended up in a severe joint instability, requiring bilateral PCA. Staged bilateral PCA using 3D-printed patient specific guides and customized hybrid plate successfully treated the carpal joint instability without associated complications and resulted in a good to excellent return to function and quality of life of the patient. PCA in chondrodystrophic and miniature breeds can be challenging. Using 3D-printed patient specific guides and customized hybrid plate in this case helped in reducing the surgical time, and offering a more stable construct.