A case of carpal intersynovial fistula in a horse.

The study discusses a case of a horse diagnosed with a fistula between its tendon sheaths that was successfully treated with surgical intervention and post-operative care, showing no signs of recurrence after the horse resumed work after two months.

Diagnosis and Radiographic Confirmation

• The horse was suspected of having a fistula, an abnormal connection, between its right extensor carpi radialis tendon sheath and the intercarpal joint. This is a relatively rare condition, which can potentially cause discomfort or limit the horse’s mobility.
• The diagnosis was confirmed using positive contrast radiography. In this procedure, a contrast material, in this case, sodium diatrizoate, is injected into the area of interest to highlight the structures in the imaging.
• Following the injection of the contrast material, the images showed the intercarpal joint and the tendon sheath connected abnormally, thus confirming the fistula.

Surgical Intervention

• Once the diagnosis was confirmed, surgical intervention was chosen as the course of action for treatment. The surgery consisted of the removal of a tag of synovial membrane.
• In addition, the fistula was repaired during the surgery. It’s crucial to note that a successful repair would prevent continued communication between the tendon sheath and the joint, which could cause further complications.

Postoperative Care and Evaluation

• After the surgery, the horse was prescribed mild exercise. This was done to prevent adhesions within the sheath. Adhesions are bands of scar tissue that can form after surgery and limit mobility, so this is a standard measure to deal with them in postoperative care.
• A month after the surgery, the same radiographic procedure was repeated. The imaging showed no continued communication between the joint and tendon sheath, meaning the surgical intervention had been successful.
• The horse showed signs of mild distension of the sheath, which was relieved by aspiration. After another subsequent month of rest, the horse was able to return to work without the distension recurring, deeming the overall procedure successfully carried out.