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.
Kaneps AJ, Hultgren BD, Riebold TW, Shires GM.Surgical incisions were made in the skin and superficial digital flexor tendons in horses. A low intensity laser therapy device was used to treat the limbs. After laser therapy was completed, skin and superficial digital flexor tendons from incised laser-irradiated, incised-control, and nonincised-control limbs were compared microscopically. Qualitative differences between laser irradiated and nonirradiated tissues were not found. The laser therapy device used in this study may be of insufficient power to affect wound healing.
Valdez H, Clark RG, Hanselka DV.Flexible medical grade carbon fiber was surgically implanted in tenectomized or lacerated superficial and deep digital flexor tendons of 13 horses (7 clinical cases and 6 experimental), ranging in age from 15 months to 10 years and weighing 300 to 500 kg. The 6 experimental horses were euthanatized at 30-, 45-, 60-, and 90-day intervals for gross and histologic evaluation of the results. Three of the experimental horses served as their own controls. Of the 7 clinically affected horses, 3 were euthanatized because they developed laminitis or the wound failed to heal. The remaining 4 horses in t...
Parry DA, Craig AS, Barnes GR.A study has been made of the ultrastructural organization of the collagen fibrils and elastic fibres in tendons and ligaments from horses of ages ranging from 2 months premature to 19 years. Diameter distributions of the collagen fibrils in the common digital extensor tendon, the superficial flexor tendon and the suspensory ligament are unimodal in the foetal tissue and at birth, and at these stages of development the three collagenous tissues are virtually indistinguishable. However, at maturity, the ligament and flexor tendon have bimodal distributions similar to that found for rat-tail tend...
Herrick WC, Kingsbury HB, Lou DY.This paper describes the result of an investigation of strains and strain rates which normally occur in the tendons of the equine foreleg and presents stress-strain curves and moduli for the tendons at these rates. It has previously been demonstrated that resistance to flexion of the joints of the distal part of the equine foreleg is provided by a passive system of tendons and ligaments. It is therefore possible, using a large displacement, high-rate testing machine, to duplicate in the laboratory the strain rates and forces which are normally produced in the tendons of the foreleg of the runn...
Webbon PM.The normal appearance of the superficial (SFT) and deep (DFT) digital flexor tendons was described and the difference between their histological structures was emphasised. Further differences were recognised between different sites from the same tendon and between tendons in the fore and hind limbs of the same animal. Both of the tendons underwent changes with age but although a number of alterations in the histological appearance were described, a particular change, involving a patchy loss of stainable nuclei, was found at the common site of SFT injuries. While this appearance has been seen i...
McIlwraith CW, Fessler JF.The usefulness of inferior check ligament desmotomy as a treatment for acquired tendon contracture in horses was evaluated in 13 cases of deep digital flexor (DDF) contracture and in 3 cases of combined superficial digital flexor (SDF) and DDF contracture. In 8 of 9 cases of DDF contracture in which the dorsal surface of the hoof had not passed beyond being vertical to the ground, the surgical procedure was successful in returning the limb to a normal position and function. Compared with DDF tenotomy, inferior check ligament desmotomy was a superior treatment technique because of decreased pos...
Strömberg B, Tufvesson G.Four autologous tendon grafting techniques, bipedicle, pedicle and free grafts of the deep digital flexor tendon and free grafts from the lateral digital extensor tendon were described. The vascularization and remodelling of the transplant and the reactions in the donor, as well as the recipient tendon, were studied by means of microangiographic and histochemical methods. The results indicated that regardless of the technique used the grafts were revascularized and replaced by a highly orientated and organized tendon. The use of free grafts may therefore be worthwhile in treatment of severe te...
Webbon PM.The results of a survey are presented in which 589 limbs from 206 horses were dissected. In174 of the limbs lesions were found in either the superficial (131) or deep (43) digital flexor tendons. Changes occurring with age were also recorded. The sites of the abnormalities and their macroscopical appearance are described and the value of the results is considered in relation to the diagnosis and the treatment of clinical lesions.
Strömberg B.Thermography is the pictorial representation of infra-red (IR) emission from the surface of an object. IR emission from biological surfaces originates from two principal sources, circulation and metabolism, which are interdepen-dent. Changes in IR emission as recorded by thermography were correlated to changes in local blood circulation (BrAnemark & Nilsson 1969) and to changes in '33Xe disappearance rate (Stromberg & Norberg 1971). In 1969 Stromberg & Tufvesson, using microradiography, demonstrated that there were vascular changes in the superficial flexor tendon (SFT) even before clinical si...
Smith RK.Optimal management of tendon overuse injuries in equine and human athletes should avoid the formation of excessive scar tissue, regenerate normal tendon matrix, and reduce re-injury rates. We hypothesized that the implantation of marrow-derived stromal stem cells (BM-MSCs), in far greater numbers than are present normally within tendon tissue, would synthesize a matrix more closely resembling tendon matrix than scar tissue, and hence increase the capacity to return to performance successfully. This article reviews the technique used clinically in the horse and the current outcome data for hors...
Whitlock D, Garcia TC, Vallance SA, Stover SM.The specific biomechanical circumstances that induce excessive superficial digital flexor tendon (SDFT) strain in horses are unknown. Objective: Carpal joint hyperextension during axial limb loading during the middle of stance disproportionately enhances SDFT strains compared to suspensory ligament (SL) strains. Methods: Superficial digital flexor tendon and SL strains were measured in 7 cadaver limbs during in vitro loading that maintained carpal extension or allowed carpal hyperextension by constraining, or allowing rotation of, the radius during loading conditions that simulated the middle ...
Yuda Y, Kasashima Y, Kuwano A, Sato K, Hattori S, Arai K.Upregulation of hyaluronidase 2 (HYAL2), one of somatic hyaluronidase (HAase), was demonstrated in granulation tissue during the healing of equine superficial digital flexor tendon injuries. The activity of HAase was assessed by hyaluronan (HA)-containing gel zymography and in situ zymography using frozen sections obtained from normal and injured tendon tissues. Elevated HAase activity was identified in the extract from the tendinopathic tissues, with lower levels of the activity in normal tendons. In situ zymography using fluorescently-labeled HA demonstrated HAase activity in the granulation...
Rich AF, Ricci E, Gates S, Hinnigan GJ, Owen KR.A 20-year-old British Warmblood gelding was presented for a progressively worsening right forelimb lameness which developed following an intense dressage training session. Initial ultrasound examination revealed a triangular, intrathecal, hypoechoic region within the superficial digital flexor tendon (SDFT) in the proximal, palmar carpal region distal to the accessory carpal bone (ACB), extending 7cm distally into the proximal metacarpal region. No significant improvement in clinical presentation was observed following an eight-week rehabilitation programme. Repeat ultrasound examination revea...
Blanco ID, Devito LG, Ferreira HN, Araujo GH, Fernandes CB, Alvarenga MA, Landim-Alvarenga FC.This study examined the effect of treating mares with equine pituitary extract (EPE) alone or in combination with hCG on the recovery rate of immature follicles by transvaginal follicular aspiration (ovum pick-up; OPU). Ten normally cycling crossbred mares aged 3-15 years and weighing 350-400 kg were subjected to each of three treatments in a random sequence with each exposure to a new treatment separated by a rest cycle during which a spontaneous ovulation occurred. The treatments were (1) superovulated with 25mg EPE and treated with 2500 IU hCG, (2) superovulation with 25mg EPE, and (3) cont...
Crevier-Denoix N, Robin D, Pourcelot P, Falala S, Holden L, Estoup P, Desquilbet L, Denoix JM, Chateau H.Although beach training is commonly used in horses, limb loading on beach sand has never been investigated. A dynamometric horseshoe (DHS) is well adapted for this purpose. Objective: To compare ground reaction force (GRF) and fetlock kinematics measured in harness trotters on 2 tracks of beach sand with different water content. Methods: Two linear sand tracks were compared: firm wet sand (FWS, 19% moisture) vs. deep wet sand (DWS, 13.5% moisture). Four French trotters (550 ± 22 kg) were used. Their right forelimb was equipped with a DHS and skin markers. Each track was tested 3 times at 7 m/...
Bosch G, van Schie HT, de Groot MW, Cadby JA, van de Lest CH, Barneveld A, van Weeren PR.Tendon injuries are notorious for their slow and functionally inferior healing. Intratendinous application of platelet-rich plasma (PRP) has been reported to stimulate the repair process of tendon injuries, but there is little conclusive evidence for its effectiveness. A placebo-controlled experimental trial was performed to test the hypothesis that a single intratendinous PRP treatment enhances the quality of tendon repair, as evidenced by improved biochemical, biomechanical, and histological tissue properties. In six horses, tendon lesions were created surgically in the Superficial Digital F...
Hagen J, Kojah K, Geiger M.The angulation of the equine fetlock determines the load of associated tendons and probably their predisposition for injuries. However, it is questionable how the individual toe conformation and tendon properties interact with the dorsal metacarpophalangeal joint angle (DMPJ). Data are needed for a tangible evaluation of the equine limb conformation for more specific orthopaedic treatment. The aim was to evaluate the correlation between the DMPJ, toe conformation and cross-sectional area (CSA) of both flexor tendons; the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (...
Takahashi T, Yoshihara E, Mukai K, Ohmura H, Hiraga A.Although the main cause of injury to the superficial digital flexor tendon (SDFT) is assumed to be high intensity loading of the tendon, to date the forces exerted on the SDFT during cantering have never been measured. Objective: To measure the force exerted on the SDFT at walk, trot and canter on a treadmill. Methods: Arthroscopically implantable force probes (AIFP) were implanted in the SDFT of the left and right forelimbs of 8 Thoroughbred horses (480-565 kg). The output of the AIFP was calibrated using the SDFT force calculated by inverse dynamics and an in vitro model of the lower forelim...
Wood AK, Sehgal CM, Reef VB.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...
Caspers MK, Gier CJ, Reesink HL.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...
Carlier S, Depuydt E, Suls M, Bocqué C, Thys J, Vandenberghe A, Martens A, Saunders J, Hellmann K, Braun G, Beerts C, Spaas JH.Mesenchymal stem cells are an innovative therapeutic for various equine orthopaedic diseases, including soft tissue injuries. Objective: To evaluate the safety and efficacy of tenogenic primed equine allogeneic peripheral blood-derived mesenchymal stem cells (tpMSCs) in horses with naturally occurring superficial digital flexor tendon (SDFT) and suspensory ligament (SL) injuries. Methods: Multicentre, blinded, randomised, placebo-controlled clinical trial. Methods: One hundred client-owned horses with SDFT and SL injuries were randomised to receive an intralesional tpMSC (66) or saline (34) in...
Anoushepour A, Eftekhari S, Masoudifard M.Superficial digital flexor tendon (SDFT) plays an important role in the locomotion of the horses with flexion of the limbs. In the hind limb, it passes over the calcaneal bone and attaches to medial and lateral surfaces of calcaneous by two bands of connective tissue; while, the medial band is weaker than the lateral one. Occasionally, severe trauma, over-extension or fracture of the calcaneous may cause rupture of the supportive bands leading to tendon luxation. An 11-year-old Thoroughbred jumping gelding with symptoms of lameness in both legs, after examination by an internal specialist vete...
Lalanne C, Bonilla AG.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 ...
Ripollés-Lobo M, Perdomo-González DI, Azor PJ, Valera M.Abnormalities in hoof shape are usually connected with limb conformation defects. The role of angular hoof deviations is important for longevity in sports competitions and is increasingly recognized as a factor associated with lameness in performance horses. In this paper, we measured the prevalence of four defects related to the angulation of the hoof in the Pura Raza Española horse (PRE): splay-footed forelimb (SFF), pigeon-toed forelimb (PTF), splay-footed rear limb (SFR), and pigeon-toed rear limb (PTR). A total of 51,134 animals were studied, of which only 15.75% did not have any of the ...
Aßmann A, Ohlerth S, Hartmann S, Torgerson P, Bischofberger A.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...
Carlier S, Depuydt E, Van Hecke L, Martens A, Saunders J, Spaas JH.Mesenchymal stem cells provide a valuable treatment option in orthopedic injuries in horses. Unassigned: The aim of this study was to evaluate the hematological, biochemical, immunological and immunomodulatory parameters following intralesional treatment with tenogenic primed equine allogeneic peripheral blood-derived mesenchymal stem cells (tpMSCs) in client-owned horses with naturally occurring superficial digital flexor tendon (SDFT) and suspensory ligament (SL) injuries. Unassigned: The immunogenicity and immunomodulatory capacities of tpMSCs were assessed in a modified mixed lymphocyte re...
Johnson SA, Sikes KJ, Johnson JW, Van Zeeland E, Wist S, Santangelo KS, King MR, Frisbie DD.Low load exercise training with blood flow restriction (BFR) has become increasingly used by human physical therapists to prescribe controlled exercise following orthopaedic injury; its effects on the equine superficial digital flexor tendon (SDFT), however, are unknown. Objective: To investigate outcomes of pressure specific BFR walking exercise on uninjured equine SDFT biomechanics and histomorphology. Methods: Controlled in vivo experiment. Methods: Four forelimbs of four horses were exposed to 40 BFR-walk sessions (10-min interval walking) on a treadmill over a 56-day study period with the...
