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Deep flexor tendon rupture
Introduction
- Rupture of the deep digital flexor tendon is most commonly in one of two sites:
- Proximally on the caudal aspect of the metatarsus, or
- Distally at the insertion into the distal phalanx.
- Cause:
- Tendon rupture proximal to the fetlock is generally due to direct trauma, such as kicking back onto a sharp object.
- Distal tendon rupture, at the digit, tends to be due to necrosis of the tendon and it's insertion into the distal phalanx.
- Signs:
- Proximal tendon rupture: both digits rotate and the fetlock sinks due to lack of any musculoskeletal support of the digits.
- Distal rupture affects only one claw which rotates with the toe tipping upwards, most often associated with swelling at the heal indicating deep sepsis of the distal phalangeal joint or navicular bursa.
- Diagnosis: clinical signs and obvious rotation of one or more digits.
- Treatment:
- Surgery to attempt repair for proximal rupture.
- Ankylosis of distal phalangeal joint [insert link]or amputation of affected digit if unilateral[insert link]
- Prognosis: reasonable if stability can be achieved successfully.
Pathogenesis
Etiology
- Proximal rupture is most commonly due to an animal kicking back on to a sharp edge such as a shovel or grain bucket etc.
- Deep rupture is invariably preceded by infection and necrosis of the deep digital flexor tendon at the point of insertion on the pyramidal process of the distal phalanx - pedal bone.
Predisposing factors
General
- Distal flexor tendon rupture is predisposed by neglected infection of the distal inter phalangeal joint or navicular bursa which commonly follows solar ulceration.
- Infection at the site of sole ulcer Sole ulcer and sole hemorrhage easily ascends into the navicular bursa, navicular bone or distal inter phalangeal joint which are close to the site of sole ulcer.
Timecourse
- Proximal rupture is generally immediate after the trauma, although may be delayed if the trauma does not entirely sever the tendon but weakens it to the point of failure.
- Distal rupture progresses after neglected sole ulcers, and so may be a gradual process over several days or weeks.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed Papers
- Recent references from PubMed and VetMedResource.
- Anderson D E, St-Jean G, Morin D E et al (1996) Traumatic Flexor Tendon Injuries in 27 Cattle. Vet Surg 25 (4), 320-326 PubMed.