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

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.