Please enable JavaScript.
Coggle requires JavaScript to display documents.
Tendon & Ligament Injuries - Coggle Diagram
Tendon & Ligament Injuries
Superficial Digital Flexor (SDF)
Stores energy, most common flexor injury
Tendonitis
Most common
Muscle weakness & poor BCS can contribute
Caused by: Repetitive & over extension of fetlock
Signs:
Lame, swelling, heat and sensitivity
Diagnosis
Signs
U/S (most common!)
Dx analgesia (RARE)
MRI
Treatment
NSAIDs
Colds
Topical
Bandage
Stall confinement
Afterwards:
Controlled exercise for 6-12m
Bio therapy
Shockwave
Bio Therapy: restore normal structure and function of tissue, mimics development
Growth Factors (PRP)
Stem Cells (Bone marrow- low #'s but cost-effective, or adipose derived)
Scaffold
Stem Cells:
Differentiate into specific cells
Secrete trophic bioactive factors
Secrete immunomodulatory factors
Growth factors in BM supernatent or plasma?
Platelets:
Abundant source of growth factors
Increase cell migration and prolif
Increase Angiogenesis & Matrix deposition
Decrease interleukins and MMPs
Fibrin scaffold, immune regulation, stem cell recruitment
PRP:
High platelet count= high growth factor concentration= high matrix gene expression
High [WBC]= increase collagen III and degredative enzyme expression (dont want!!)
ESWT (Shockwave)
Support bandage
Stall rest afterwards
Palmar Annular Desmotomy
Relieves constriction through fetlock canal
Prognosis: Guarded, re-injury high
Deep Digital Flexor Tendon
Movement, less common
Signs: Lame but not always, swelling and effusion
Usually in digit or Fetlock level
Diagnosis:
Diagnostic analgesia is important (wasn't in SDF), MRI, tenescopy
Treatment
Medical Options: similar to that of SDF
Sx: Palmar annular desmotomy, tenoscopy
Trimming and shoeing
Prognosis: Guarded
46% of race horse injuries are tendons, caused by degenerative change
Heal slow due to poor blood supply
Suspensory Desmitis
Most common ligamentous injury
Due to hyperextension of fetlock
Lesion Locations:
Origin, body, branches
Diagnosis
Signs, diagnostic analgesia (most popular!), MRI, rads, nuclear scintigraphy
Surgical Options
Fenestration (ligament splitting): acute core lesions, any location
Retinacular release: SL origin in HL
Chronic poor healing in HL --> neurectomy of the deep branch of the lateral plantar nerve +/- suspensory ligament fasciotomy + biologics
Prognosis: depends
Distal (Inferior) Check Desmitis
Acute onset of lameness and swelling
Diagnosis:
DA
Sonogram
Treatment:
Meds, IC desmotomy for chronic/recurrent
Prognosis: good for early, not for late
Distal Sesamoidean Desmitis
Lameness and swelling
DA, US, MRS
Tx: Meds, sx: digital annular desmotomy
Prognosis: Guarded