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Quantitative effect of tenorrhaphy on intrinsic vasculature of the equine superficial digital flexor tendon

Chris L. CrowsonDepartment of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK 74078-2005.
Present address is Woodside Equine Clinic LLC, PO Box 989, Ashland, VA 23005.

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Henry W. JannDepartment of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK 74078-2005.

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Larry E. SteinDepartment of Physiological Sciences, Oklahoma State University, Stillwater, OK 74078-2005.

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L. P. ClaypoolCollege of Veterinary Medicine, and the Department of Statistics, College of Arts and Sciences, Oklahoma State University, Stillwater, OK 74078-2005.

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H. David MollDepartment of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK 74078-2005.

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Margret A. BlaikDepartment of Veterinary Clinical Sciences, Oklahoma State University, Stillwater, OK 74078-2005.

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Abstract

Objective—To compare effects of the locking-loop suture pattern (LLP) and 3-loop pulley (3LP) suture pattern for tenorrhaphy on the intrinsic vasculature of the superficial digital flexor tendon (SDFT) of horses in vitro after surgery.

Sample Population—16 forelimbs obtained from 8 mature horses.

Procedure—Tenotomy and subsequent tenorrhaphy was performed in anesthetized horses. Following systemic administration of heparin, horses were euthanatized and the limbs were removed and placed under tension to load the flexor tendons. The intrinsic vasculature was then perfused with a mixture of barium sulfate and water. Four-millimeter sections of the SDFT were prepared for microangiographic analysis. Mean vessel density was calculated for each section by use of a grid consisting of 1.5-mm2 vascular assessment squares (VAS). Comparisons were made among the control, LLP, and 3LP groups.

Results—Mean ± SD vessel density was 3.11 ± 0.38, 1.47 ± 0.47, and 2.01 ± 0.63 perfused vessels/1.5 mm2 for control, LLP, and 3LP groups, respectively. Significant differences in vascular density were detected between the control and 3LP groups, control and LLP groups, and LLP and 3LP groups.

Conclusions and Clinical Relevance—Use of the LLP and 3LP pattern has deleterious effects in vitro on the intrinsic vasculature of the SDFT. However, the 3LP pattern was less disruptive to the intrinsic vasculature, compared with the effects for the LLP. Use of the 3LP tenorrhaphy suture pattern in clinical situations may result in less damage to the intrinsic vasculature of the SDFT of horses during convalescence. ( Am J Vet Res 2004;65:279–282)

Abstract

Objective—To compare effects of the locking-loop suture pattern (LLP) and 3-loop pulley (3LP) suture pattern for tenorrhaphy on the intrinsic vasculature of the superficial digital flexor tendon (SDFT) of horses in vitro after surgery.

Sample Population—16 forelimbs obtained from 8 mature horses.

Procedure—Tenotomy and subsequent tenorrhaphy was performed in anesthetized horses. Following systemic administration of heparin, horses were euthanatized and the limbs were removed and placed under tension to load the flexor tendons. The intrinsic vasculature was then perfused with a mixture of barium sulfate and water. Four-millimeter sections of the SDFT were prepared for microangiographic analysis. Mean vessel density was calculated for each section by use of a grid consisting of 1.5-mm2 vascular assessment squares (VAS). Comparisons were made among the control, LLP, and 3LP groups.

Results—Mean ± SD vessel density was 3.11 ± 0.38, 1.47 ± 0.47, and 2.01 ± 0.63 perfused vessels/1.5 mm2 for control, LLP, and 3LP groups, respectively. Significant differences in vascular density were detected between the control and 3LP groups, control and LLP groups, and LLP and 3LP groups.

Conclusions and Clinical Relevance—Use of the LLP and 3LP pattern has deleterious effects in vitro on the intrinsic vasculature of the SDFT. However, the 3LP pattern was less disruptive to the intrinsic vasculature, compared with the effects for the LLP. Use of the 3LP tenorrhaphy suture pattern in clinical situations may result in less damage to the intrinsic vasculature of the SDFT of horses during convalescence. ( Am J Vet Res 2004;65:279–282)