Topic:Superficial Digital Flexor Tendon
The Superficial Digital Flexor Tendon (SDFT) in horses is a critical component of the equine musculoskeletal system, primarily responsible for supporting the limb during locomotion. It is located on the back of the leg and extends from the muscle belly in the upper limb to its attachment on the pastern bone in the lower limb. The SDFT is prone to injury due to its high load-bearing function, particularly in performance horses. Injuries to this tendon can result from overuse, sudden trauma, or degenerative changes, leading to conditions such as tendinitis. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, injury mechanisms, and rehabilitation strategies for the Superficial Digital Flexor Tendon in horses.
Comparison of collagen fibril populations in the superficial digital flexor tendons of exercised and nonexercised thoroughbreds. This study was undertaken to test the hypothesis that collagen fibrils, the submicroscopic units of strength in tendon, would hypertrophy in response to a specific defined training programme. Fibril diameters were measured in central and peripheral regions of superficial digital flexor tendon (SDFT) samples from five 18-month-old horses which underwent a subsequent 18 month training programme and 6 age- and sex-matched controls. Central region fibrils from the trained horses had a mass-average diameter (MAD) of 105.3 nm, which was significantly lower (P < 0.01) than that of 131.7 nm for the...
Age-related differences in collagen crimp patterns in the superficial digital flexor tendon core region of untrained horses. To measure collagen fibril crimp angles and lengths as well as collagen fibril mass-average diameters in central and peripheral regions of the superficial digital flexor tendon of wild horses, to ascertain any age-related changes in either region in the absence of imposed galloping exercise. Methods: Measurements from a random cull of wild horses. Methods: Superficial digital flexor tendon samples were taken from 23 wild horses ranging in age from two to ten years. Methods: Horses were divided into 'young' (< 5 years, n = 10), 'middle-aged' (5 to < 10 years, n = 9) and 'ol...
An age-related study of morphology and cross-link composition of collagen fibrils in the digital flexor tendons of young thoroughbred horses. The superficial digital flexor tendon is the most commonly injured tendon in the racing Thoroughbred. Despite the clinical significance of this structure, only limited data exist regarding normal age-related morphology of the tensile units, the collagen fibrils. The age at which these collagen fibrils become mature in composition and structure may be of importance. Consequently, the association of age and collagen fibril crosslink composition, diameter distribution and crimp morphology in the superficial and deep digital flexor tendons of Thoroughbreds up to and including three years of age ha...
Palmaroproximal approach for arthrocentesis of the proximal interphalangeal joint in horses. A technique was developed for arthrocentesis of the palmaroproximal pouch of the pastern joint. The landmark for percutaneous puncture is a 'V' shaped depression formed by the palmar aspect of the proximal phalanx (P1) dorsally, an eminence associated with the attachment of the collateral ligaments to P1 and the middle phalanx distally and the insertion of the lateral branch of the superficial digital flexor tendon palmarodistally. Comparison of arthrocentesis between the palmaroproximal approach and the traditional dorsal approach in 8 cadavers and 8 horses demonstrated that the palmaroproxim...
Segmental variations of in vitro mechanical properties in equine superficial digital flexor tendons. To determine the local variations of mechanical properties of the equine superficial digital flexor tendon (SDFT). Methods: 10 SDFT of adult horses, selected for absence of abnormality. Methods: Needles (with a dark marker at both ends) pinned perpendicularly through each tendon to delimit 7 segments. Each tendon was tested in traction until rupture; test was filmed, using an 8-mm video camera. For each image, the coordinates of the center of mass of each marker and the corresponding force were registered. The third-degree polynomial that best fits the stress-strain curve thus obtained was cal...
Comparison of media and sera used for in vitro culture of equine superficial digital flexor tendon explants. To compare the effects of different commercial nutrient media and sera on protein synthesis and maintenance of cellular density in cultures of the equine superficial digital flexor tendon (SDFT). Methods: 8 healthy 2- to 4-year-old horses. Methods: First Dulbecco's modified Eagle's medium, Ham's F12 nutrient mixture, RPMI 1640 medium, minimum essential medium with Earle's salts, minimum essential medium with Hanks' salts, and a Dulbecco's modified Eagle's medium/Ham's F12 nutrient mixture with 10% fetal bovine serum (FBS) were compared. Then FBS, fetal equine serum, and donor horse serum, each...
Influence of shoeing on ground reaction forces and tendon strains in the forelimbs of ponies. Strains in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament of the deep digital flexor muscle (inferior check ligament [ICL]) and the interosseus medius muscle (suspensory ligament [SL]) in the right forelimb of 5 ponies were measured using mercury-in-silastic strain gauges a few hours after implantation. Tendon strains were recorded at the walk with normal flat shoes, egg-bar shoes, a 7 degrees increased hoof angle accomplished by application of a heel-wedge and a 7 degrees decreased hoof angle using a toe-wedge, consecutively. Ground reactio...
Load redistribution after desmotomy of the accessory ligament of the deep digital flexor tendon in adult horses. An analysis of joint moments was used to study the biomechanical implications, load redistribution and kinematic pattern following desmotomy of the accessory ligament of the deep digital flexor tendon (AL) in adult horses. Recordings of 6 sound horses were made before and 10 days after desmotomy of the AL of the right forelimb at the walk and the trot. Kinematic recordings of the right forelimb and the left distal forelimb were made using the CODA-3 system. Kinetic recordings of the ground reaction forces in both forelimbs were made using a Kistler force plate simultaneously with the kinematic...
Factors affecting the ultrasonic properties of equine digital flexor tendons. The velocity, attenuation and apparent backscattering coefficient of 6-11-MHz ultrasound were measured in three orthogonal directions in equine deep digital flexor (DDF) and superficial digital flexor (SDF) tendons at 0 degree C. Ultrasonic measurements were examined for correlation with tendon water, collagen, DNA and glycosaminoglycans contents, determined by chemical analyses and with structure observed by scanning electron microscopy. The SDF tendon contained more water, more DNA (i.e., more cells), less collagen and less glycosaminoglycans and exhibited lower velocities and attenuations t...
Effect of maturation and aging on material and ultrasonographic properties of equine superficial digital flexor tendon. Results of studies in human beings and other species have indicated that aging significantly influences the strength, modulus of elasticity, and energy storage ability of tendon. We wanted to determine the effects of aging on the material and ultrasonographic properties of equine superficial digital flexor (SDF) tendon. Ultrasonographic measurements of left forelimb SDF tendon cross-sectional area and mean echogenicity were made in 23 standing horses ranging in age from 2 to 23 years. All horses had not been in work for a minimum of 6 months prior to the study. After euthanasia, left forelimb ...
Ultrasonographic cross-sectional area and mean echogenicity of the superficial and deep digital flexor tendons in 50 trained thoroughbred racehorses. Fifty Thoroughbred horses were examined. All horses had been in race training for a minimum of 4 months before examination and had worked at racing speed; 24 horses had raced. All horses were clinically sound at the time of examination. Ultrasonography was performed, using a 7.5-MHz transducer with built-in fluid offset. Videotaped images of the palmar soft tissue structures were obtained at 4, 8, 12, 16, 20 and 24 cm distal to the base of the accessory carpal bone (DACB). Images were digitized, and each image was calibrated. Values for cross-sectional area (CSA) and mean echogenicity (ME) wer...
Ultrasonography as a method to determine tendon cross-sectional area. Ultrasonographic cross sectional area (CSA) measurements of equine superficial digital flexor (SDF) tendon were obtained to determine the feasibility of ultrasonography for CSA measurement of tendon in vivo and in vitro. Ultrasonographic measurements were compared with a more traditional CSA measurement method, ink-blot analysis. In addition, values for ultrasonographic SDF tendon mean echogenicity were obtained in vivo and in vitro. The left forelimb SDF tendons of 23 horses were evaluated ultrasonographically. Cross sectional images were acquired at 4-cm intervals distal to the base of the a...
Tendon, tendon sheath, and ligament injuries in the pastern. The palmar (plantar) aspect of the pastern is an anatomically complex area and an understanding of this is a prerequisite for accurate diagnosis of injuries in this area. The gross and normal ultrasonographic anatomy are described, and injuries of the superficial and deep digital flexor tendons and the digital flexor tendon sheath, the distal sesamoidean ligaments, and the palmar ligaments of the proximal interphalangeal joint are discussed.
Soft tissue injuries of the tarsus. Contrast radiography provides a clear survey of the size, shape, and location of extratendovaginal fluid-filled cavities, distended bursa, and tendon sheaths and demonstrates intersynovial communication. Ultrasonography effectively demonstrates Achilles tendon injury, slippage of the SDFT off the summit of the calcaneus, assorted ligamentous injuries, and cystic or solid extratendovaginal masses. It will also demonstrate distended bursae and tendon sheaths, but it is not as effective in demonstrating a synovial herniation, or a narrow synovial fistula. Contrast radiography may prove to be the ...
Transection of the accessory ligament of the superficial digital flexor tendon for treatment of tendinitis: long term results in 61 standardbred racehorses (1985-1992). Medical records and lifetime race results were obtained for 61 Standardbred racehorses treated consecutively from 1985 to 1992 with transection of the accessory ligament of the superficial digital flexor tendon (AL-SDF) for tendinitis of one or both forelimbs. A clinical diagnosis of tendinitis was confirmed in all cases by ultrasonographic examination. After surgery, 50 (82%) horses raced and 42 (69%) completed 5 or more starts. Eight horses (13%) failed to start and/or complete 5 or more races due to a recurrence of tendinitis. Six (10%) horses did not start and/or complete 5 or more starts ...
Transection of the accessory ligament of the superficial digital flexor muscle for the treatment of superficial digital flexor tendinitis in standardbreds: 40 cases (1988-1992). Medical records of 40 racing Standardbreds with superficial digital flexor tendinitis that underwent transection of the accessory ligament of the superficial digital flexor (SDF) muscle (superior check desmotomy) were reviewed. Surgery was performed bilaterally in 32 horses and unilaterally in 8. Concurrent palmar annular desmotomy was performed in 8 horses in which tendinitis involved the distal metacarpal region and confinement of the deep and SDF tendons by the annular ligament was suspected. Follow-up information was obtained for 32 horses, by telephone, and racing results were available f...
The cross-sectional areas of normal equine digital flexor tendons determined ultrasonographically. Fifty-two animals, comprising 22 Irish Draught crosses (Group A), 15 Thoroughbreds (Group B) and 15 ponies (Group C) were examined ultrasonographically using a 7.5 mHz linear array probe and stand-off pad. All animals were free of tendon disease as determined from clinical and ultrasonographical examination. The superficial (SDFT) and deep (DDFT) digital flexor tendons were scanned at 7 transverse (axial) levels between the carpus and metacarpophalangeal joint. Each transverse image was digitised using a commercially available frame grabber and the cross-sectional areas of each tendon at each ...
Three-dimensional sonographic imaging of the equine superficial digital flexor tendon. In a feasability study, a technique for constructing 3-dimensional sonographic images of the superficial digital flexor tendon (SDFT) was established in 6 clinically normal horses and applied to 7 horses with injured SDFT. Two-dimensional B-mode sonographic images were recorded on videotape as the sonographic transducer was manually moved along the palmar aspect of the metacarpal region. Selected videofields were digitized, and 3-dimensional images were constructed, using a computer work station and dedicated software program. The 3-dimensional images were of high quality and presented qualita...
Superior check ligament desmotomy for treatment of superficial digital flexor tendonitis in thoroughbred and standardbred horses. Bilateral superior check ligament desmotomy was performed on 31 Thoroughbred and 17 Standardbred horses as the sole method of treatment for superficial digital flexor tendonitis. Horses resumed racing between 6 and 19 months after surgery. Horses that were able to compete in 5 or more races without injury to the tendon again were considered to have had a successful return to racing. Twenty-five Thoroughbreds were suitable for later study and 13 of these (52%) raced on 5 or more occasions. Fifteen Standardbreds were suitable for later study and 10 of these (66%) raced on 5 or more occasions. Wi...
Treatment of superficial digital flexor tendinitis. This article reviews the research and clinical findings relevant to the treatment of acute tendinitis in the horse. The goals of treatment are to reduce inflammation, minimize scar tissue formation, and promote restoration of normal tendon function. A wide variety of treatments have and still are being used to treat tendinitis, which indicates that there is no uniformly successful way to return a horse to full athletic function after injury. Therapy depends on the severity of tendinitis and duration of injury and can be divided into treatment during the inflammatory, repair, and maturation pha...
Differential scanning calorimetric studies of superficial digital flexor tendon degeneration in the horse. Differential scanning calorimetry (DSC) of equine superficial digital flexor tendons revealed the presence of a small exothermic peak at 23 degrees C of unknown origin, and a large endothermic peak at 70 degrees C due to denaturation of cross-linked collagen fibres. In the central degenerated core of damaged tendons the denaturation temperature remained at 70 degrees C but the enthalpy decreased in relation to the extent of degeneration of the tendon. We suggest that this reduction in enthalpy is due to depolymerisation and denaturation of the collagen fibres. This contention is supported by t...
Exercise-induced hyperthermia as a possible mechanism for tendon degeneration. Mathematical modelling of tendon thermodynamics predicted that the temperature of the central core of the equine superficial digital flexor tendon would plateau at 11 degrees C above the tendon surface temperature during a sustained gallop. A mean temperature differential (between tendon core and surface) of 5.4 (S.E. +/- 1.0) degrees C was demonstrated in vivo in four horses. Peak intra-tendinous temperatures in the range 43-45 degrees C were recorded. Temperatures above 42.5 degrees C are known to result in fibroblast death in vitro [Hall (1988) Radiobiology for the Radiologist, 3rd Edn., pp...
Ultrasonographic evaluation and long-term follow-up of flexor tendonitis/desmitis in the metacarpal/metatarsal region in Dutch warmblood horses and standardbred racehorses. Over a 2 year-period, the ultrasonographic localization and distribution of flexor tendinous and ligamentous injuries, the long-term follow-up, and the outcome were studied in 101 Dutch Warmblood horses (DW) with a mean age of 8.7 years and in 71 Standardbred racehorses (ST) with a mean age of 5.2 years. The ratio between forelimb and hind limb flexor tendonitis/desmitis in the DW-group was 4:1 and in the ST-group group 4:3. In the DW-group, tendonitis/desmitis of the suspensory ligament (32%), the superficial digital flexor tendon (29%), the distal carpal check ligament (17%) of the forelimb ...
Scintigraphic and ultrasonographic diagnosis of soft tissue injury in a thoroughbred horse. A 2.5-year-old female Thoroughbred horse was referred to the veterinary teaching hospital for right front limb lameness of 1 year duration. Physical examination and diagnostic nerve blocks failed to localize the origin of the lameness. Scintigraphy with 99mTc-MDP suggested increased radionuclide uptake in the palmar metacarpal soft tissues of the right front limb. Ultrasonographic examination revealed hypoechoic lesions in the superficial digital flexor tendon and the suspensory ligament, suggesting tendinitis and desmitis. Combined imaging modalities improved detection and characterization of...
Sonographic brightness of the flexor tendons and ligaments in the metacarpal region of horses. Sonographic observations were made of the image mean gray scale (MGS) of the flexor tendons and ligaments in the left and right metacarpal regions of each of 10 clinically normal horses. In images made in the dorsal and sagittal planes, the MGS was measured at multiple sites in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament (AL), and suspensory ligament (SL), and at single sites in the medial and lateral limbs of the SL, and the palmar ligament. Relative sonographic brightness of each tendon and ligament was calculated by dividing the value ...
Ultrasonographically detected changes in equine superficial digital flexor tendons during the first months of race training. The forelimb superficial digital flexor (SDF) tendons of 6 Thoroughbreds were examined clinically and ultrasonographically during the first 4 months of race training. Sonograms were interpreted clinically and by use of computer-aided analysis. Tendon tissue from all horses was examined histologically at the end of the study. Computer-aided analysis of sonograms of the SDF tendons revealed trends toward an increase in mean cross-sectional area and a decrease in mean echogenicity over time with training. An inverse relation was found between increase in cross-sectional area and decrease in mean ...
Factors affecting the clinical outcome of injuries to the superficial digital flexor tendon in National Hunt and point-to-point racehorses. Ultrasonographic examination was used to define the severity of injuries to the superficial digital flexor tendon in 73 National Hunt or point-to-point racehorses and the factors influencing the outcome of the cases were examined. Thirty-four of the horses (46 per cent) returned to work with an average time out of training of 13.5 months. The rate of recurrence of the injury was 35 per cent. The severity of the lesions was related to the outcome; all the mildly affected horses returned to work, with 63 per cent of them racing and an average time out of training of 10.2 months; 50 per cent of t...
Ultrasonographic observations of the flexor tendons and ligaments of the metacarpal region of horses. Observations were made in dorsal and sagittal planes of the ultrasonographic mean gray scale of the flexor tendons and ligaments of the metacarpal regions of 5 Thoroughbred geldings, during weight bearing and nonweight bearing. In images made when the horses were nonweight bearing, the mean gray scale of the superficial and deep digital flexor tendons and accessory ligament was significantly reduced, but that of the interosseous medius muscle (suspensory ligament) was not. When relaxed, collagen fiber bundles in the tendons and ligaments acted as diffuse, rather than specular, reflectors of ul...