Topic:Deep Digital Flexor Tendon
The Deep Digital Flexor Tendon (DDFT) is a critical structure in the equine limb, extending from the muscles in the upper leg down to the coffin bone in the hoof. It is responsible for flexing the lower limb and plays a significant role in the horse's movement and weight-bearing capabilities. The DDFT runs behind the cannon bone and passes over the navicular bone before attaching to the pedal bone. Injuries to the DDFT can occur due to overuse, trauma, or degenerative changes, often leading to lameness and requiring careful management. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, injury mechanisms, and treatment options related to the Deep Digital Flexor Tendon in horses.
The effect of botulinum toxin injection into the deep digital flexor muscle on foot biomechanics in healthy horses. To examine the effects of botulinum toxin inoculation into the deep digital flexor (DDF) muscle on foot biomechanics. Unassigned: 6 healthy horses were injected with botulinum toxin in the DDF of 1 forelimb. The opposite forelimb was untreated. Ground reaction forces (GRF) were measured using a pressure sensor in regions of interest, including the dorsal hoof wall (toe). The location of the center of pressure (COP) was measured relative to the dorsal hoof wall during static standing and at peak stance during walking. Repeat measurements 3, 7, 14, 28, and 42 days after injection were compared t...
Evaluation of computed tomographic anatomy of the foot in Jeju horses. Foot diseases are common causes of lameness in horses. Computed tomography (CT) is a valuable tool for diagnosing musculoskeletal lesions in horses and providing a detailed evaluation of foot diseases. Objective: The objective of this study was to establish reference ranges related to the feet of normal Jeju horses by measuring the angles and length of the hoof, and the Hounsfield Unit (HU) value of soft tissues in the foot. Methods: Sixteen normal Jeju horses (mean age: 4.25 years; mean body weight: 282.06 kg) without lameness were examined using CT. After CT scanning, the angles and lengths ...
Evaluating the Accuracy of a Vision-Based Algorithm for Groundline Estimation in Trotting Horses Using Multiple Camera Angles. Equine lameness diagnosis largely relies on subjective visual assessments, which can be biased. Although marker-based methods, force plates and inertial measurement units (IMUs) provide objective measurements, they require specialized setups. Vision-based algorithms offer a portable, markerless alternative, but their accuracy needs thorough testing. Objective: To evaluate a custom vision-based algorithm for estimating the groundline across multiple camera angles, including handheld use in horses trotting on a treadmill. Methods: Experimental comparative study. Methods: Eight Standardbred trott...
High-metacarpal deep digital flexor tenotomy and Steward clog shoeing for managing chronic refractory laminitis: A retrospective clinical study. To describe outcomes following high-metacarpal deep digital flexor tenotomy (DDFT) combined with Steward clog application in horses and ponies with refractory chronic laminitis. Methods: Retrospective observational study. Methods: Client-owned horses and ponies (7 horses, 8 ponies) with severe refractory laminitis. Methods: Medical records (2018-2019) were reviewed. All underwent standing high-metacarpal DDFT tenotomy proximal to the accessory ligament (AL-DDFT) junction, followed by customized Steward clogs application. Preoperative assessment included radiography and venography. Postoperativ...
Four-step tenoscopic technique to resect a torn proximal manica flexoria while sparing the mesotendons of the deep digital flexor tendon in 30 horses. To describe a modified two-portal tenoscopic technique for proximal manica flexoria (MF) resection designed to preserve the mesotendons (MTs) of the deep digital flexor tendon (DDFT). Methods: Prospective clinical study. Methods: Client-owned horses (n = 30). Methods: MF resection was performed in four steps: (1) Transection of the lateral attachment of the MF to the superficial digital flexor tendon (SDFT), staying abaxial to the lateral MT; (2) transection of the medial attachment of the MF to the SDFT between the flexor tendons from distal to proximal until reaching the level of the med...
Use of preoperative computed tomography (CT) to plan repair of comminuted fractures of the middle phalanx in six Warmblood horses: Configuration, treatment and long-term outcome. To describe the additional information provided by computed tomography (CT) in planning and assisting repair of comminuted fractures of the middle phalanx (MP) in Warmblood horses. Methods: Case series. Methods: Six adult Warmblood horses. Methods: The case records of horses undergoing CT examination prior to internal fixation of comminuted MP fractures were reviewed. All horses underwent radiographic and preoperative CT examination. A standardized fast protocol (SFP) to assess CT images was used. Surgical repair consisted of fracture repair and proximal interphalangeal joint arthrodesis using...
Cytochrome c oxidase I deep amplicon sequencing for metabarcoding of equine strongyle communities: unexpectedly high Strongylus spp. prevalence in treated horses. Equines are parasitized by complex communities of Strongylidae (Nematoda) comprising multi-species infections. Currently, Cyathostominae are most prevalent, while Strongylus species are only rarely detected. Since eggs and, in most cases, infective larvae cannot be differentiated to species level, except for Strongylus spp., species-specific knowledge of the pathology, epidemiology and ecology of these parasitic nematodes is limited. Reference sequence data for several cyathostomin species are limited or missing. Deep amplicon sequencing of internal transcribed spacer 2 (ITS-2) regions of nema...
The effect of heel elevation on the stiffness gradient index of the digital flexor tendons in the equine forelimb of clinically normal horses. To evaluate the effect of heel elevation on measurement of stiffness gradients by means of acoustoelastography in the digital flexor tendons of clinically normal horses. Unassigned: 15 clinically normal horses. Unassigned: For each horse, stiffness gradient index (SGI) for superficial digital flexor tendons (SDFT) and deep digital flexor tendons (DDFT) were evaluated in both forelimbs at 0, 4 and 8 degrees of heel elevation. Acoustoelastography (AEG) was used for data acquisition at three sites, approximately 6, 12, and 18 cm distal to the accessory carpal bone in the metacarpal region. Lif...
Autologous conditioned serum IRAP efficacy for tendon and ligament injuries in horses: An observational study. Tendon and ligament injuries in equine athletes pose significant challenges, often leading to prolonged recovery, reduced performance, and increased risk of reinjury. Current treatment strategies, including conservative and surgical approaches, have shown limited success in fully restoring tendon integrity. Autologous blood derivatives, such as autologous conditioned serum (ACS), have emerged as potential regenerative therapies. However, the clinical efficacy of ACS in the treatment of equine tendinopathies remains under investigation. Unassigned: This study aimed to compare the clinical outco...
Metabolic heterogeneity exists across equine distal limb tendons and ligaments in healthy, metabolically normal horses. To (1) identify tissue-specific metabolic profiles of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), and suspensory ligament (SL) and (2) evaluate metabolic profile differences in the SDFT, DDFT, and SL between the equine forelimb and hindlimb. Unassigned: 2 SDFT, DDFT, and SL specimens were collected from the forelimbs and hindlimbs of 10 horses of mixed breed, age, and sex that were euthanized for other reasons. One specimen was processed for histology to confirm that there were no underlying soft-tissue pathologies. One specimen was processed for 2 forms of...
Diagnostic performance of ultrasonography, bursography and standing magnetic resonance to detect navicular intrabursal pathology in horses with foot pain. Navicular intrabursal pathology (NIP) is a common cause of forelimb lameness in horses. An accurate diagnosis of which structure is involved is essential for therapy and prognosis. Objective: The study aimed to compare the diagnostic performance of ultrasonography, bursography and standing magnetic resonance (MRI) imaging as diagnostic tools of the proximal NIP using bursoscopy as the gold standard. Methods: Prospective blinded study. Methods: A total of 21 feet from 17 horses were included. The feet underwent ultrasonography, followed by MRI, and thereafter bursography and bursoscopy. The i...
Pharmacological alternatives to oxytetracycline as potential treatment of flexural limb deformities in foals: a preliminary in vitro cell viability and proliferation study. Flexural limb deformities are a widespread condition in foals. Oxytetracycline is a common conservative treatment option with relaxing effects on the muscle-tendon-unit, potentially mediated through a matrix-metalloproteinase (MMP)-inhibitor mechanism. Its high therapeutic dose for this indication, potential negative side effects, and the guidelines for prudent use of antimicrobials make investigating alternatives desirable. In this study, the influence of substances with potentially similar mechanisms of action, however without antimicrobial properties, on viability and proliferation of juven...
Magnetic resonance Imaging for diagnosing and managing deep digital flexor tendinopathy in equine athletes: Insights, advances and future directions. Deep digital flexor (DDF) tendinopathy is a significant cause of lameness and poor performance in equine athletes with substantial implications for their return to athletic performance. Magnetic resonance imaging (MRI) is increasingly integrated into the diagnostic workup of horses with foot pain and has revolutionised the diagnosis and management of these injuries. This review discusses the principles of MRI in the context of deep digital flexor tendon (DDFT) injury, comparing high-field and low-field systems and highlighting the clinical relevance of technical parameters, including field str...
In vivo effects of cold therapy and bandaging on core temperatures of equine superficial and deep digital flexor tendons. To compare core temperatures of superficial and deep digital flexor tendons (SDFT, DDFT) during application of a compression cooling system versus ice boots and during subsequent lower limb bandaging. Methods: Experimental study. Methods: Paired forelimbs of six sedated horses. Methods: Thermocouples were placed in the core of SDFT and DDFT of both front limbs of each horse. A compression cooling system was applied to one front limb and an ice boot was applied to the other front limb for 60 min and then removed for 60 min. Standing bandages were then applied to both front limbs for 60 mi...
Intrathecal enalapril reduces adhesion formation in experimentally induced digital flexor tendon sheath injuries in horses. The objectives of the study were to describe a standing percutaneous adhesion induction model in the digital flexor tendon sheath (DFTS) of horses and to evaluate the effect of intrathecal administration of the angiotensin-converting enzyme (ACE) inhibitor enalapril on tendon healing and adhesion formation. Methods: Randomized, blinded, controlled experimental study. Methods: Eight healthy horses. Methods: A collagenase-induced adhesion model was implemented in the deep digital flexor tendon (DDFT) of both forelimbs under standing ultrasonographic guidance. Daily intrathecal injections of 5 ...
Accessory Ligament of the Deep Digital Flexor Tendon of the Horse Forelimb and Its Relationship with the Superficial Digital Flexor Tendon: A Plastination, Histological, and Morphometry Study. The accessory ligament of the deep digital flexor tendon (AL-DDFT) plays a crucial role in the stay apparatus of the horse. This study aimed to investigate the anatomical relationship between the AL-DDFT, the superficial digital flexor tendon (SDFT), and other structures in the metacarpal region. Sixteen distal forelimbs from eight horses, aged 1 to 6 years, were evaluated through macroscopic, microscopic, and morphometric analyses, utilizing detailed dissection, E12 plastinated sections, and histological analysis. During lateral dissection, a connection was observed between the AL-DDFT and th...
Intra-arterial contrast enhanced computed tomography of the deep digital flexor tendon and palmar veins in the distal forelimb in Jeju horses: Evaluating contrast-enhancing factors. Few studies have investigated the adequate contrast enhancement (CE) evaluation depending on concentration, volume, and rate of administration of contrast media (CM) and the scan parameters in equine contrast enhanced computed tomography (CECT). Objective: To investigate CE of the deep digital flexor tendon (DDFT) and veins depending on the computed tomography (CT) voltage and concentration, volume, and rate of CM administration during intra-arterial CECT of equine distal forelimbs. Methods: In vivo experiments. Methods: Six horses underwent 54 CT scans. First, the CE of DDFT and veins was eva...
Effect of breed, obturator type and surgical experience on tenoscopic portal creation into the digital flexor tendon sheath in horses. To determine the influence of breed (cob [CB] and non-cob [NC]), obturator type and surgical experience on the number of attempts, time taken and iatrogenic damage (ID) created when entering the digital flexor tendon sheath (DFTS) tenoscopically. Methods: Prospective experimental cadaveric study. Methods: A total of 104 cadaver limbs. Methods: An equal number of randomly selected CB and NC limbs were operated using a conical obturator (OB) or a switching stick (SS) by one boarded (BS) and one resident surgeon (RS). Skin measurements, number of attempts and time taken to enter the DFTS were rec...
Equine bone marrow MSC-derived extracellular vesicles mitigate the inflammatory effects of interleukin-1β on navicular tissues in vitro. Safe, efficacious therapy for treating degenerate deep digital flexor tendon (DDFT) and navicular bone fibrocartilage (NBF) in navicular horses is critically necessary. While archetypal orthobiologic therapies for navicular disease are used empirically, their safety and efficacy are unknown. Mesenchymal stem cell-derived extracellular vesicles (EV) may overcome several limitations of current orthobiologic therapies. Objective: To (1) characterise cytokine and growth factor profiles of equine bone marrow mesenchymal stem cell (BM-MSC)-derived extracellular vesicles (BM-EV) and (2) evaluate the ...
Metabarcoding study to reveal the structural community of strongylid nematodes in domesticated horses in Thailand. Mixed strongylid infections significantly impact equine health and performance. Traditional microscopy-based methods exhibit limitations in accurately identifying strongylid species. Nemabiome deep amplicon sequencing approach previously succeeded in describing the strongylid communities in livestock including equids. However, there are no available studies that describe the structural communities of strongylid parasites in horses in Thailand. Therefore, this study was undertaken encompassing the ITS-2 rDNA metabarcoding assay to characterize strongylid species within horse fecal samples colle...
Ex vivo study shows novel, rapid, suture-free tenotomy technique for the equine deep digital flexor tendon. To describe the feasibility of a novel thread-transecting technique for the tenotomy of the equine deep digital flexor tendon (DDFT). Methods: 39 equine distal limb specimens. Methods: Under ultrasonographic guidance, a surgical thread was percutaneously placed around the DDFT through 2 needle punctures (lateral and medial) using a Tuohy needle in equine limbs (22 forelimbs, 17 hindlimbs). The DDFT was transected by a back-and-forth motion of the thread until the loop emerged from the entry puncture site. Each specimen was dissected and assessed for completeness of transection and iatrogenic d...
Presence and size of synovial masses within the navicular bursa correlate well between magnetic resonance imaging and bursoscopy and have a guarded prognosis. Focal hyperintense lesions within the navicular bursa emanating from the dorsal border of the deep digital flexor tendon (DDFT) can be recognised on T1-weighted magnetic resonance images (MRI) and have been attributed to lameness in horses. Removal of these lesions, also referred to as synovial masses, by navicular bursoscopy is currently recommended. Objective: To investigate the correlation between MRI and navicular bursoscopic findings. It is hypothesised that the prognosis following surgery is proportional to the size of the DDFT lesion. Methods: Retrospective analysis of clinical records....
Ex-vivo evaluation of a percutaneous looped thread desmotomy of the accessory ligament of the deep digital flexor tendon in horses. To determine the ability to completely transect the equine accessory ligament of the deep digital flexor tendon (AL-DDFT) via an ultrasonographically-guided, percutaneous looped thread desmotomy using FiberWire suture as a cutting device. Methods: Ex-vivo study. Methods: A total of 24 normal equine distal forelimb specimens. Methods: Under ultrasonographic guidance, a Jamshidi needle was placed between the suspensory ligament and the AL-DDFT, and between the AL-DDFT and the deep digital flexor tendon, through two stab incisions. FiberWire suture was fed through the needle and looped around the...
Does Direct MRI Tenography Improve the Diagnostic Performance of Low-Field MRI to Identify Artificially Created Soft-Tissue Lesions within the Equine Cadaveric Digital Flexor Tendon Sheath? Tenosynovitis of the digital flexor tendon sheath (DFTS) is diagnosed using ultrasonography and contrast tenography. Nevertheless, making a precise preoperative diagnosis is challenging. This study aimed to determine and compare the sensitivity and specificity of low-field MRI and MRI tenography (MRIt) to detect artificially created soft-tissue lesions in the DFTS. In 21 DFTSs, 118 lesions were made tenoscopically in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), manica flexoria (MF) and proximal scutum. MRI and MRI, following intrathecal gadolinium administra...
Minimally invasive ultrasound-assisted cutting thread tenotomy of the deep digital flexor tendon in horses: An ex vivo study. To evaluate the feasibility and limitations associated with a minimally invasive ultrasound-assisted cutting thread technique for tenotomy of the deep digital flexor tendon (DDFT) in horses. Methods: Ex vivo study. Methods: Twenty cadaveric forelimbs. Methods: Forelimbs were placed on a jig to mimic a standing semiflexed position and the midmetacarpal region was prepared to perform tenotomy of the DDFT using a percutaneous technique with a cutting thread. For that purpose, the thread was placed percutaneously around the DDFT (first dorsally and then palmarly) with the aid of a curved 20 gauge ...
Desmitis of the accessory ligament of the deep digital flexor tendon in the forelimb: A retrospective case study of 91 horses. Desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) is a commonly reported injury. Despite the commonality of this injury, the literature is limited to small case series, with the reported success following treatment varying from 18% to 75%. Objective: To identify the prognosis and factors associated with a return to work following ALDDFT injury. Methods: Retrospective case series. Methods: Medical records of horses from four equine hospitals (January 2000 and December 2018) with a diagnosis of desmitis of ALDDFT were reviewed. Data retrieved included case detail, use...
Equine non-septic tenosynovitis: A systematic literature review of site-specific pathological lesions, outcomes and surgical complications. Non-septic tenosynovitis is a clinically relevant and often performance limiting musculoskeletal injury in the horse. Objective: To review the published literature to determine which tendon sheaths are commonly affected by non-septic tenosynovitis and to describe the most frequently reported pathological lesions, outcomes, and surgical complications in equine non-septic tenosynovitis. Methods: Systematic review. Methods: Literature searches were conducted in July 2021 from the online search engines PubMed, Scopus, Web of Science Core, VetMed Resource and ProQuest Theses & Dissertations. Th...
Macrophage phenotype impacts in vitro equine intrasynovial deep digital flexor tenocyte matrix metalloproteinase gene expression and secretion. To investigate matrix metalloproteinase (MMP) and their inhibitors tissue inhibitor matrix metalloproteinase (TIMP) gene expression and secretion during equine deep digital flexor tendon (DDFT) tenocyte and macrophage (undifferentiated, proinflammatory, and regulatory) co-culture. Methods: Third passage DDF tenocytes and donor-matched macrophages differentiated from peripheral blood CD14+ monocytes from 5 healthy horses ages 9-11 years, euthanized for reasons unrelated to musculoskeletal conditions. Methods: Passage 3 DDT tenocyte aggregate cultures were co-cultured with undifferentiated (cont...
Comparison of Ultrasound and Magnetic Resonance Imaging for Identifying Soft Tissue Abnormalities in the Palmar Aspect of the Equine Digit. Damage to the soft tissue structures of the digit is a common source of equine lameness. While magnetic resonance imaging (MRI) allows for the most complete diagnostic imaging of the equine digit, ultrasound is more readily available and less expensive. This prospective diagnostic accuracy study compares ultrasound to MRI for the diagnosis of injuries visible with ultrasound within the digit, including the deep digital flexor tendon (DDFT), collateral sesamoidean ligament (CSL), and navicular bursa. Clinical patients underwent an MRI of the digit and a blinded ultrasound of the digit between t...
Contrast administration via ultrasound-guided injection of the cranial tibial artery results in contrast enhancement of the soft tissues of the metatarsus in horses undergoing CT. Delivery of mesenchymal stem cells (MSC) via intravascular techniques to treat diffuse and/or inaccessible soft tissue injuries has grown in popularity. The purpose of the current prospective, analytical pilot study was to utilize CT to validate this novel technique and provide additional evidence to support its use for injectate delivery to specific soft tissue structures. Of particular interest was the proximal suspensory ligament, which presents a challenging injection target. Six adult horses without lameness underwent CT of the distal hindlimbs. Scans were obtained prior to ultrasound-gui...