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Veterinary surgery : VS2016; 45(3); 380-385; doi: 10.1111/vsu.12454

Frequency of Penetration of the Digital Flexor Tendon Sheath and Distal Interphalangeal Joint Using a Direct Endoscopic Approach to the Navicular Bursa in Horses.

Abstract: To evaluate the frequency of inadvertent penetration of the digital flexor tendon sheath (DFTS) and/or distal interphalangeal joint (DIPJ) when using a direct endoscopic approach to the navicular bursa, and to evaluate an alternate direct approach to the navicular bursa. Methods: Cadaveric study. Methods: Equine cadaver limbs (n = 40 for direct; n = 12 for alternate approach). Methods: Four surgeons performed the direct endoscopic approach to the navicular bursa on 10 limbs each. Frequencies of inadvertent synovial penetration and iatrogenic damage were compared between surgeons. Use of an alternate direct approach, adopting a straight parasagittal trajectory, was evaluated by 2 surgeons. Results: Inadvertent synovial penetration occurred in 45% of limbs (DFTS 37.5%; DIPJ 17.5%; and both structures 10%). Successful bursa entry was achieved on the first attempt in 45% of limbs. Significant variation in frequency of inadvertent synovial penetration was observed between surgeons (range 10-80%). Inadvertent synovial penetration did not occur when using the alternate direct technique. Iatrogenic damage to navicular bone fibrocartilage and/or deep digital flexor tendon occurred in 55% of limbs using the direct endoscopic approach and in 0% of limbs using the alternate direct approach. Conclusions: Because of the considerable risk of inadvertent penetration of the DFTS and/or the DIPJ when making a direct endoscopic approach to the navicular bursa, it is advisable to investigate for inadvertent penetration when treating navicular bursa sepsis using a direct approach. The alternate direct technique may reduce the risk of inadvertent penetration; however, the view within the bursa may be restricted.
© 2016 The Authors. Veterinary Surgery published by Wiley Periodicals Inc. on behalf of The American College of Veterinary Surgeons.
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Publication Date: 2016-03-11 PubMed ID: 26971252PubMed Central: PMC5069599DOI: 10.1111/vsu.12454Google Scholar: Lookup
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  • Evaluation Study
  • Journal Article

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 article examines the rate of unintentional damage to horse tendons and joints during veterinarial endoscopic procedures to access the navicular bursa, as well as offering evaluation on a different procedure that could possibly lower such risks.

Objective and Methodology

  • The study aimed to analyze the frequency of unintended penetration of the digital flexor tendon sheath (DFTS) and the distal interphalangeal joint (DIPJ) during a direct endoscopic approach to the navicular bursa in horses.
  • The researchers conducted a cadaveric study using equine limbs – 40 for the direct approach and 12 for an alternative approach.
  • Four surgeons performed the direct approach on ten limbs each, with the frequency of unintentional synovial penetrations and iatrogenic (caused by treatment) damage being compared among the four surgeons.
  • An alternate direct approach, which involves a straight path along the length of the body, was evaluated by two surgeons.

Results

  • Unintentional synovial penetration occurred in 45% of limbs (DFTS in 37.5%, DIPJ in 17.5%, and both structures in 10%).
  • The first attempt to enter the bursa was successful in 45% of limbs.
  • There was significant variation among surgeons, with unintentional synovial penetration rates ranging from 10-80%.
  • No cases of unintended synovial penetration occurred when using the alternate direct technique.
  • The direct endoscopic approach resulted in iatrogenic damage to, for instance, navicular bone fibrocartilage or deep digital flexor tendon, in 55% of limbs, while no such instances occurred when using the alternate direct approach.

Conclusions

  • The researchers concluded that the possibility of inadvertently penetrating the DFTS and/or the DIPJ when using the direct endoscopic approach to the navicular bursa is significantly high.
  • Due to this risk, it is recommended that an investigation for unplanned penetration be carried out when treating navicular bursa sepsis using this direct approach.
  • While the alternate direct technique may be able to reduce the risk of unintended penetration, the view inside the bursa may be limited during the procedure.

Cite This Article

APA
Kane-Smyth J, Taylor SE, García EC, Reardon RJ. (2016). Frequency of Penetration of the Digital Flexor Tendon Sheath and Distal Interphalangeal Joint Using a Direct Endoscopic Approach to the Navicular Bursa in Horses. Vet Surg, 45(3), 380-385. https://doi.org/10.1111/vsu.12454

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 45
Issue: 3
Pages: 380-385

Researcher Affiliations

Kane-Smyth, Justine
  • The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.
Taylor, Sarah Elizabeth
  • The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.
García, Eugenio Cillán
  • The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.
Reardon, Richard J M
  • The Royal (Dick) School of Veterinary Studies, The University of Edinburgh, Edinburgh, United Kingdom.

MeSH Terms

  • Animals
  • Arthroscopy / adverse effects
  • Arthroscopy / veterinary
  • Bursa, Synovial / injuries
  • Bursa, Synovial / surgery
  • Cadaver
  • Female
  • Forelimb / surgery
  • Hindlimb / surgery
  • Horses
  • Iatrogenic Disease / veterinary
  • Male
  • Tarsal Bones / surgery
  • Tendon Injuries / etiology
  • Tendon Injuries / veterinary

References

This article includes 13 references
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