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1.
OBJECTIVE: To calculate forces in the flexor tendons and the influence of heel wedges in affected and contralateral (compensating) forelimbs of horses with experimentally induced unilateral tendinitis of the superficial digital flexor (SDF) tendon. ANIMALS: 5 Warmblood horses. Procedure-Ground reaction force and kinematic data were obtained during a previous study while horses were trotting before and after induction of tendinitis in 1 forelimb SDF and after application of 6 degrees heel wedges to both forehooves. Forces in the SDF, deep digital flexor (DDF), and the suspensory ligament (SL) and strain in the accessory ligament (AL) of the DDF were calculated, using an in vitro model of the distal region of the forelimb. RESULTS: After induction of tendinitis, trotting speed slowed, and forces decreased in most tendons. In the affected limb, SL force decreased more than SDF and DDF forces. In the compensating limb, SDF force increased, and the other forces decreased. After application of heel wedges, SDF force in both limbs increased but not significantly. Furthermore, there was a decrease in DDF force and AL strain. CONCLUSIONS AND CLINICAL RELEVANCE: The increase in SDF force in the compensating forelimb of horses with unilateral SDF tendinitis may explain the high secondary injury rate in this tendon. The lack of decrease of SDF force in either limb after application of heel wedges suggests that heel wedges are not beneficial in horses with SDF tendinitis. Instead, heel wedges may exacerbate the existing lesion.  相似文献   

2.
Loads on the suspensory ligament, deep digital flexor tendon, superficial digital flexor tendon, and long digital extensor tendon of the equine hind limb were determined in ponies by use of implanted strain gauges consisting of silicone rubber tubes filled with mercury. Recordings were made simultaneously with force plate measurements and high-speed film recordings while the ponies were walking. The relationship between strain gauge signals and tendon loads was obtained from tension-strain tests performed after death of the ponies. The suspensory ligament and the 2 digital flexor tendons were loaded during the stance phase, and the extensor tendon was loaded mainly during the swing phase. The loading pattern of the suspensory ligament, with peak loads of 4.6 N/kg of body weight, correlated well with the vertical component of the ground reaction force. Maximal loading of the deep digital flexor tendon was observed during the second half of the stance phase, with peak values of 6.7 N/kg. The superficial digital flexor tendon was loaded maximally at the beginning of the stance phase, with a peak load of 4.1 N/kg, and the long digital extensor tendon was loaded maximally during the swing phase, with a peak load of 0.3 N/kg. Recordings made from this procedure for calibration of the strain gauge signals to tendon load and tendon strain, in combination with the force plate measurements, enabled verification of the results by torque analysis of the lower portion of the hind limb, using the vector of the ground reaction force, limb conformation, and limb geometric configuration. Torque analysis of the lower extremity indicated that the determined tendon loads were in agreement with the recorded ground reaction forces.  相似文献   

3.
Strains of the suspensory ligament and deep digital flexor, superficial digital flexor, and long digital extensor tendons in the equine (pony) hind limb were recorded in vivo, using implanted strain gauges consisting of silicone rubber tubes filled with mercury. The relationship between strain gauge signals and tendon strains was obtained from tension-strain tests performed on isolated tendons after death of the ponies. During normal walking, maximal tendon strain (elongation over initial length, relative to the length of the structures at first ground contact) was 3.1% in the suspensory ligament and 3.4%, 2.3%, and 0.3% in the deep digital flexor, the superficial digital flexor, and the long digital extensor tendons, respectively. Changes (that occurred during walking) in the distance from origin to insertion of these musculotendinous structures were computed from limb geometric configuration and limb conformation. Maximal increase in origin to insertion length was 3.1% in the suspensory ligament and 2%, 1.6%, and 1.5% in the deep digital flexor, superficial digital flexor, and long digital extensor musculotendinous structures, respectively. The differences in strain, comparing the entire musculotendinous structure and its tendon, were explained by muscular contraction or relaxation.  相似文献   

4.
OBJECTIVE: To test the sensitivity to measurement and modeling errors of a method for noninvasive calculation of flexor tendon forces in the equine forelimb and to calculate tendon forces for Dutch Warmblood horses during trotting. SAMPLE POPULATION: A normative set of kinematic and ground-reaction force (GRF) data obtained from horses during trotting in another study. PROCEDURE: Forces in the flexor tendons were calculated from the data set before and after addition of fixed relative and absolute errors. Amount of error was based on normal accuracy of the variables. A similar analysis was performed for a measure of strain of the accessory ligament of the deep digital flexor tendon. RESULTS: The only errors that had a substantial influence on accuracy were modeling errors in the mechanical properties of the suspensory ligament and measurement errors in the point of application of the GRF and position of the marker on the distal interphalangeal joint. Influence of the measurement errors could be minimized by applying usual correction methods. CONCLUSIONS AND CLINICAL RELEVANCE: After correction of measurement errors, the method can be used to calculate mean tendon forces for a group of horses and to evaluate the influence of factors such as surface properties, type of shoe, speed, and fatigue on tendon forces. The method could become an important tool for use in research on the cause, prevention, and treatment of tendon injuries in horses.  相似文献   

5.
Tendon/ligament mineralization is recognized in horses but information regarding its clinical significance is limited. The aims of this observational study were to report the structures most commonly affected by ultrasonographically detectable mineralization and, for these, determine frequency of diagnosis and key clinical features. Cases presented at our hospital in April 1999–April 2013 and September 2014–November 2015 were included: a total of 27 horses (22 retrospective, five prospective). Mineralizations were most common in deep digital flexor tendons (10) and suspensory ligament branches (eight), representing 10% and 7% (estimated), respectively, of horses diagnosed with injuries to these structures during the study. Two deep digital flexor tendon and three suspensory ligament branch cases showed bilateral mineralization. Deep digital flexor tendon mineralization was restricted to the digital flexor tendon sheath, most commonly in the proximal sheath (±sesamoidean canal), and seven of 10 cases involved hindlimbs. Suspensory ligament branch mineralization was visible in the same ultrasound window as the proximal sesamoid bones in 10/11 limbs and six of eight cases involved forelimbs. Previous corticosteroid medication was a feature of one deep digital flexor tendon and one suspensory ligament branch case. Mineralization was associated with lameness in some but not all limbs. Mineralized foci within the deep digital flexor tendon preceded hypoechoic lesion formation in two limbs. Of the cases with deep digital flexor tendon or suspensory ligament branch injury only, one of three and two of three cases, respectively, became sound. Findings indicated that tendon/ligament mineralization can be associated with lameness in some horses, but can also be an incidental finding.  相似文献   

6.
Magnetic resonance (MR) imaging abnormalities in horses with lameness localized to the proximal metacarpal or metatarsal region have not been described. To accomplish that, the medical records of 45 horses evaluated with MR imaging that had lameness localized to either the proximal metacarpal or metatarsal region were reviewed. Abnormalities observed in the proximal suspensory ligament or the accessory ligament of the deep digital flexor tendon included abnormal high signal, enlargement, or alteration in shape. Twenty-three horses had proximal suspensory ligament desmitis (13 hindlimb, 10 forelimb). Sixteen horses had desmitis of the accessory ligament of the deep digital flexor tendon. One horse had desmitis of the proximal suspensory ligament and the accessory ligament of the deep digital flexor tendon on the same limb and one horse had desmitis of the proximal suspensory ligament on one forelimb and desmitis of the accessory ligament of the deep digital flexor tendon on the other forelimb. Four horses did not have abnormalities in the proximal suspensory ligament or accessory ligament of the deep digital flexor tendon. Eighty percent of horses with forelimb proximal suspensory ligament desmitis and 69% of horses with hindlimb proximal suspensory ligament desmitis returned to their intended use. Sixty-three percent of horses with desmitis of the accessory ligament of the deep digital flexor tendon were able to return to their intended use. MR imaging is a valuable diagnostic modality that allows diagnosis of injury in horses with lameness localized to the proximal metacarpal and metatarsal regions. The ability to accurately diagnose the source of lameness is important in selecting treatment that will maximize the chance to return to performance.  相似文献   

7.
OBJECTIVE: To determine the relative contributions of the muscles, tendons, and accessory ligaments to the passive force-length properties of the superficial (SDF) and deep digital flexor (DDF) myotendinous complexes. SAMPLE POPULATION: 8 cadaveric forelimbs from 6 adult Thoroughbreds. PROCEDURE: In vitro, limb configurations during slack position and myotendinous lengths during subsequent axial loading of forelimbs were recorded before and after transection of accessory ligaments. Expressions were derived to describe the force-length behavior of each muscle, tendon, and accessory ligament-tendon unit; linear stiffness was computed for these components. The elastic modulus was established for the SDF and DDF tendons. RESULTS; Linear stiffness was 2.80 +/- 0.38 kN/cm for the SDF muscle, 3.47 +/- 0.66 kN/cm for the DDF muscle, 2.73 +/- 0.18 kN/cm for the SDF tendon, 3.22 +/- 0.20 kN/cm for the DDF tendon, 6.46 +/- 0.85 kN/cm for the SDF accessory ligament, 1.93 +/- 0.11 kN/cm for the SDF accessory ligament-tendon unit, and 2.47 +/- 0.11 kN/cm for the DDF accessory ligament-tendon unit. The elastic modulus for the SDF and DDF tendons was 920 +/- 77 and 843 +/- 56 MPa, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Both the muscle-tendon and ligament-tendon portions of SDF and DDF myotendinous complexes had important roles in supporting the forelimb of horses. Although muscle tension can be enhanced by elbow joint flexion and active contraction, the accessory ligaments transmitted more force to the distal tendons than did the muscles under the conditions tested.  相似文献   

8.
Tendon and ligament injuries are common causes of impaired performance in equine athletes. Gray‐scale ultrasonography is the current standard method for diagnosing and monitoring these injuries, however this modality only provides morphologic information. Elastography is an ultrasound technique that allows detection and measurement of tissue strain, and may provide valuable mechanical information about equine tendon and ligament injuries. The purpose of this study was to determine the feasibility, reproducibility, and repeatability of elastography; and to describe elastographic characteristics of metacarpal tendons in sound horses. Nineteen legs for 17 clinically sound horses without evidence of musculoskeletal pathology were included. Elastographic images of the superficial and deep digital flexor tendons and the branches of the suspensory ligament (tendon of the interosseous muscle) were described quantitatively and qualitatively. There was no statistically significant difference between operators (P = 0.86) nor within operators (P = 0.93). For qualitative assessments, reproducibility (0.46) was moderate and repeatability (0.78) was good. Similar to human Achilles tendons, equine tendons were classified as predominantly hard using elastography. There was no statistically significant difference in stiffness of the flexor tendons (P = 0.96). No significant difference in stiffness was found with altered leg position during standing (P = 0.84) and while nonweight bearing (P = 0.61). The flexor tendons were softer when imaged in longitudinal versus transverse planes (P < 0.01) however, the suspensory branches were not (P = 0.67). Findings supported future clinical application of elastography as a noninvasive “stall‐side” imaging modality for evaluation of the tendons and ligaments of the distal forelimb in horses.  相似文献   

9.
OBJECTIVE: To measure the effects of transection of the accessory ligament of the superficial digital flexor (SDF) muscle (superior check desmotomy) on flexor tendon and suspensory ligament (SL) strain in vitro. STUDY DESIGN: In vitro experimental biomechanical investigation. ANIMALS USED: Ten equine cadaver forelimbs. METHODS: The effects of superior check desmotomy were determined using equine cadaver forelimbs secured in a servocontrolled hydraulic testing machine. Strain sensors were used to measure strain on the superficial and deep digital flexor tendons and SL, and a goniometer was used to measure joint angles when the limb was loaded at 890 N and 3,115 N before desmotomy, and at 3,115 N after desmotomy. RESULTS: Superior check desmotomy was associated with significantly increased strains on the SDF tendon and SL, and significant alterations in the angles of the metacarpophalangeal and carpal joints. CONCLUSIONS: The superior check ligament has an important role in maintaining joint angles and load distribution in the forelimb. Lengthening of the SDF musculotendinous unit after superior check desmotomy may be associated with increased strain on the SL. CLINICAL RELEVANCE: Transection of the accessory ligament of the SDF muscle may predispose horses to SL desmitis postoperatively.  相似文献   

10.
In a two-phase study, ultrasound was used to delineate the normal sonographic anatomy of soft tissues of the equine distal limb. The study was limited to the soft tissues of the palmar surface of the limb just proximal to the fetlock joint. In the first phase, cadavers were evaluated with a B-mode ultrasound machine, † Then the limbs were radiographed and dissected to compare their gross, radiographic, and ultrasonographic appearances. In the second phase, nine normal adult horses were ultrasonographically scanned. The sonographic appearance of the normal animals was compared with that of the cadavers. Front and rear limbs of all horses had similar ultrasonographic appearances. Flexor tendons and the suspensory ligament were easily identified as having linear, uniformly intense ecogenicity. The borders of the digital sheath and of the proximal palmar pouch of the fetlock joint had a less organized and less intense ecogenic appearance than the flexor tendons and suspensory ligament, and they were poorly delineated unless distended with fluid. Ultrasonography was used in three lame horses and aided the diagnoses of synovial proliferation in the fetlock joint, tendosynovitis, and bowed tendon. Diagnostic ultrasonography was effective in identifying and characterizing soft-tissue structures of the distal equine limb. It is a valuable, noninvasive diagnostic aid.  相似文献   

11.
The usefulness of inferior check ligament desmotomy as a treatment for acquired tendon contracture in horses was evaluated in 13 cases of deep digital flexor (DDF) contracture and in 3 cases of combined superficial digital flexor (SDF) and DDF contracture. In 8 of 9 cases of DDF contracture in which the dorsal surface of the hoof had not passed beyond being vertical to the ground, the surgical procedure was successful in returning the limb to a normal position and function. Compared with DDF tenotomy, inferior check ligament desmotomy was a superior treatment technique because of decreased postoperative pain, better postoperative appearance, and improved return to function. In 4 cases of DDF contracture in which the dorsal SDF contracture was also involved, inferior check ligament desmotomy was generally insufficient to allow return of the limb to normal alignment and function.  相似文献   

12.
The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% mepivacaine hydrochloride solution. Ultrasonographic examinations similar to the initial examination then were performed immediately, 1 h and 24 h postinjection. Cross-sectional area and mean pixel value were determined for the superficial and deep digital flexor tendons, the accessory ligament of the deep digital flexor tendon, the suspensory ligament, and the suspensory branches at each level and time period. Subjective ultrasonographic changes also were noted. No significant difference was noted in the cross-sectional area or mean pixel value of any structure at any level or time period compared to baseline. Subjective changes in the tendons and ligaments were not noted. There was mild hypoechoic swelling of the surrounding soft tissues and gas in the region of the injections. Gas could interfere with the evaluation of the origin of the suspensory ligament and the proximal portion of the accessory ligament of the deep digital flexor tendon within the first hour but was not detectable ultrasonographically at 24 h. Based on these findings, if gas interferes with an ultrasonographic examination performed temporally close to perineural anesthesia, a repeat examination at 24 h is recommended.  相似文献   

13.
Reasons for performing study: The specific biomechanical circumstances that induce excessive superficial digital flexor tendon (SDFT) strain in horses are unknown. Hypothesis: Carpal joint hyperextension during axial limb loading during the middle of stance disproportionately enhances SDFT strains compared to suspensory ligament (SL) strains. Methods: Superficial digital flexor tendon and SL strains were measured in 7 cadaver limbs during in vitro loading that maintained carpal extension or allowed carpal hyperextension by constraining, or allowing rotation of, the radius during loading conditions that simulated the middle of stance at the walk. The effect of carpal hyperextension on SDFT and SL strains and joint angles was assessed using repeated measures ANOVA. Results: Limb loading generally resulted in higher SL strains than SDFT strains for both carpal extension and hyperextension loading conditions. Compared to carpal extension, carpal hyperextension resulted in increased strains in both the SDFT and the SL; however, a greater increase in strain was seen in the SDFT. On average, carpal hyperextension caused approximately 3° greater carpal extension, 1° greater metacarpophalangeal joint hyperextension, 1° greater proximal interphalangeal joint flexion and <1° greater distal interphalangeal joint flexion than did carpal extension. Conclusions and clinical relevance: Carpal joint hyperextension is likely to induce disproportionately higher strain in the SDFT than in the SL. Factors that affect carpal stability are likely to affect the risk for superficial digital flexor tendinopathy.  相似文献   

14.
Objective: To develop a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon (AL‐DDFT) in horses. Study Design: Experimental. Animals: Cadaveric forelimbs (n=10) and 4 forelimbs from 2 horses anesthetized for terminal teaching procedures, and 12 forelimbs of 6 experimental horses. Methods: Saline distention of the carpal flexor sheath facilitated insertion of an arthroscope into the distal medial aspect of the sheath between the AL‐DDFT and deep digital flexor tendon (DDFT). Location of an instrument portal on the lateral aspect of the metacarpus was identified with a needle. The lateral aspect of the AL‐DDFT was transected and the arthroscope and instrument were switched to transect the remaining fibers on the medial aspect. Cadaveric specimens were dissected for evaluation. Experimental horses were monitored for 30 days postoperatively. Results: Minor complications including incomplete division of the AL‐DDFT and shallow incision into the suspensory ligament were observed in some cadaver specimens. The AL‐DDFT was completely transected in all experimental horses with no suspensory ligament damage. Mean±SD surgical time (incision to skin closure) was 28.3±11.8 minutes. On ultrasonographic examination, transection of the AL‐DDFT was complete in all experimental horses. Minor DDFT fiber disruption was noted in 1 limb during ultrasound examination at day 30. Conclusions: A tenoscopic approach through the carpal flexor sheath provided adequate access for desmotomy of the AL‐DDFT.  相似文献   

15.
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16.
Effective treatments for horses diagnosed with severe deep digital flexor (DDF) tendinopathy are limited. In this study, three Quarter Horses diagnosed with severe bilateral DDF tendinopathy underwent bilateral desmotomy of the accessory ligament of the DDF tendon after failing to respond to conservative therapy. Lameness markedly improved in all three horses. Given that severe DDF tendinopathy is typically associated with persistent or recurrent lameness, desmotomy of the accessory ligament of the DDF tendon might be a treatment option to alleviate lameness in horses with DDF tendinopathy. This treatment option appears promising; however, a larger number of cases is necessary to support the results in these three horses.  相似文献   

17.
Objective: To describe partial removal of the intrathecal component of the deep digital flexor tendon (DDFT) in horses with chronic septic DDF tendonitis and tenosynovitis unresponsive to conventional therapy, and to report long‐term outcome. Study Design: Case series. Animals: Horses (n=4). Methods: Four horses with chronic septic DDF tendonitis and tenosynovitis were treated by surgical tenectomy of the intrathecal component of the DDFT, followed by stabilization in casts and subsequent corrective shoeing. All horses were previously managed unsuccessfully with combinations of conventional therapy consisting of systemic antibiotics, through and through tendon sheath lavage/open drainage, regional limb perfusions, tenoscopy with debridement and transection of the palmar/plantar annular ligament, and intrathecal antibiotics. Results: Time from initial injury/diagnosis to tenectomy ranged from 10 to 210 days. Mean hospitalization time after surgery was 82 days. Long‐term follow‐up (>1.5 years; mean, 3.8 years) was available. All 4 horses were able to walk comfortably at pasture and were used as broodmares. Conclusions: Intrathecal tenectomy is a viable surgical procedure for treatment of chronic septic tenosynovitis of the digital sheath that is complicated by septic tendonitis of the DDFT.  相似文献   

18.
Injuries of the plantar soft tissues of the tarsus and proximal metatarsus can be a source of lameness in horses, however published information is lacking on high field MRI characteristics of these tissues. Objectives of the current anatomic study were to (1) describe high‐field MRI features of the plantar tarsal and proximal metatarsal soft tissues; and (2) compare MRI findings with gross and histological appearances of selected structures for a sample of cadaver limbs from non‐lame horses. Single hindlimbs for 42 horses, and right and left hindlimbs for eight horses were scanned using high‐field MRI. The MRI findings were described for the 50 single limbs; and the MRI, gross postmortem and histological findings were compared for the eight pairs of hindlimbs. The superficial digital flexor tendon had uniform low signal intensity, surrounded by the flexor retinaculum of intermediate to high signal intensity on all sequences. The lateral digital flexor tendon had slightly higher signal intensity, enclosed on the plantaromedial aspects by the low signal intensity metatarsocalcaneal ligament. The accessory ligament of the deep digital flexor tendon varied in size and signal intensity. The proximal and distal plantar ligaments, accessory ligament of the suspensory ligament, and calcaneoquartal ligament had low signal intensity. The long plantar ligament comprised a number of related parts, separated by lines of high signal intensity corresponding with fibrous septae seen in gross anatomical specimens. The plantar aspect of the ligament had uniform low signal intensity in all sequences, but the dorsal half was more heterogeneous with multifocal spots or lines of higher signal intensity.  相似文献   

19.
Objective This study documents the results of non-surgical treatment and treatment by superior check desmotomy in Thoroughbred racehorses with superficial digital flexor (SDF) tendonitis. Design A prospective study was made of 124 thoroughbred racehorses with unilateral or bilateral SDF tendonitis. Procedure The flexor tendons were assessed by physical and ultrasonographic examination before treatment, and the lesions detected in affected tendons were characterised according to lesion type, length and cross-sectional area. Ninety three horses were managed non-surgically and 31 by superior check desmotomy. Recurrent or new injuries were defined as injuries affecting a previously injured superficial digital flexor tendon, the contralateral SDF tendon, or the suspensory ligament (interosseous muscle) in either forelimb. Results No statistically significant difference was found in ultrasonographic lesion severity between treatment groups. Horses managed by superior check desmotomy were 1.3 times more likely to complete five or more races than horses managed non-surgically (95% confidence limits 0.93–1.82). Horses treated surgically were 1.2 times more likely to develop recurrent or new injuries after returning to training than horses managed non-surgically (95% CL 0.95–1.55). Horses under-going superior check desmotomy were 5.5 times more likely to develop suspensory desmitis than horses treated non-surgically (95% CL 1.13–26.4). There was no difference in the time to recurrent or new injury between treatment groups. Conclusion There was no statistically significant difference between treatment groups in the proportions of horses able to complete five or more races after an episode of superficial digital flexor tendonitis. Superior check desmotomy did not appear to offer an advantage over non-surgical treatment in preventing recurrent or new injuries in Thoroughbred racehorses. Horses undergoing superior check desmotomy appeared to be at greater risk of developing suspensery ligament injuries than horses managed non-surgically.  相似文献   

20.
Objective: To report outcome after the surgical treatment of lacerations of the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), suspensory ligament (SL), and/or distal sesamoidean ligaments (DSL) in horses. Study Design: Case series. Animals: Horses (n=106) with lacerations of the SDFT, DDFT, SL, and/or DSL. Methods: Medical records (1988–2002) were reviewed for signalment, limb and tendon/ligament involvement (location and extent of injury, tendon sheath involvement), method of repair, and outcome. Results: The median age of horses was 7 years and the follow‐up time ranged from 1 to 10 years. Fifty‐five percent of horses returned to their previous level of performance, 27% to a lower level, and 18% were euthanatized. Multivariate statistical analysis demonstrated that the number of structures transected had the most significant influence on outcome. No significant association was detected between outcome and tendon sheath involvement, tendon suturing, casting, or limb affected. Fetlock hyperextension was the most significant complication. Conclusions: A high survival rate can be expected after SDFT, DDFT, SL, and/or DSL lacerations in horses, but only 55% of affected horses returned to their previous activity level. The number of structures affected was the major factor determining whether horses returned to an equal level of performance.  相似文献   

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