Endoscopy of the Digital Flexor Tendon Sheath in Horses

Authors

  • ALAN J. NIXON BVSc, MS, DiplomateACVs

    Corresponding author
    1. Department of Clinical Sciences, New York State College of Veterinary Medicine, Cornell University, Ithaca, New York
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2 Department of Clinical Sciences, New York State College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.

Abstract

An arthroscopic procedure for examination of the digital flexor tendons and tendon sheath was developed in 16 equine limbs and 12 horses. Distension of the tendon sheath and insertion of the arthroscope was accomplished through a cul-de-sac on the palmar or plantar surface of the tendon sheath 1 to 2 cm palmar or plantar to the digital neurovascular structures and between the annular ligament and proximal digital annular ligament. A single arthroscope entry point allowed examination of all regions of the tendon sheath cavity and most surfaces of the digital flexor tendons within the sheath. Distal to the fetlock, surgical procedures could be performed through additional entry portals on the lateral, medial, or palmar surfaces of the tendon sheath. The palmar digital vessels and nerves were avoided by palmar placement of the instrument incisions and insertion of a needle before incising the skin. The fetlock canal and proximal regions of the tendon sheath were examined by redirecting the arthroscope. Flexion of the fetlock aided passage of the arthroscope into the proximal tendon sheath regions. Evaluation of the palmar surface of the superficial digital flexor tendon was limited by the midline attachment of the tendon sheath, otherwise the surfaces of the tendons and tendon sheath could be examined with 25° and 70° arthroscopes. The tendon sheath was more tightly invested to the tendons in the proximal regions, limiting the arthroscope movements and second instrument access.

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