Tendon Laceration and Therapy of Joint Dz Flashcards
What 3 things can cause tendon disruption?
Trauma
Activity
Sepsis
What 3 modalities can you use to diagnose a tendon laceration?
Physical exam (joint angle sometimes is just not normal)
Ultrasound
Tenoscopy
What does the fetlock joint look like if just the SDF tendon is lacerated?
Dropped fetlock
What does the fetlock joint look like if the SDF and DDF tendons are lacerated?
Dropped fetlock and toe up
What does the fetlock joint look like if the SDF and DDF tendons and the suspensory ligament are lacerated?
Fetlock is on the ground
NOTE: Only real chance for this horse is a fetlock arthrodesis.
If you have a complete rupture of the common calcanean tendon and gastrocnemius muscle, what 2 things will you see clinically?
Non-weight bearing
Hock can be flexed without flexing the stifle
How can you rest for rupture of the common calcanean tendon?
Try flexing the hock without flexing the stifle
NOTE: This is often a cause of euthanasia
What is the treatment for common and long digital extensor tendon lacerations?
Cast for 3-6 weeks and stall rest for another 6 weeks
What are 3 differentials for excessive fluid in the tendon sheath (seen on ultrasound)?
Septic arthritis
Septic tenosynovitis
Abscess
Describe a tendon sheath and its purpose.
Fibrous outside, synovial membrane inside.
Lubricates and protects.
What is the concern if a laceration goes into a tendon sheath?
Infection can spread more, need to be sure to use a sterile probe to investigate, and then flush wound VERY thoroughly.
What are the 5 steps of treating septic tenosynovitis?
Aspirate for bacterial culture Lavage Tourniquet (regionnal IV anesthesia) Systemic abx Pain meds
What are 5 steps of management of a tendon laceration?
Debridement Culture Lavage Reapposition Drainage
What 3 medical treatments would you provide for a tendon laceration?
Abx
Anti-inflammatories
Sodium hyaluronate
What type of suture material would you use for reapposition of a ruptured tendon?
Nylon or PDS
What suture pattern would you use to reappose a ruptured tendon?
3-loop pulley
In what species does tenorrhaphy lack sufficient strength to withstand weightbearing forces?
The horse of course.
What else is required in the equine patient after tenorrhpahy?
External coaptation
What are 5 different types of support that you can provide following a tenorrhaphy?
Cast Kimsey leg saver Bandages Splints Shoeing
Why do tendon lacerations heal so slowly?
Poor blood supply
In cattle, what is the difference between tenorrhaphy and casting vs. just casting?
No difference.
How should you manage a horse with transected flexor tendons?
4-12 weeks of external coaptation
Stall confinement
Hand walking
Ultrasound
What is the prognosis for a tendon laceration in a cow?
Good for life and productivity
What 2 concerns might you have for a cow with a tendon laceration?
Prolonged convalescence
Persistent lameness
What is the prognosis for equines with a digital flexor tendon laceration?
54% return to soundness
NOTE: partial disruption have a better prognosis.
What are 5 things that can attribute to long-term failure?
Extensive adhesion Pain Tendon contracture Annular lig. constrictuon Breakdown and recumbency
What are 4 ways that tendon injuries can occur?
Direct trauma
Fatigue/lack of conditioning
Improper surface
Improper shoeing
What are 4 types of tendon injury?
Strain
Tear
Rupture
Avulsion/fx
What are 3 mechanical properties of tendons?
Great tensile strength
Transmit muscle contraction to bone
Store and transfer elastic energy
What tendons are most frequently injured in the equine athlete?
SDF
DDF (inferior check, suspensory lig, distal sesamoidean lig)
What do long sloping pasterns predispose a horse to?
Bowed tendons
How do tendons heal?
Inflammatory phase
Fibroplasia
Collagen
Intrinsic/extrinsic
