equis - Articles
Flexor tendon: trauma
Introduction
- Potentially catastrophic injury → loss of limb stability.
- Cause: trauma - contact with sharp object.
- Signs: external wound (may be small), altered limb stability, eg dropped fetlock, elevated toe, dropped tarsus.
- Diagnosis: sterile palpation Musculoskeletal: physical examination - adult, radiography Forelimb: radiography Hindlimb: radiography, synovial fluid assessment Synovial fluid: collection; surgical exploration, ultrasonography depending on degree of external trauma Ultrasonography: flexor tendon.
- Treatment: for wound; immobilization, eg Robert Jones bandage Musculoskeletal: Robert Jones bandage; surgical repair, cast Musculoskeletal: external fixation - casts; extended heel shoe
. - Prognosis: fair to poor for athletic function, depending on extent of damage.
Presenting signs
- Dropped joint.
- Acute, severe lameness.
- Superficial wound to back of fetlock/metacarpus/metatarsus/carpus/tarsus.
Acute presentation
- Abrupt change is comfort and lameness.
- Degree of lameness can vary from lame at a walk to non-weightbearing.
Pathogenesis
Etiology
- Trauma:
- Over-reach.
- Direct kick.
- Kicking out at gates, metal sheeting.
- Rolling and hitting sharp object.
Pathophysiology
- Traumatic laceration at back of foot/limb → severance of flexor tendon(s) → loss of weight bearing capacity and stay apparatus → loss of limb stability → hyperextension of joint.
- Hyperextension → tension and tearing of digital vessels and nerves → possible loss of digital arterial supply → limits healing capacity and → digital necrosis.
- Partial thickness tear can → full thickness with weightbearing.
- Calcaneal tendon:
- Partial thickness tear can → full thickness with weight bearing.
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.
- Everett E, Barrett J G & DeVita R (2012) Biomechanical testing of a novel suture pattern for repair of equine tendon lacerations. Vet Surg 41 (2), 278-285 PubMed.
- Jordana M, Wilderians H, Boswell J et al (2011) Outcome after lacerations of the superficial and deep digital flexor tendons, suspensory ligament and/or distal sesamoidean ligaments in 106 horses. Vet Surg 40 (3), 277-283 PubMed.
- Whitfield-Cargile C, Dabareiner R M & Sustaire D (2011) Use of a fetlock support brace to manage lacerations of equine flexor tendons. Equine Vet Educ 23 (1), 46-52 VetMedResource.
- Kidd J A, Voute L C & Hewetson M (2004) Rupture of the flexor tendons of a horse secondary to a non-responsive digital sheath sepsis. Vet Rec 155 (7), 201-204 PubMed.
- Valdes-Vasquez M A et al (1996) Evaluation of an autologus tendon graft repair method for gap healing of the deep digital flexor tendon in horses. Vet Surg 25, 342-350 PubMed.
- Taylor D S et al (1995) Digital flexor tendon lacerations in horses; 50 cases (1975-1990). JAVMA 206 (3), 342-346 PubMed.
- Gaughan E M et al (1995) The influence of sequential intratendinous sodium hyaluronate on tendon healing in horses. Vet Comp Ortho Trauma 8, 40-45 VetMedResource.
- Easley K J et al (1990) Mechanical properties of four suture patterns for transected equine tendon repair. Vet Surg 19, 102-106 PubMed.
Other sources of information
- Watkins J P et al (1999) Tendon and Ligament Disorders. In: Equine Surgery. Ed: Aver J A & Stick J A. W B Saunders Co, USA. pp 111-115.