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Veterinary surgery : VS2023; doi: 10.1111/vsu.14065

Ex-vivo evaluation of a percutaneous looped thread desmotomy of the accessory ligament of the deep digital flexor tendon in horses.

Abstract: To determine the ability to completely transect the equine accessory ligament of the deep digital flexor tendon (AL-DDFT) via an ultrasonographically-guided, percutaneous looped thread desmotomy using FiberWire suture as a cutting device. Methods: Ex-vivo study. Methods: A total of 24 normal equine distal forelimb specimens. Methods: Under ultrasonographic guidance, a Jamshidi needle was placed between the suspensory ligament and the AL-DDFT, and between the AL-DDFT and the deep digital flexor tendon, through two stab incisions. FiberWire suture was fed through the needle and looped around the AL-DDFT. Using a sawing motion, the ligament was transected, and the suture exited through the lateral incision. Surgical sites were dissected and assessed for completeness of transection, iatrogenic injuries, and suture remnants. Descriptive statistics were reported. Results: The procedure met the successful criteria in 18/24 (75%) of the limbs. The median surgical time was 11 min (range 7-25). No suture failure or suture remnants were noted in any of the specimens. Complications included iatrogenic injury to the medial and lateral neurovascular bundles in 4/24 and 1/24 specimens, respectively. Conclusions: Complete transection of the AL-DDFT was achieved in 22/24 (92%) of the specimens; however, the neurovascular bundles were injured in 5/24 (21%) of the specimens. Conclusions: A percutaneous looped thread desmotomy of the AL-DDFT can be studied as an alternative technique for use in equine models prior to its clinical use in patients. Additional studies are required to evaluate efficacy and safety in anesthetized or standing horses.
© 2023 American College of Veterinary Surgeons.
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Publication Date: 2023-12-22 PubMed ID: 38140785DOI: 10.1111/vsu.14065Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research study investigates the efficacy of a procedure called percutaneous looped thread desmotomy, a technique used to cut the accessory ligament of the deep digital flexor tendon in horses, using an ultrasonographically-guided process. The overall success rate was high, but there were some incidents of collateral damage to the surrounding neurovascular bundles.

Objective and Methodology

The purpose of the study was to assess the effectiveness of a technique called percutaneous looped thread desmotomy as a means to cut the accessory ligament of the deep digital flexor tendon (AL-DDFT) in horses. This was achieved via ex-vivo testing of 24 normal equine distal forelimb specimens.

The process involved:

  • Placement of a Jamshidi needle between the suspensory ligament and the AL-DDFT, and between the AL-DDFT and the deep digital flexor tendon, via two stab incisions
  • Feeding a FiberWire suture through the needle to loop around the AL-DDFT
  • Transecting the ligament using a sawing motion
  • Extraction of the suture through the lateral incision

Finally, the surgical sites were dissected and inspected for any remnant sutures, completeness of the ligament transection, and any damage inflicted during the process.

Results

The outcomes of the experiment were generally consistent but did yield some complications.

  • Overall, the procedure was successful in 75% of the limbs
  • The median duration of the surgery was 11 minutes, with a range of 7 to 25 minutes
  • No issues with the suture – neither failure nor remnants – were found in any of the samples
  • However, in some cases, there was incidental damage to the medial and lateral neurovascular bundles

Conclusions

The researchers concluded that the technique, percutaneous looped thread desmotomy, was efficient in severing the AL-DDFT in the majority (92%) of the specimens. However, there was a risk observed, with 21% of the samples showing injury to the surrounding neurovascular bundles.

Importantly, the researchers suggested that the technique could potentially serve as an alternative surgical technique in equine models. However, before considering it for clinical application, additional studies are required to ascertain its efficacy and safety in anesthetized or upright horses.

Cite This Article

APA
Orozco Lopez D, Mochal-King C, Fontenot R, O'Shea CM. (2023). Ex-vivo evaluation of a percutaneous looped thread desmotomy of the accessory ligament of the deep digital flexor tendon in horses. Vet Surg. https://doi.org/10.1111/vsu.14065

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Orozco Lopez, David
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Mochal-King, Cathleen
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Fontenot, Robin
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
O'Shea, Caitlin M
  • Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.

Grant Funding

  • 20230101 / Mississippi State University Terri Nusz Endowment for Equine Surgery

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Citations

This article has been cited 1 times.
  1. 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).
    doi: 10.3390/ani14202952pubmed: 39457884google scholar: lookup
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