Flashcards in CAL: Cases Tendon and Lig Injury Deck (13):
How would a horse with perineus tertius rupture present and locomote?
- ability to flex the stifle while the hock is extended
- metatarsal protracted in a vertical orientation d/t lack of hock flexion
Tx perineus tertius rupture? Prognosis?
- 3 months rest
- prog good, function usually repaired by fibrotic repair of ligament
What is a slipped SDFT? Presentation?
- SDFT displaced from point of hock (calcaneous)
- acute presentation, displacement d/t trauma usually tearing of the medial retinaculum or occasionally split of the SDFT
- distress d/t altered mechanics of the hock (constant flexion/extension)
- can be intermittent of permentnat
Tx and prognosis of a slipped SDFT?
- conservative (if permenant, tendon will eventually function in new position)
- surgical repair with mesh (poor success rate)
- intermittent displacement moe of a problem
> prog fair for permenant but will drop a level of ability
> guarded for intermittent without surgery
What is a common site for DDFT injuries and what does this cause? Best dxx to confirm?
- just proximal to the navicular bursa -> navicular syndrome
- MRI or navicular bursoscopy best imaging modalities
Tx DDFT injury? Prog?
- rest up to 12 mo
- correct foot balance to minimise load on DDF T
- navicular bursoscopy
- debride torn fibres
- not all DDFt injuries in the foot are amenable to bursoscopy
> prog conservative 25% return to work surgical 50% retun to previous level of work
If you are presented with a horse with lacerations to the palmar mid-metacarpus, very lame, with toe off the ground in stance, what structures are involved?
- complete transection of the SDFT and DDFT
- look at diagram on CAL
What must be remembered when looking at lacerations?
Laceration of tendon most likely a differnet place to the skin
What dxx useful for assessing lacerations to the distal limbs? Exception?
- unless massive skin deficit
What associated structures other than tendon/ligament can be involved with laceration/penetration wounds?
- tendon sheaths
- may get infected and need tx = septic joints
Management of a horse with complete transection of the SDFT and DDFt
> support MCP joint eg. Kimzey splint
- wound mangmenet
- special show
> surgery (recommended for completel transection)
- debride ST and tendon ends
- repair of tendon if cast removal for partial laceration : 6 weeks
> cast removal for complete transection : 10-12 weeks with change @ 6-8weeks
- protect tendon loading after cast removal by either palmar splint SDFT) and/or fish tail shoe (DDFT)
What does a flexural deformity of the DIP joint look like? Causes? Confirm you dx?
- fully weight bearing but holds the foot on tip toes
- ALDDFT desmitis
- adhesions of DDFt and other structures
- palpation (proximal metatarsal region)
- ultrasound (similar signs to forelimb)