Page 391 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

366 CHAPTER 1

VetBooks.ir 1.725 1.726

Figs. 1.725, 1.726 Subcutaneous tissue thickening palmar to the annular ligament is unlikely to cause a
stenosing syndrome. (1.725) Transverse sonogram showing a normal annular ligament and synovial sheath.
Hypoechogenic thickening of the subcutaneous tissues is probably due to focal contusion/haematoma formation
(double arrow). (1.726) Longitudinal scan of the same area with the annular ligament indicated by the bracket.

(Coblation ) hook probe. Postoperatively, the horse associated with digital tenosynovitis, the second
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should be treated as for tenosynovitis, with early with ‘palmar foot pain’ and ‘navicular syndrome’.
passive manipulations of the fetlock to reduce adhe- Tendonitis of the DDFT has also been described
sions. Open surgery through a larger skin incision in the distal antebrachium, within the carpal flexor
has been used extensively and often been successful, tendon sheath, as a result of protruding osteochon-
but is associated with a higher risk of wound break- dromas or physeal scar spikes (see Carpal canal
down, fibrosis and recurrence of PAL syndrome. syndrome, p. 163) or spontaneously, in the tarsal
sheath (see Thoroughpin, p. 370) and, occasion-
Prognosis ally, in association with desmitis of the AL-DDFT
The prognosis is good in acute and subacute cases (see p. 342).
with conservative management, guarded in chronic
tenosynovitis and fair with chronic PAL syndrome Aetiology/pathophysiology
treated by desmotomy. DDF tendonitis is usually a spontaneous strain
injury and is due to repeated trauma (cyclic injury)
DEEP DIGITAL FLEXOR TENDONITIS IN or overextension injury. Direct trauma and puncture
THE DIGITAL FLEXOR TENDON SHEATH of the tendon through the palmar fetlock or pastern
area without contamination of the sheath can occur.
Definition/overview Puncture wounds may be surprisingly difficult to
Spontaneous traumatic injury to the DDFT nearly identify, but should be suspected when lesions occur
always occurs in sheathed areas, most commonly on the palmar aspect of the tendon in the pastern or
in the DFTS or within the foot (at the level of fetlock region.
the podotrochlear bursa). The two syndromes are Injuries may be diffuse, focal (either central or
differentiated clinically, the first condition being peripheral) or in the form of longitudinal marginal