Septic tenosynovitis and focal osteomyelitis of the lateral proximal sesamoid bone in a thoroughbred gelding.

This study discusses the diagnosis and successful surgical management of chronic septic tenosynovitis and related bone infection in a thoroughbred horse.

Study Overview

• This research article details the clinical case of a seven-year-old thoroughbred gelding diagnosed with chronic septic tenosynovitis and focal osteomyelitis of the lateral proximal sesamoid bone.
• The condition was managed surgically through open annular ligament desmotomy and curettage of the impacted sesamoid.
• The study highlights the methodologies, treatments, and eventual resolution of sepsis in the horse, allowing the animal to return to full work.

Diagnosis

• The thoroughbred horse was diagnosed with chronic septic tenosynovitis, a serious bacterial infection involving the tendon sheaths, and focal osteomyelitis, a localized infection in the bone.
• The affected bone was the lateral proximal sesamoid bone, a small bone within the horse’s lower leg.
• The diagnosis was likely made through a combination of physical examination, symptom evaluation and possibly imaging studies to identify the extent of the infection.

Surgical Management

• To address the infection, the horse underwent open annular ligament desmotomy, a surgical procedure that involves cutting the ligament to relieve restrictive pressure.
• Curettage of the affected sesamoid was also performed. This entails scooping out the infected or destroyed bone and tissue.
• Postoperatively, the area was thoroughly flushed or lavaged, an essential measure to cleanse the area, helping prevent further infection.

Postoperative Care and Result

• After surgery, an incisional wound was left with a small 2cm gap at the base to allow for drainage. This is a standard postoperative practice in such surgeries to facilitate the release of any build-up of infection or fluid within the wound.
• The lower leg was then bandaged and the horse was treated with a regimen of antibiotics to combat the infection and non-steroidal anti-inflammatory drugs to manage pain and inflammation.
• The study reported resolution of sepsis and a gradual return of the horse to full strength, indicating the success of the diagnosis, surgical approach, and postoperative management.