Treatment of chronic digital septic tenosynovitis in 12 horses by modified open annular ligament desmotomy and passive open drainage.

This study explores a modified open annular ligament desmotomy surgery followed by passive open drainage to treat chronic digital septic tenosynovitis in 12 horses caused by injury. Outcomes indicated success with infection control in 11 out of the 12 horses; however, one horse had to be euthanized due to persistent infection and financial reasons.

The Condition and Its Treatment

• The research focuses on treating a horse’s condition named chronic digital septic tenosynovitis. This condition usually results from a form of trauma either open wounds or self-sealing punctures that leads to inflammation and infection in the horse’s tendon sheath.
• As a treatment, the study opted for a surgical procedure called modified open annular ligament desmotomy followed by a process known as passive open drainage. This modified approach enabled the removal of infection carriers and better access to affected areas, consequently ensuring a more successful clean and flushing of the septic tendon sheath.

The Procedure

• The surgical operation involved a complete transection or cutting of the palmar/plantar annular ligament on the horse’s fetlock and the proximal digital annular ligament. This step permitted effective debridement (removal of infected tissue), synovectomy (removal of the affected synovial membrane), and removal of fibrin, a protein involved in blood clotting and wound healing, often present in infections.
• The incision was then partly stitched, leaving a 2 centimeters gap open at the bottom, facilitating passive open drainage, allowing the wound to drain and heal naturally.
• During the surgery, Gentamicin, an antibiotic particularly useful in treating bacterial infections, was given intrathecally, meaning it was administered directly into a space where it could move around fluidly and function promptly.

Post-surgery and Outcome

• After the operation, the horses undertook a recovery treatment regimen that included the use of ceftiofur, an antibiotic drug used on animals, and non-steroidal anti-inflammatory drugs. To protect the wound, a sterile bandage was used until healing completed via the body’s natural process, known as second intention.
• The study showed that out of 12 horses, infection was controlled in 11, and they were able to return to their previous levels of activity. However, one horse had to be euthanized due to the infection’s persistence and due to financial constraints.