Page 339 - The Veterinary Care of the Horse

• Radiography may be used to rule out the presence of an avulsion fracture or new bone at

the site of insertion of the ligament on the proximal sesamoid bones.
VetBooks.ir • Sampling the fluid within the tendon sheath (synoviocentesis) to check for infection and

allow analysis of the tendon sheath fluid.

Treatment

Acute injuries normally respond to:
• box rest

• introduction of a programme of controlled walking exercise at the appropriate time

• cold therapy

• support bandaging
• topical anti-inflammatory medication

• systemic NSAIDs, e.g. phenylbutazone, if necessary

• injections of hyaluronic acid and corticosteroids into the DFTS to reduce inflammation.

Chronic injuries often fail to respond to the above treatment. In these cases, surgical release

of the inflamed and thickened ligament may be required. A minimally invasive approach is
possible with a small incision or using a tenoscope (arthroscope). Following surgery, the

horse is kept on box rest with controlled exercise to reduce adhesions.

Prognosis

If the palmar annular ligament is inflamed with no other complications, then the prognosis

following either box rest or surgery is reasonably good. However, if there is an associated
tendon injury or adhesions within the digital sheath, the outlook is less favourable.

CURB

Traditionally, a curb is the name given to a swelling that develops at the back of the leg
below the point of the hock when the plantar ligament is strained. The origin of the plantar

ligament is the upper part of the calcaneus. It attaches distally to the fourth tarsal bone and
the head of the lateral splint bone (Figure 7.12). However, now that there are sophisticated

ultrasound machines capable of producing excellent images, it is recognized that there are
several possible causes of swelling in this area. These include: