Intrathecal deep digital flexor tenectomy for treatment of septic tendonitis/tenosynovitis in four horses.

OBJECTIVE: To describe partial removal of the intrathecal component of the deep digital flexor tendon (DDFT) in horses with chronic septic DDF tendonitis and tenosynovitis unresponsive to conventional therapy, and to report long-term outcome. STUDY DESIGN: Case series. ANIMALS: Horses (n=4). METHODS: Four horses with chronic septic DDF tendonitis and tenosynovitis were treated by surgical tenectomy of the intrathecal component of the DDFT, followed by stabilization in casts and subsequent corrective shoeing. All horses were previously managed unsuccessfully with combinations of conventional therapy consisting of systemic antibiotics, through and through tendon sheath lavage/open drainage, regional limb perfusions, tenoscopy with debridement and transection of the palmar/plantar annular ligament, and intrathecal antibiotics. RESULTS: Time from initial injury/diagnosis to tenectomy ranged from 10 to 210 days. Mean hospitalization time after surgery was 82 days. Long-term follow-up (>1.5 years; mean, 3.8 years) was available. All 4 horses were able to walk comfortably at pasture and were used as broodmares. CONCLUSIONS: Intrathecal tenectomy is a viable surgical procedure for treatment of chronic septic tenosynovitis of the digital sheath that is complicated by septic tendonitis of the DDFT.

Fractures of the greater tubercle of the humerus in horses: 15 cases (1986-2004).

OBJECTIVE: To determine clinical and radiographic abnormalities in and outcome of horses with fractures of the greater tubercle of the humerus and to develop a radiographic technique for obtaining a cranioproximal-craniodistal oblique projection of the proximal portion of the humerus in standing horses. DESIGN: Retrospective case series. ANIMALS: 15 horses. PROCEDURES: Data collected from medical records included signalment, history, horse use, severity and duration of lameness, radiographic and ultrasonographic findings, treatment, and outcome. RESULTS: All horses had a history of acute, unilateral lameness. Twelve of 15 had visual or palpable abnormalities in the shoulder region. In 6 of 8 horses, the fracture could be seen on a cranioproximal-craniodistal projection of the proximal portion of the humerus. In 2 horses, this was the only projection on which the fracture could be seen, and in an additional 2, this was the projection on which the fracture could be seen most reliably. Ten horses underwent surgery (fragment removal, 7; open reduction and internal fixation, 2; and exploration without fragment removal, 1), and 5 were treated with variable periods of stall rest and turnout. Eleven horses returned to athletic use, including 9 of the 10 treated surgically and 2 of the 5 treated without surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that horses with fractures of the greater tubercle of the humerus can return to athletic soundness following treatment and emphasized the need for obtaining a cranioproximal-craniodistal radiographic projection of the proximal portion of the humerus in horses suspected to have an injury in this region.