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Veterinary surgery : VS2011; 40(3); 266-271; doi: 10.1111/j.1532-950X.2011.00801.x

Evaluation of a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon in horses.

Abstract: To develop a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT) in horses. Methods: Experimental. Methods: Cadaveric forelimbs (n=10) and 4 forelimbs from 2 horses anesthetized for terminal teaching procedures, and 12 forelimbs of 6 experimental horses. Methods: Saline distention of the carpal flexor sheath facilitated insertion of an arthroscope into the distal medial aspect of the sheath between the AL-DDFT and deep digital flexor tendon (DDFT). Location of an instrument portal on the lateral aspect of the metacarpus was identified with a needle. The lateral aspect of the AL-DDFT was transected and the arthroscope and instrument were switched to transect the remaining fibers on the medial aspect. Cadaveric specimens were dissected for evaluation. Experimental horses were monitored for 30 days postoperatively. Results: Minor complications including incomplete division of the AL-DDFT and shallow incision into the suspensory ligament were observed in some cadaver specimens. The AL-DDFT was completely transected in all experimental horses with no suspensory ligament damage. Mean±SD surgical time (incision to skin closure) was 28.3±11.8 minutes. On ultrasonographic examination, transection of the AL-DDFT was complete in all experimental horses. Minor DDFT fiber disruption was noted in 1 limb during ultrasound examination at day 30. Conclusions: A tenoscopic approach through the carpal flexor sheath provided adequate access for desmotomy of the AL-DDFT.
Publication Date: 2011-03-01 PubMed ID: 21361985DOI: 10.1111/j.1532-950X.2011.00801.xGoogle Scholar: Lookup
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  • Journal Article

Summary

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The research is about exploring a tenoscopic approach to perform desmotomy (surgical cutting) of the accessory ligament of the deep digital flexor tendon in horses. The study finds that this approach, via the carpal flexor sheath, is effective with a mean surgical time of around 28 minutes and minor postoperative complications.

Methods

  • The project was experimental and involved a total of 26 forelimbs of horses. Cadaveric (from dead organisms) forelimbs made 10 of these. Four others were from horses anesthetized for terminal teaching procedures, and 12 were from 6 experimental horses.
  • A technique involving saline distention (filling with a saline solution) of the carpal flexor sheath was used to insert an arthroscope (an instrument for viewing joint interiors) into the distal medial aspect of the sheath between the accessory ligament of the deep digital flexor tendon (AL-DDFT) and the deep digital flexor tendon (DDFT).
  • Identification of an instrument portal on the lateral aspect of the metacarpus was done using a needle.
  • The AL-DDFT was transected (cut across) on its lateral aspect. Subsequently, the arthroscope and instrument were switched to cut across the remaining fibers of AL-DDFT on the medial aspect.
  • The team dissected the Cadaveric specimens for evaluation and monitored the experimental horses postoperatively for 30 days.

Results

  • The observed complications were minor in the cadaver specimens and included an incomplete division of the AL-DDFT and shallow incision into the suspensory ligament. These complications did not occur in the experimental horses.
  • The researchers completed the transection of the AL-DDFT in all experimental horses without causing suspensory ligament damage.
  • From incision to skin closure, the mean surgical time was approximately 28.3±11.8 minutes.
  • Postoperative ultrasonographic examination confirmed complete transection of the AL-DDFT in all experimental horses. Only one limb exhibited minor DDFT fiber disruption at the ultrasound examination 30 days after the surgery.

Conclusion

  • The research concluded that performing desmotomy of the AL-DDFT through a tenoscopic approach via the carpal flexor sheath proved adequate.
  • This method demonstrated a fair surgical duration with minor complications and proved a feasible solution for AL-DDFT desmotomy in horses.

Cite This Article

APA
Caldwell FJ, Waguespack RW. (2011). Evaluation of a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon in horses. Vet Surg, 40(3), 266-271. https://doi.org/10.1111/j.1532-950X.2011.00801.x

Publication

ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 40
Issue: 3
Pages: 266-271

Researcher Affiliations

Caldwell, Fred J
  • Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, 1500 Wire Road, Auburn, AL 36849, USA. caldwfj@auburn.edu
Waguespack, R Wayne

    MeSH Terms

    • Animals
    • Cadaver
    • Forelimb / surgery
    • Horse Diseases / surgery
    • Horses
    • Tendinopathy / surgery
    • Tendinopathy / veterinary

    Citations

    This article has been cited 1 times.
    1. Taintor J, Caldwell F, Almond G. Aseptic tenosynovitis of the carpal flexor sheath caused by rupture of the accessory ligament of the deep digital flexor tendon. Can Vet J 2013 Aug;54(8):765-8.
      pubmed: 24155477