Page 109 - Manual of Equine Field Surgery
P. 109
r
Semitendinosus Tenotomy and Myotomy 105
-+------ Bistoury
knife
••
Fibrotic
.
region
Fibrous
bands
I .
ii ~,r,.,-:,~..:e~
Figure 17-2 The use of a bistoury knife to transect restrictive scar tissue on the distal aspect of the affected
.
region.
EXPECTED OUTCOME COMPLICATIONS
Reported cases treated with tenotomy have had Dehiscence, seroma formation, and infection are
good results, but only a small number of cases possible but not common if the tenotomy only is
have been reported. 2•3 Horses with mild scarring performed. If myotomy is performed, the likeli-
often improve considerably with tenotomy, and hood of these complications increases. Extensive
the procedure has minimal complications. In the postoperative fibrosis may result in recurrence of
author's opinion, horses with more severe fibrosis the gait abnormality.
generally require myotomy for improvement and
have a higher likelihood of recurrence. In 011e
report, 75o/o of horses treated with myotomy had ALTERNATIVE PROCEDURES
75°/o or greater improvement in gait. At approxi-
mately 2-year follow-up, one third of these horses Transection of the semitendinosus muscle's in-
had some recurrence of gait restriction. Some sertion on the calcaneal tuber has also been
horses with some recurrence of restriction were described for cases where a taut band is palpable.
able to perform at their intended level.4 Horses The limb is protracted during surgery after
with fibrosis confined to the semitendinosus tenotomy of the tibial insertion. If a taut band
muscle have a better outcome than those with is palpable over the calcaneal tuber insertion, it is
additional fibrosis in the biceps femoris or semi- transected through an incision caudal and distal
membranosus muscles.5 In cases where muscles to the first incision.2•7
other than the sernitendinosus are involved, tran- Complete removal of the area of fibrosis and a
section of fibrosis in the involved muscle may be 4-cm portion of tendon has also been described."
beneficial. 1'6 The procedure can be effective, but a high inci-
