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Desmitis of the accessory ligament of the deep digital flexor tendon in the forelimb: A retrospective case study of 91 horses.
Abstract: 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, history, lameness treatment and follow-up. Success was defined as returning to work. Backward stepwise logistic regression was used to identify variables significantly associated with return to work. Results: Ninety-one horses were included. The mean age was 13.5 years (standard deviation 4.9 years). Thirty-four percent (28/91) of horses were sound at the initial presentation. Sixty-eight percent (62/91) of horses were managed using controlled exercise alone, 28% (29/91) were treated with intra-lesional injection, therapeutic ultrasound, extracorporeal shockwave therapy or desmectomy of the ALDDFT and 3% (3/91) were euthanased without treatment. Sixty-four percent (54/85) of horses returned to work. Horses that were lame at follow-up were less likely to return to work (odds ratio [OR] 107.93, 95% confidence interval [CI] 20.06-580.61, p < 0.001) than those that returned to soundness. Identification of adhesions on ultrasonography was also associated with having reduced odds for return to work when compared to horses without adhesions (OR 0.10, 95% CI 0.01-0.76, p = 0.03). Conclusions: Retrospective nature of the study, the potential of selection bias with regards to follow-up. Conclusions: Sixty-four percent (54/85) of horses returned to work following injury of the ALDDFT. Persistence of lameness and adhesion formation were significantly associated with a poor outcome.
© 2023 The Authors. Equine Veterinary Journal published by John Wiley & Sons Ltd on behalf of EVJ Ltd.
Publication Date: 2023-10-02 PubMed ID: 37783565DOI: 10.1111/evj.14010Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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This research is a retrospective case study of 91 horses with a common injury called desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT). It identifies prognosis and factors affecting the horse’s return to work after the injury. The study concludes that a successful recovery with a return to work is achieved in 64% of cases, with factors like remaining lameness and adhesion formation on ultrasonography linked to a worse outcome.
Study Methodology
- The researchers examined medical records of horses diagnosed with desmitis of ALDDFT from four vet hospitals between January 2000 and December 2018.
- They gathered various data, including details about the horse, its use, its medical history, lameness treatment, and follow-up.
- The team measured success as a return to work after the injury. They used backward stepwise logistic regression to find variables significantly linked to a return to work.
Results
- In total, 91 horses were part of the study. Their average age was 13.5 years old. At the start of the study, 34% of the horses weren’t displaying symptoms.
- Most horses (68% or 62 out of 91) were managed using controlled exercise alone. Around 28% were treated with intra-lesional injection, therapeutic ultrasound, extracorporeal shockwave therapy, or desmectomy of the ALDDFT. A small percentage (3%) were euthanized without treatment.
Outcomes
- From the horses who received treatment (excluding those euthanized), 64% were able to return to work.
- Determining factors were significantly linked to the horse’s ability to work again. Horses that remained lame post-treatment had more chances of not being able to work again. The presence of adhesions on ultrasonography also lessened the success rate.
Conclusion
- The researchers highlighted the study’s retrospective nature and the potential for bias in follow-up selection.
- Despite these limitations, 64% of horses were able to return to work following the treatment of an ALDDFT injury. Continued lameness and the formation of adhesions were associated with poorer outcomes.
Cite This Article
APA
Lynch N, Taylor CJ, McGilvray T, Tucker R, Bathe A, Elliott CRB, Smith RKW.
(2023).
Desmitis of the accessory ligament of the deep digital flexor tendon in the forelimb: A retrospective case study of 91 horses.
Equine Vet J, 56(5), 936-943.
https://doi.org/10.1111/evj.14010 Publication
Researcher Affiliations
- Royal Veterinary College, Hatfield, UK.
- Rossdales Equine Hospital, Newmarket, UK.
- Royal Veterinary College, Hatfield, UK.
- Liphook Equine Hospital, Liphook, UK.
- Rossdales Equine Hospital, Newmarket, UK.
- Lambourn Equine Vets, Lambourn, UK.
- Royal Veterinary College, Hatfield, UK.
MeSH Terms
- Animals
- Horses
- Retrospective Studies
- Horse Diseases / therapy
- Horse Diseases / pathology
- Female
- Male
- Forelimb / pathology
- Ligaments / injuries
- Lameness, Animal
References
This article includes 10 references
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- Becker C. Function and dysfunction of the accessory ligament of the deep digital flexor tendons in horses, PhD thesis. Holland: University of Utrecht. 1996.
- Becker C, Savelberg H, Barnveld A. In vitro mechanical properties of the accessory ligament of the deep digital flexor tendon in horses in relation to age. Equine Vet J 1994;26:454–459.
- Alzola DR, Riggs CM, Gardner DS, Freeman SL. Ultrasonographic scoring system for superficial digital flexor tendon injuries in horses: intra‐ and inter‐rater variability. Vet Rec 2017;24:655–661.
Citations
This article has been cited 1 times.- Eren G, López-Albors O, Guilabert Segura R, Jordan Montesinos J, Latorre R. 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. Animals (Basel) 2024 Oct 14;14(20).
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