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Tenoscopic surgery for treatment of lacerations of the digital flexor tendon sheath.
Abstract: Lacerations to the digital flexor tendon sheath (DFTS) are a common injury in the horse, but little information is available in the literature regarding prognostic indicators. Objective: To ascertain whether laceration of the DFTS carried a better prognosis if treated by tenoscopic lavage, debridement and repair within 36 h of the original injury. Methods: A retrospective analysis of 39 horses treated surgically for lacerations to the DFTS was performed over a 3 year period. The injury-to-surgery interval was recorded as <36 or >36 h. The structures damaged by the injury were also recorded, as well as age, sex, use and outcome. Results: Sixteen horses had laceration and contamination of the DFTS alone, of which 15 (94%) returned to their original or intended use. Sixteen horses had lacerations involving the superficial digital flexor tendon, of which 12 (75%) made a full recovery. Six horses had lacerations to both superficial and deep digital flexor tendons, 5 were subjected to euthanasia intraoperatively and one is paddock sound. Treatment within 36 h of initial laceration carried a significantly better prognosis for return to intended athletic use (25 of 28 horses allowed to recover from anaesthesia) than treatment after 36 h (2 of 5 P = 0.03; Fisher's Exact Test). Conclusions: If sepsis is treated early using tenoscopic visualisation, lavage and repositol antibiotics, the limiting factor in return to athletic function is tendon damage. Conclusions: This study supports anecdotal evidence that early treatment of synovial sepsis improves the prognosis for return to intended use. It also provides information on prognostic indicators including extent of damage to collateral structures.
Publication Date: 2004-10-06 PubMed ID: 15460078DOI: 10.2746/0425164044877396Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
Summary
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This research investigates the impact of prompt surgical intervention on the prognosis of horses suffering from digital flexor tendon sheath (DFTS) lacerations. It concludes that early tenoscopic treatment within 36 hours of the injury improves the chances of a horse returning to its original or intended use, and the prognosis is further shaped by the extent of tendon damage.
Study Background
- Such lacerations are quite common in horses, but there is a lack of comprehensive data in the literature regarding factors that could affect prognosis.
- The objective of this study was to determine whether DFTS lacerations had a better outcome if treated by tenoscopic surgery within 36 hours of the initial injury.
Methods and Participants
- The researchers performed a retrospective analysis of 39 horses, all of which had undergone surgical treatment for DFTS lacerations over a three-year period.
- Several parameters were recorded, including time from injury to surgery, specifics of the injury such as damaged structures, as well as data regarding the horse’s age, sex, use, and the outcome of the treatment.
Results
- The analysis showed that 15 out of 16 horses having an isolated DFTS laceration returned to their original or intended use. Horses having lacerations involving the superficial digital flexor tendon showed a lower full recovery rate (75%).
- When both superficial and deep digital flexor tendons were lacerated, 5 out of 6 horses had to be euthanised, indicating the serious implications of extensive injury.
- Importantly, treatment within 36 hours of the laceration significantly improved prognosis for return to activity, underscoring the value of prompt surgical intervention.
Conclusions
- Early treatment of sepsis arising from such injuries, using tenoscopic visualisation, lavage, and repositol antibiotics can play a critical role in improving the chances of a full return to functional capability.
- Tendon damage is the primary factor limiting a return to athletic function after such an injury.
- These findings thus support anecdotal evidence favouring early treatment, and provide quantitative data on prognostic indicators such as extent of damage to collateral structures.
Cite This Article
APA
Fraser BS, Bladon BM.
(2004).
Tenoscopic surgery for treatment of lacerations of the digital flexor tendon sheath.
Equine Vet J, 36(6), 528-531.
https://doi.org/10.2746/0425164044877396 Publication
Researcher Affiliations
- Donnington Grove Veterinary Surgery, Oxford Road, Newbury, Berkshire RG14 2JB, UK.
MeSH Terms
- Age Factors
- Animals
- Debridement / methods
- Debridement / veterinary
- Endoscopy / veterinary
- Euthanasia, Animal
- Female
- Horses / injuries
- Male
- Prognosis
- Retrospective Studies
- Sex Factors
- Tendon Injuries / surgery
- Tendon Injuries / veterinary
- Tenosynovitis / prevention & control
- Tenosynovitis / veterinary
- Therapeutic Irrigation / methods
- Therapeutic Irrigation / veterinary
- Time Factors
- Treatment Outcome
Citations
This article has been cited 6 times.- Albanese V, Straticò P, Fischer H, Petrizzi L. Equine Distal Limb Wounds: Economic Impact and Short-Term Prognosis of Non-Synovial Versus Synovial Lesions in Southern Germany. Vet Sci 2025 Mar 1;12(3).
- Vajs T, Nekouei O, Biermann NM. A Descriptive Study of the Clinical Presentation, Management, and Outcome of Horses with Acute Soft Tissue Trauma of the Tarsus and the Association with Synovial Involvement. Animals (Basel) 2022 Feb 21;12(4).
- Crosby DE, Labens R, Hughes KJ, Nielsen S, Hilbert BJ. Factors Associated With Survival and Return to Function Following Synovial Infections in Horses. Front Vet Sci 2019;6:367.
- Stack JD, Cousty M, Steele E, Handel I, Lechartier A, Vinardell T, David F. Comparison of Serum Amyloid A Measurements in Equine Synovial Fluid With Routine Diagnostic Methods to Detect Synovial Infection in a Clinical Environment. Front Vet Sci 2019;6:325.
- Isgren CM, Salem SE, Singer ER, Wylie CE, Lipreri G, Graham RJTY, Bladon B, Boswell JC, Fiske-Jackson AR, Mair TS, Rubio-Martínez LM. A multi-centre cohort study investigating the outcome of synovial contamination or sepsis of the calcaneal bursae in horses treated by endoscopic lavage and debridement. Equine Vet J 2020 May;52(3):404-410.
- Robinson CS, Singer ER, Piviani M, Rubio-Martinez LM. Are serum amyloid A or D-lactate useful to diagnose synovial contamination or sepsis in horses?. Vet Rec 2017 Oct 21;181(16):425.
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