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Navicular bursa: bursoscopy
Introduction
- Bursoscopy has only been used in a limited number of anatomical bursae in the horse Bursoscopy: overview .
- Bursoscopy of the navicular bursa is an important technique in the diagnosis and treatment of conditions affecting this structure.
Uses
- To examine the:
- Fibrocartilage on the flexor surface of the navicular bone.
- Navicular bursa.
- Dorsal surface of the deep digital flexor tendon (DDFT).
- Distal sesamoidean impar ligament (limited view)
- To identify and treat:
- Adhesions between the DDFT and the palmar aspect of the navicular bone.
- Thinning or full-thickness erosion of the flexor fibrocartilage of the navicular bone.
- Fibrillation and tears of the dorsal aspect of the DDFT Deep digital flexor tendon: tendinitis .
- Synovitis of the navicular bursa.
- Tears in the distal sesamoidean impar ligament Foot: laminitis .
- Penetrating wounds and contamination of the bursa Navicular bursa: puncture .
- technique of choice for treatment of infectious navicular bursitis.
Advantages
- Minimally invasive.
- Increased visualization.
- Multiple bursoscopies can be performed.
- Good cosmetic appearance following surgery.
- Reduced convalescence.
- Better prognosis for return to previous level of performance (and beyond) vs Street-nail procedure Foot: street-nail procedure /surgical bursotomy.
Disadvantages
- Expensive equipment.
- High levels of surgical expertise, knowledge and experience of technique required.
Alternative techniques
- MRI Magnetic resonance imaging .
- Infectious bursitis: Street-nail procedure Foot: street-nail procedure for chronic bursitis or extensive damage to podotrochlear structures.
Time required
Preparation
- Induction of anesthesia Anesthesia: induction - overview and aseptic preparation.
Procedure
- Depends on whether diagnostic and/or surgical procedures are undertaken: 30-120 min.
Decision taking
Criteria for choosing test
- Identification on radiography, scintigraphy, ultrasound or MRI of lesion amenable to bursoscopic surgery.
- Lameness localized to navicular bursa by intrabursal anesthesia Navicular bursa: injection +/- absence of conclusive diagnosis.
- Navicular bursa penetration.
Requirements
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Preparation
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Technique
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Aftercare
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Smith M R & Wright I M (2012) Endoscopic evaluation of the navicular bursa: Observations, treatment and outcome in 92 cases with identified pathology. Equine Vet J 44 (3), 339-345 PubMed.
- Haupt J L & Caron J P (2010) Navicular bursoscopy in the horse: a comparative study. Vet Surg 39, 742-747 PubMed.
- Smith M R W, Wright I M & Smith R K W (2007) Endoscopic assessment and treatment of lesions of the deep digital flexor tendon in the navicular bursae of 20 lame horses. Equine Vet J 38 (1), 18-24 PubMed.
- Cruz A M et al (2001) Podotrochlear bursa endoscopy in the horse: a cadaver study. Vet Surg 30, 539-545 PubMed.
- Wright I M et al (1999) Endoscopy of the navicular bursa: a new technique for the treatment of contaminated and septic bursae. Equine Vet J 31, 511 PubMed.
Other sources of information
- Ross M W & Dyson S J (2003) Eds. Diagnosis and Management of Lameness in the Horse. 2nd edn. W B Saunders.