Page 108 - Manual of Equine Field Surgery

104 LIMB SURGERIES

Saphenous a. and n.

and medial

saphenous v.

,r:~ Incision line

Tendon of Y

semitendinosus m. B

A

Figure 17-1 Location (A) and incision (B) of the semitendinosus tendon of insertion on the proximal tibia

of the semitendinosus muscle beginning at the POSTOPERATIVE CARE

distal extent of the fibrosis and extending

distally. Blunt dissection is used to deepen the

incision to the level of palpable fibrosis. A blunt-

tipped bistoury is used to transect the muscle

or tendon attachments at the distal extent of the Postoperative Care

fibrotic area (Figure 17-2). Taut vertical fibrotic

bands that appear to limit cranial movement Bandaging: If myotomy is performed, the gauze

when the limb is pulled forward by an assistant packing is changed the following day and

are transected.1 The horse is then walked several removed in 2 days.
Exercise Restridions: Stall rest with light hand-
steps to judge the effect of the release. If necessary, walking is advised for the first 2 weeks,. followed

the procedure is repeated until the gait improves by gradually increasing exercise. Full turnout is

or until the entire area distal to the fibrosis has allowed 6 weeks following surgery.

been transected, The incision is lavaged copiously Medications: Phenylbutazone is administered at

with sterile saline and packed with sterile roll 4.4 mg/kg BID for the initial 24 hours and 2.2

gauze. Partial closure of the skin is performed and mg/kg Bl D for an additional 5 days. Antibiotic

the remainder of the incision is left to heal by therapy is continued until 24 hours after drain or

second intention. Alternatively, a Penrose drain packing removal. Horses should receive a tetanus

can be placed and the incision closed primarily. toxoid booster if it has been longer than 6 months

When other muscles such as the semimernbra- since the previous vaccination.

nosus or biceps femoris are involved, a similar Suture Removal: Skin sutures are removed 12

myotomy procedure can be performed. days postoperatively.