Page 76 - Manual of Equine Field Surgery

CHAPTER 11

Lateral Digital Extensor Tenectomy

Joanne Kramer

INDICATION performed standing, local anesthetic is infiltrated

directly over and deep to the distal and proximal

skin incision sites. The lateral aspect of the mid to
Treatment of conventional stringhalt (Figure

11-1). distal tibia and the proximal metatarsal region are

clipped and prepared aseptically.

EQUIPMENT PROCEDURE

Large Carmalt forceps are used for removing the A 3-cm incision is made directly over the palpa-

muscle tendon unit from the proximal incision.
ble lateral digital extensor tendon just proximal to

its junction with the long digital extensor tendon.

The tendon is elevated to the level of the incision.
ANATOMY A second 10-cm vertical skin incision is made

directly over the lateral digital extensor starting at

The lateral digital extensor muscle of the hind the muscle tendon junction and extending proxi-

limb originates from the lateral collateral ligament mally (Figure 11-3, A). Pulling on the isolated

of the stifle and the adjacent region of the tibia lateral digital extensor tendon in the distal inci-

and fibula. It proceeds lateral to the long digital sion can be used to guide the exact location of the

extensor muscle and enters its tendon sheath in proximal incision. The subcutaneous tissue and

the groove of the lateral malleolus of the tibia. In fasciae are incised to expose the lateral digital

this region, the tendon and sheath are covered by extensor muscle belly. Blunt dissection and large

extensive crural fascia and the distal extensor reti- Carmalt forceps are used to elevate the muscle to

naculum of the tarsus. Just distal to the tarsus, the the level of the incision. A small amount of sharp

lateral digital extensor tendon joins the long and blunt dissection is also used to free restrict-

digital extensor tendon (Figure 11-2). ing tissue from the muscle tendon unit. The lateral

digital extensor tendon is then excised in the distal

incision (Figure 11-3, B). The entire tendon is

POSITIONING AND PREPARATION then pulled through the proximal incision (Figure

11-3, C). This is the most difficult aspect of the

The procedure is performed with the horse under procedure and is best accomplished by placing

general anesthesia in lateral recumbency with large forceps underneath the tendon of the lateral

the affected limb up or standing with sedation digital extensor muscle and pulling proximally

and local anesthesia. When the procedure is and laterally. The muscle is then severed in the

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