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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.
In vivo tendon forces in the forelimb of ponies at the walk, validated by ground reaction force measurements.
Acta anatomica    January 1, 1993   Volume 146, Issue 2-3 162-167 doi: 10.1159/000147439
Jansen MO, van den Bogert AJ, Riemersma DJ, Schamhardt HC.The load distribution over tendinous structures in the equine forelimb was studied by computing forces from in vivo signals of implanted liquid-metal strain gauges in 5 ponies. For validation, these tendon forces were converted to joint moments, which were summed and compared to the calculated joint moments caused by the ground reaction force. Mean peak forces per kilogram body weight (n = 5) amounted to 5.2 N/kg for the superficial digital flexor tendon, 3.8 N/kg for the deep digital flexor tendon, 7.3 N/kg for the distal accessory (check) ligament and 8.4 N/kg for the third interosseous musc...
Ultrasonographic and histopathological findings in equine superficial digital flexor tendon injury.
Equine veterinary journal    January 1, 1993   Volume 25, Issue 1 23-29 doi: 10.1111/j.2042-3306.1993.tb02896.x
Marr CM, McMillan I, Boyd JS, Wright NG, Murray M.The ultrasonographic and histopathological findings in 12 normal and 28 injured superficial digital flexor tendons, with lesions ranging in duration from 2 days to 15 months, were compared. A consistent relationship between the ultrasonographic and histological findings was demonstrated. The echogenicity of lesions, the distinctness of their delineation from the surrounding tissue, and the presence and arrangement of the linear echoes were useful features by which to assess the ultrasonograms. Acute lesions were anechoic, a complex mixture of anechoic and hypoechoic areas, or diffusely hypoech...
Effect of sodium hyaluronate in collagenase-induced superficial digital flexor tendinitis in horses.
American journal of veterinary research    December 1, 1992   Volume 53, Issue 12 2371-2376 
Foland JW, Trotter GW, Powers BE, Wrigley RH, Smith FW.Superficial digital flexor tendinitis was induced in each forelimb of 8 horses by injecting 4,000 U of collagenase into the midmetacarpal region of the tendon. In each horse, each tendon was treated 24 and 96 hours after the collagenase injection with SC injections of sodium hyaluronate (treated limbs) or an equal volume of 0.9% NaCl solution (control limbs). Exercise was restricted for the first 3 weeks of the study, and a controlled exercise program was instituted for the remainder of the study. Horses were evaluated clinically for lameness, tendon swelling, and midmetacarpal limb circumfere...
Functional significance of the morphology and micromechanics of collagen fibres in relation to partial rupture of the superficial digital flexor tendon in racehorses.
Research in veterinary science    November 1, 1992   Volume 53, Issue 3 354-359 doi: 10.1016/0034-5288(92)90139-s
Wilmink J, Wilson AM, Goodship AE.The high incidence of partial rupture of the superficial digital flexor tendor in the equine athlete represents a major cause for concern in the racing industry. Frequently, the lesion is localised to the central core of the tendon. This study tested the hypothesis that the site specific structural failure results from differences in the collagen fibre morphology and associated micromechanics between central and peripheral regions of the tendon. Bundles of collagen fibres were dissected from central and peripheral sites in the mid-metacarpal region of the tendon. Crimp morphology was quantifie...
Bilateral subluxation of the pastern joint in the forelimbs of a foal.
The Veterinary record    July 25, 1992   Volume 131, Issue 4 68-70 doi: 10.1136/vr.131.4.68
Harrison LJ, May SA.A three-month-old foal was presented with subluxation of the proximal interphalangeal joint in both forelimbs. The condition, which was considered to represent an unusual manifestation of breakdown of the suspensory apparatus, appeared to have developed as a consequence of extreme overexertion, 10 days previously. This had resulted in rupture of the palmar supporting structures of the joint; namely, the superficial distal sesamoidean ligament, the insertion of the superficial digital flexor tendon and the palmar joint capsule. Severe laxity of the flexor tendons had been present in the neonata...
Ultrasonographical and pathological studies of equine superficial digital flexor tendons; initial observations, including tissue characterisation by analysis of image grey scale, in a thoroughbred gelding.
Equine veterinary journal    July 1, 1992   Volume 24, Issue 4 318-320 doi: 10.1111/j.2042-3306.1992.tb02844.x
Nicoll RG, Wood AK, Rothwell TL.No abstract available
Microwave thermography: a non-invasive technique for investigation of injury of the superficial digital flexor tendon in the horse.
Equine veterinary journal    July 1, 1992   Volume 24, Issue 4 269-273 doi: 10.1111/j.2042-3306.1992.tb02833.x
Marr CM.Microwave thermographs were recorded from 77 normal horses. In 51% the lowest temperature was recorded in the mid-metacarpal region, and in 41% it was in the distal metacarpal region. The mean temperature of the normal limbs ranged from 25.04 to 37.4 degrees C. Maximum temperature differences between symmetrical points in both forelimbs ranged from 0 to 5.33 degrees C and differences in mean limb temperatures between both forelimbs ranged from 0 to 2.91 degrees C. In 48 horses with acute (less than 4 weeks' duration) injury of the superficial digital flexor tendon (SDFT) (36 unilateral, 12 bil...
The effect of regional nerve blocks on the lameness caused by collagenase induced tendonitis in the midmetacarpal region of the horse: a study using gait analysis, and ultrasonography to determine tendon healing.
Zentralblatt fur Veterinarmedizin. Reihe A    June 1, 1992   Volume 39, Issue 5 349-364 doi: 10.1111/j.1439-0442.1992.tb00192.x
Keg PR, van den Belt AJ, Merkens HW, Barneveld A, Dik KJ.The influence of regional nerve blocks on lameness resulting from tendon injury was studied in six horses. Tendonitis was induced in the midmetacarpal region of the Superficial Digital Flexor Tendon (SDF), Deep Digital Flexor Tendon (DDF) and the Suspensory Ligament (SL) through collagenase injections. The results were evaluated through sequential clinical examinations, ultrasonographic imaging and kinetic gait analysis (force plate) during a period of 144 days post injury and subsequently compared with gross and microscopic findings. The lameness corresponding to the SDF and DDF tendon lesion...
Four forearm flexor muscles of the horse, Equus caballus: anatomy and histochemistry.
Journal of morphology    June 1, 1992   Volume 212, Issue 3 269-280 doi: 10.1002/jmor.1052120306
Hermanson JW, Cobb MA.Two of the forearm flexors of the horse, the superficial and deep digital flexor muscles, are critical to support the digital and fetlock joints, exhibit differing insertions, and are passively supported by the proximal and distal check ligaments, respectively. These two muscles differ in histochemical composition and architecture. The differences are correlated with the different stress levels transmitted through their tendons, and the different frequencies of clinical breakdown that have been reported. Both muscles contain type I and type IIa fibers. A few type IIb fibers occurred in the dee...
Healing of transected equine superficial digital flexor tendons with and without tenorrhaphy.
Veterinary surgery : VS    January 1, 1992   Volume 21, Issue 1 40-46 doi: 10.1111/j.1532-950x.1992.tb00009.x
Jann HW, Good JK, Morgan SJ, Berry A.Healing of transected superficial digital flexor tendons was evaluated mechanically and histologically in eight horses. Tendons sutured with polyglyconate had higher loads at failure than nonsutured tendons at weeks 5 and 9. The tendon stress at failure (force per unit area) was higher in the sutured tendons at week 5 but not at week 9, reflecting the increased size of the scar at week 9. Histologically, scars after tenorrhaphy were consistently more mature than nonsutured tenotomy scars. The mean maturity score for sutured tendons was higher than for nonsutured tendons at weeks 5 and 9. Overa...
Preliminary studies on the vascular anatomy of the equine superficial digital flexor tendon.
Equine veterinary journal    January 1, 1992   Volume 24, Issue 1 46-51 doi: 10.1111/j.2042-3306.1992.tb02778.x
Kraus-Hansen AE, Fackelman GE, Becker C, Williams RM, Pipers FS.The vascular and microvascular anatomy of normal equine superficial digital flexor tendons was studied by dissection of vinyl-perfused specimens and by microangiography on high detail film. The presence of an extensive intratendinous vascular latticework was confirmed, and a 'nutrient artery' described closely associated with the accessory ligament of the superficial digital flexor tendon (proximal check ligament). Circumferential stripping of the paratenon from the tendon to eliminate afferent vessels was performed bilaterally in three horses and unilaterally in a fourth, followed by a treadm...
Desmitis of the accessory ligament of the deep digital flexor tendon: 27 cases (1986-1990).
Equine veterinary journal    November 1, 1991   Volume 23, Issue 6 438-444 doi: 10.1111/j.2042-3306.1991.tb03757.x
Dyson SJ.Desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) was diagnosed in 27 horses between September 1986 and December 1990. The first observed clinical sign in four horses was localised swelling in the proximal metacarpus. Twenty horses became lame suddenly during a work period and most developed swelling within 24 h of exercise. The injury was confirmed by ultrasonographic examination. Ten of 13 horses with uncomplicated desmitis of the ALDDFT resumed full work, within three to nine months of the onset of clinical signs, without recurrence of clinical signs in the perio...
Reciprocal apparatus dysfunction as a cause of severe hind limb lameness in a horse.
Journal of the American Veterinary Medical Association    October 15, 1991   Volume 199, Issue 8 1047-1048 
Reeves MJ, Trotter GW.A 2-year-old Appaloosa mare was admitted because of acute, severe hind limb lameness (grade 4 of 5). The hock could be flexed or extended without influencing the position of the stifle joint, and the fetlock and proximal interphalangeal joints could be extended while the hock was maintained in flexion. The diagnosis was functional loss of the reciprocal apparatus. The differential diagnoses for functional loss of the reciprocal apparatus include disruption of the common calcaneal tendon, the gastrocnemius muscle, the peroneus tertius, or the superficial digital flexor muscle. In this horse, th...
Identification of subclinical tendon injury from ground reaction force analysis.
Equine veterinary journal    July 1, 1991   Volume 23, Issue 4 266-272 doi: 10.1111/j.2042-3306.1991.tb03715.x
Dow SM, Leendertz JA, Silver IA, Goodship AE.In this study a method of analysing ground reaction forces was developed to help in the diagnosis of subclinical flexor tendon injury. A Kistler force plate was used to obtain records from a population of Thoroughbreds in National Hunt training over a period of two years. Characteristic features of the force patterns generated were measured and shown to have low variance, both between horses and over a period of two racing seasons in animals that were sound throughout the trial. Specific changes in the loading pattern of the limb, which correlated with injury of the superficial digital flexor ...
Desmotomy of the accessory ligament of the superficial digital flexor muscle in equine cadaver limbs.
Veterinary surgery : VS    July 1, 1991   Volume 20, Issue 4 245-252 doi: 10.1111/j.1532-950x.1991.tb01254.x
Shoemaker RS, Bertone AL, Mohammad LN, Arms SW.Effects of longitudinal compression before and after transection of the accessory ligament of the superficial digital flexor (SDF) muscle were measured in eight equine cadaver forelimbs. When compression was increased from 890 N to 3115 N, the metacarpophalangeal (MCP) and carpal joints hyperextended 20 degrees and 4 degrees, respectively, and strain in the SDF and deep digital flexor tendons was increased 3.5% and 1.4%, respectively. The accessory ligament did not elongate. Immediately after transection of the accessory ligament at 3115 N load, a 2.8 mm gap formed between the transected ends ...
Ultrasonographic evaluation of fetlock annular ligament constriction in the horse.
Equine veterinary journal    July 1, 1991   Volume 23, Issue 4 285-288 doi: 10.1111/j.2042-3306.1991.tb03719.x
Dik KJ, van den Belt AJ, Keg PR.The diagnosis of restriction of free movement of the flexor tendons through the fetlock canal usually rests on the characteristic clinical appearance of this condition, or airtendography. In a series of seven normal Warmblood horses and 16 diseased horses of various breeds, the efficacy of ultrasonography in the diagnosis of this condition was determined. In normal limbs, the annular ligament is a very thin structure usually not visible on sonograms. In diseased limbs, ultrasonography outlined flexor tendon injury, distension and thickening of the digital sheath, peritendovaginal tissue prolif...
Endoscopy of the digital flexor tendon sheath in horses.
Veterinary surgery : VS    July 1, 1990   Volume 19, Issue 4 266-271 doi: 10.1111/j.1532-950x.1990.tb01182.x
Nixon AJ.An arthroscopic procedure for examination of the digital flexor tendons and tendon sheath was developed in 16 equine limbs and 12 horses. Distension of the tendon sheath and insertion of the arthroscope was accomplished through a cul-de-sac on the palmar or plantar surface of the tendon sheath 1 to 2 cm palmar or plantar to the digital neurovascular structures and between the annular ligament and proximal digital annular ligament. A single arthroscope entry point allowed examination of all regions of the tendon sheath cavity and most surfaces of the digital flexor tendons within the sheath. Di...
A comparison of repair methods for gap healing in equine flexor tendon.
Veterinary surgery : VS    July 1, 1990   Volume 19, Issue 4 254-265 doi: 10.1111/j.1532-950x.1990.tb01181.x
Bertone AL, Stashak TS, Smith FW, Norrdin RW.In nine horses (18 forelimbs), a 3 cm section of superficial digital flexor tendon was removed and the tendons were repaired with immobilization for 6 weeks and (1) no suture (n = 6); (2) a double locking loop tenorrhaphy with carbon fiber (n = 6); or (3) a double locking loop tenorrhaphy with size 2 nylon suture (n = 6). Clinical assessment, gross evaluation, morphometry, histology, and mechanical testing were performed on two limbs from each treatment group at weeks 6, 12, and 24. At weeks 6 and 12, the unsutured tissue was less mature than the tissue sutured with nylon. By week 24, the carb...
What is your diagnosis? Tendinitis of the superficial digital flexor tendon.
Journal of the American Veterinary Medical Association    May 15, 1990   Volume 196, Issue 10 1671-1672 
Strasser S, Solomon B.No abstract available
Clinical experience with quantitative analysis of superficial digital flexor tendon injuries in Thoroughbred and Standardbred racehorses.
The Veterinary clinics of North America. Equine practice    April 1, 1990   Volume 6, Issue 1 129-145 doi: 10.1016/s0749-0739(17)30560-6
Genovese RL, Rantanen NW, Simpson BS, Simpson DM.A method to quantitate as well as to document SDFT pathology has been described. This report indicates that computer-assisted evaluation of SDFT damage can improve the accuracy of prognosis in clinical practice. It would appear that a 3.8 severity rating is a limit past which prognosis for successful racing starts to worsen rapidly.
Mechanical properties of four suture patterns for transected equine tendon repair.
Veterinary surgery : VS    March 1, 1990   Volume 19, Issue 2 102-106 doi: 10.1111/j.1532-950x.1990.tb01149.x
Easley KJ, Stashak TS, Smith FW, Van Slyke G.Thirty-six superficial digital flexor tendons from nine fresh equine cadavers were transected and sutured with size 2 monofilament nylon. Nine tendons were repaired with each of four suture patterns: single-locking loop, double-locking loop, triple-locking loop, or three-loop pulley. The times required for application, tensile strengths, resistance to distraction (gap), and modes of failure were analyzed. The mean times required were: single-locking loop, 3 mins, 15 secs; double-locking loop, 4 mins, 15 secs; triple-locking loop, 10 mins, 50 secs; and three-loop pulley, 4 mins. The double-lock...
Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber in two horses.
Journal of the American Veterinary Medical Association    August 15, 1989   Volume 195, Issue 4 495-498 
Meagher DM, Aldrete AV.Lateral luxation of the superficial digital flexor tendon from the calcaneal tuber occurs in horses as a result of tearing or rupture of the medial retinaculum of the tendon. This report describes the repair of this condition in 2 Thoroughbred race horses, using a surgical technique in which 2 cancellous bone screws were placed in the calcaneus lateral to the tendon, along with suturing the medial retinaculum.
Application of a Hall-effect transducer for measurement of tendon strains in horses.
American journal of veterinary research    July 1, 1989   Volume 50, Issue 7 1089-1095 
Stephens PR, Nunamaker DM, Butterweck DM.Custom-designed Hall-effect strain sensors (HES) were implanted surgically onto the superficial digital flexor tendons of the forelimbs of 4 adult Thoroughbreds. Strains were recorded at various gaits, using a portable amplifer and FM cassette recorder. Strain calculations used the original length (L) as the HES position with the forelimb in the relaxed neutral position during anesthesia. A characteristic deflection in the strain cycle recording was confirmed to correspond to initial hoof contact with the ground (heel strike) by simultaneous recording of weight bearing via a footswitch. Heel s...
Solitary osteochondroma of the radius in three horses.
Journal of the American Veterinary Medical Association    September 1, 1988   Volume 193, Issue 5 563-564 
Held JP, Patton CS, Shires M.Osteochondroma of the distal portion of the radius was diagnosed in 3 horses with a history of lameness and distention of the common tendon sheath of the superficial and deep digital flexor tendons at the level of the carpal canal. In 2 horses, the exostosis was removed through an incision at the caudal border of the lateral digital extensor muscle above the carpal ligament.
Kinetics and kinematics of the equine hind limb: in vivo tendon loads and force plate measurements in ponies.
American journal of veterinary research    August 1, 1988   Volume 49, Issue 8 1344-1352 
Riemersma DJ, Schamhardt HC, Hartman W, Lammertink JL.Loads on the suspensory ligament, deep digital flexor tendon, superficial digital flexor tendon, and long digital extensor tendon of the equine hind limb were determined in ponies by use of implanted strain gauges consisting of silicone rubber tubes filled with mercury. Recordings were made simultaneously with force plate measurements and high-speed film recordings while the ponies were walking. The relationship between strain gauge signals and tendon loads was obtained from tension-strain tests performed after death of the ponies. The suspensory ligament and the 2 digital flexor tendons were ...
Congenital vascular tumours in the skin of horses.
Journal of comparative pathology    May 1, 1987   Volume 97, Issue 3 365-368 doi: 10.1016/0021-9975(87)90103-4
Johnstone AC.Congenital vascular tumours in the skin of the legs of two horses showed histological features at biopsy which were consistent with capillary haemangioma but, at necropsy, one tumour had invaded the superficial digital flexor tendon and was therefore classified as a haemangiosarcoma.
In vitro mechanical properties of equine tendons in relation to cross-sectional area and collagen content.
Research in veterinary science    November 1, 1985   Volume 39, Issue 3 263-270 
Riemersma DJ, Schamhardt HC.The mechanical properties of the deep digital flexor tendon (DDFT), the superficial digital flexor tendon (SDFT) and the suspensory ligament (SL) of the hindlimb of the horse were studied in vitro. The tendons were observed at several morphologically distinct sites. The loaded tendon is homogeneously strained, in spite of large variations in cross-sectional area. Consequently the modulus of elasticity was inversely proportional to the corresponding cross-sectional area and ranged from 738 MPa (megaPascal, N mm-2) to 1398 MPa within the DDFT, from 1000 MPa to 1282 MPa within the SDFT and from 5...
Management of acquired flexural deformity of the metacarpophalangeal joint in Equidae.
Journal of the American Veterinary Medical Association    November 1, 1985   Volume 187, Issue 9 915-918 
Wagner PC, Shires GM, Watrous BJ, Kaneps AJ, Schmotzer WB, Riebold TW.Fifteen horses with flexural deformity of the metacarpophalangeal joint were evaluated and their conditions were designated as mild, moderate, or severe. Evaluations were made on the basis of clinical signs and lesions seen on radiography. Horses with mild deformities were treated with corrective trimming and shoeing; those with moderate deformities were treated with desmotomy of the accessory ligament of the deep digital flexor tendon and corrective shoeing. Desmotomies of the accessory ligaments of both deep and superficial digital flexor tendons were performed on horses severely affected, f...
Healing of surgically created defects in the equine superficial digital flexor tendon: collagen-type transformation and tissue morphologic reorganization.
American journal of veterinary research    October 1, 1985   Volume 46, Issue 10 2091-2096 
Watkins JP, Auer JA, Gay S, Morgan SJ.Full-thickness defects were surgically created in the superficial digital flexor tendons of the front limbs of 20 horses. Tissues formed within the defect were evaluated histologically, and the collagen composition of the tissue was determined by immunofluorescence. Transformation occurred from loose fibrillar areas of types I and III collagen and pericellular types IV and V collagen to dense bundles of type I collagen fibers. Loose fibrillar areas of types I and III collagen were present after 24 weeks. Histologically, in horses killed after 2 weeks, the tissue within the defect was a randoml...
Healing of surgically created defects in the equine superficial digital flexor tendon: effects of pulsing electromagnetic field therapy on collagen-type transformation and tissue morphologic reorganization.
American journal of veterinary research    October 1, 1985   Volume 46, Issue 10 2097-2103 
Watkins JP, Auer JA, Morgan SJ, Gay S.The effect of pulsing electromagnetic field (PEMF) therapy on the healing of surgically created defects in equine superficial digital flexor tendons was evaluated. Defects were created in both front superficial digital flexor tendons of 20 horses. The defect in 1 limb was exposed to a PEMF for 2 hours daily. The other limb served as a control. Histologic and immunofluorescent evaluations were done in horse killed at postsurgical weeks 2, 4, 8, 12, and 24. Therapy with the PEMF significantly (P less than 0.05) delayed the maturation of the tissue formed within the defect at postsurgical weeks 8...