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Tenoscopic-assisted treatment of open digital flexor tendon sheath injuries in horses: 20 cases (1992–2001)

Karl E. Frees DVM, MS1,2, James D. Lillich DVM, MS, DACVS3, Earl M. Gaughan DVM, DACVS4, and Richard M. DeBowes DVM, MS, DACVS5,6
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  • 1 Department of Clinical Sciences, Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.
  • | 2 Present address is Wilhite Equine Veterinary Services, 1604 Farview Rd, Raymore, MO 64083.
  • | 3 Department of Clinical Sciences, Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.
  • | 4 Department of Clinical Sciences, Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.
  • | 5 Department of Clinical Sciences, Veterinary Medical Teaching Hospital, College of Veterinary Medicine, Kansas State University, Manhattan, KS 66506-5606.
  • | 6 Present address is the Department of Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA 99164-6610.

Abstract

Objective—To determine history, physical and diagnostic examination findings, medical treatment, and outcome of horses with open injuries to the digital flexor tendon sheath treated with the assistance of tenoscopy.

Design—Retrospective study.

Animals—20 horses.

Procedure—Medical records of 20 horses with open injuries to the digital flexor tendon sheath were reviewed. Signalment, history, physical and diagnostic examination results, bacteriologic culture and susceptibility testing results, surgical and medical treatments, and follow-up examination results were determined. Outcome was determined by use of telephone interview or physical examination.

Results—All horses were treated with tenoscopicassisted lavage and débridement. Eighteen horses survived, and 2 were euthanatized during treatment. All horses were either grade-4 or grade-5 lame before treatment. Ten horses returned to previous use. Four horses were considered mildly lame and in athletic use. Three horses were considered mechanically lame and are in use with reduced expectations. One horse was lost to follow-up after being sold. One horse was euthanatized for financial reasons and 1 because of complications from regional sepsis.

Conclusions and Clinical Relevance—Tenoscopy appears to be a useful modality in the treatment of open injury to the digital flexor tendon sheath in horses. Direct viewing, guided débridement, and targeted large-volume lavage are advantages obtained with intrathecal arthroscopy. Tenoscopy, when combined with antimicrobial and anti-inflammatory treatment, appears to offer a good chance of survival for affected horses. (J Am Vet Med Assoc 2002;220:1823–1827)

Abstract

Objective—To determine history, physical and diagnostic examination findings, medical treatment, and outcome of horses with open injuries to the digital flexor tendon sheath treated with the assistance of tenoscopy.

Design—Retrospective study.

Animals—20 horses.

Procedure—Medical records of 20 horses with open injuries to the digital flexor tendon sheath were reviewed. Signalment, history, physical and diagnostic examination results, bacteriologic culture and susceptibility testing results, surgical and medical treatments, and follow-up examination results were determined. Outcome was determined by use of telephone interview or physical examination.

Results—All horses were treated with tenoscopicassisted lavage and débridement. Eighteen horses survived, and 2 were euthanatized during treatment. All horses were either grade-4 or grade-5 lame before treatment. Ten horses returned to previous use. Four horses were considered mildly lame and in athletic use. Three horses were considered mechanically lame and are in use with reduced expectations. One horse was lost to follow-up after being sold. One horse was euthanatized for financial reasons and 1 because of complications from regional sepsis.

Conclusions and Clinical Relevance—Tenoscopy appears to be a useful modality in the treatment of open injury to the digital flexor tendon sheath in horses. Direct viewing, guided débridement, and targeted large-volume lavage are advantages obtained with intrathecal arthroscopy. Tenoscopy, when combined with antimicrobial and anti-inflammatory treatment, appears to offer a good chance of survival for affected horses. (J Am Vet Med Assoc 2002;220:1823–1827)