Tendon Lacerations

Question 1

sign of a tear to the SDFT

Answer 1

dropped fetlock

Question 2

extensor tendons of hindlimb

Answer 2

• long digital extensor tendon

- lateral digital extensor tendon

Question 3

what to remember when considering tenorrhaphy

Answer 3

ONLY do if >50% of tendon torn

MUST close paratenon in areas not within tendon sheath

Question 4

goals of tenorrhaphy

Answer 4

• minimizes gap
• restores gliding (MUST close paratenon in areas not within tendon sheath)
• preserves vasculature

Question 5

this closure technique for tenorrhaphy is the G.S. for severe laceration and is used for intrasynovial repairs

Answer 5

locking loop suture

Question 6

surgery options for flexor tendon lacerations

Answer 6

-GA
-debride
+/- tenorrhaphy ONLY if >50% torn: minimizes gap, restores gliding (MUST close paratenon in areas not within sheath), preserves vasculature

Question 7

prognosis for direct trauma/tears to the extensor tendons

Answer 7

great because not weight bearing like flexors

Question 8

suture closure options for tenorrhaphy (3)

Answer 8

• locking loop suture (G.S. for severe lacerations): intrasynovial repair
• 3 loop pulley
• 6 strand salvage (SSS): NOT good if a lot of vascular damage because leads to more vascular compromise than other repair options

Question 9

sign that both the SDFT and DDFT are lacerated

Answer 9

fetlock dropped even further + toe up

Question 10

which is more common: tendon laceration of the flexor tendons or the extensor tendons?

Answer 10

flexor tendons; also have a worse prognosis

Question 11

what can sometimes be mistaken for SDFT and DDFT tears?

Answer 11

noodly foals: will present with fetlock hyperextension and toe up because their muscles are weak.

use heel extension show to fix NOT brace (won’t get them stronger)

Question 12

what to beware of when a horse presents with tendon laceration (3)

Answer 12

• contralateral limb laminitis
• neurovascular damage
• capsular tears/joint involvement

Question 13

complications possible when treating tendon lacerations (8)

Answer 13

• necrotic tendonitis
• infection
• vascular damage
• synovial sepsis/joint infection
• cast complications
• excessive granulation tissue
• adhesions (can cause pain)
• acquired flexural deformity

Question 14

this closure technique for tenorrhaphy is NOT good if a lot of vascular damage because leads to more vascular compromise than other repair options

Answer 14

6 strand salvage (SSS)

Question 15

what can you use if you suspect joint involvement in a tendon laceration case?

Answer 15

contrast rads to determine if wound communicaters with joint

Question 16

which has a worse prognosis: lacerations to flexor or extensor tendons

Answer 16

flexor tendon lacerations are more common with a worse prognosis

Question 17

causes of tendon lacerations (3)

Answer 17

• percutaneous/direct trauma
• overload (use trauma)
• infection

Question 18

extensor tendons of forelimb

Answer 18

• common digital extensor tendon

- lateral digital extensor tendon

Question 19

treatment for flexor tendon lacerations (4)

Answer 19

• splinting/cast
• surgery: GA, debride +/- tenorrhaphy (only if >50% torn)
• tendon implants (polylactic acid L implant)
• corrective shoeing

Question 20

diagnosing tendon lacerations (5) which is G.S.

Answer 20

• distance exam
• PE (lameness exam and palpation)
• rads (use contrast rads if you suspect a capsular tear/synovial involvement)
• US: G.S.
• tenoscopy

Question 21

treatment for lacerations of the extensor tendons

Answer 21

conservative unless extensor tendon sheath is lacerated (which then requires lavage)

conservative: wound management, splinting, bandage