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  Discussion on Research Summary: Desomotomy of the Superior Check Ligament for CL desmitis and Flexor Contracture
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DrO

Posted on Saturday, Mar 5, 2011 - 11:42 am:

This continues to be shown to be a useful procedure for Superior Check Ligament desmitis and mild flexor contracture. One problem with this surgery is the difficulty of reaching the SCL without damaging neighboring structures. The second paper below offers a solution.
DrO

Vet Surg. 2011 Mar 1.
Desmotomy of the Accessory Ligament of the Deep Digital Flexor Tendon in the Forelimb of 24 Horses 2 Years and Older.

Yiannikouris S, Schneider RK, Sampson SN, Roberts G.

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Washington State University, Pullman, WA.
Abstract

Objective: To report outcome after desmotomy of the accessory ligament of the deep digital flexor tendon (ALDDFT) in adult horses (≥2 years) for treatment of desmitis of the ALDDFT or flexural deformity of the distal interphalangeal joint (FDDIJ). Study Design: Case series. Animals: Horses with desmitis of the ALDDFT (n=9) and FDDIJ (n=15). Methods: Records (April 1996-July 2008) of 24 adult horses (mean age, 6.7 years) that had ALDDFT desmotomy were reviewed. Follow-up data was obtained 12-120 months after desmotomy. Results: Outcome was available for 22 horses; 18 (82%; 6 of 8 horses with desmitis of the ALDDFT and 12 of 14 with FDDIJ) returned to their intended use within 6-24 months (mean, 12 months). Conclusion: In mature horses, ALDDFT desmotomy resulted in successful return to intended use in most horses with ALDDFT desmitis (75%) or FDDIJ (86%).

Vet Surg. 2011 Mar 1.
Evaluation of a Tenoscopic Approach for Desmotomy of the Accessory Ligament of the Deep Digital Flexor Tendon in Horses.
Caldwell FJ, Waguespack RW.

Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL.
Abstract

Objective: To develop a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT) in horses. Study Design: Experimental. Animals: Cadaveric forelimbs (n=10) and 4 forelimbs from 2 horses anesthetized for terminal teaching procedures, and 12 forelimbs of 6 experimental horses. Methods: Saline distention of the carpal flexor sheath facilitated insertion of an arthroscope into the distal medial aspect of the sheath between the AL-DDFT and deep digital flexor tendon (DDFT). Location of an instrument portal on the lateral aspect of the metacarpus was identified with a needle. The lateral aspect of the AL-DDFT was transected and the arthroscope and instrument were switched to transect the remaining fibers on the medial aspect. Cadaveric specimens were dissected for evaluation. Experimental horses were monitored for 30 days postoperatively. Results: Minor complications including incomplete division of the AL-DDFT and shallow incision into the suspensory ligament were observed in some cadaver specimens. The AL-DDFT was completely transected in all experimental horses with no suspensory ligament damage. Mean±SD surgical time (incision to skin closure) was 28.3±11.8 minutes. On ultrasonographic examination, transection of the AL-DDFT was complete in all experimental horses. Minor DDFT fiber disruption was noted in 1 limb during ultrasound examination at day 30. Conclusions: A tenoscopic approach through the carpal flexor sheath provided adequate access for desmotomy of the AL-DDFT.
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