scholarly journals Deep Digital Flexor Tendon Injury at the Level of the Proximal Phalanx in Frontlimbs With Tendon Sheath Distension Characterized by Standing Low-Field Magnetic Resonance Imaging in Horses: 13 Cases (2015–2021)

2021 ◽  
Vol 8 ◽  
Author(s):  
Elisabeth Cornelia Susanna van Veggel ◽  
Kurt T. Selberg ◽  
Brenda van der Velde-Hoogelander ◽  
Katrien Vanderperren ◽  
Stefan Marc Cokelaere ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Proximal Phalanx ◽  
Case Series ◽  
Tendon Sheath ◽  
Tendon Injury ◽  
Mri Findings ◽  
Retrospective Case ◽  
Low Field ◽  
Previous Level ◽  
Flexor Tendon Sheath

Objective: To describe the MRI findings for 13 horses with deep digital flexor tendon (DDFT) injury at the proximal phalanx where the tendon goes from ovoid to bilobed in frontlimbs with tendon sheath distension. In addition, the prognosis of this lesion was assessed.Design: Retrospective case series.Animals: Thirteen client-owned horses.Procedures: Medical records were reviewed, and data were collected regarding signalment, history, MRI findings, and outcomes of horses. Findings of MRI were recorded and whether the case was confirmed with tenoscopy.Results: A diagnosis of DDFT injury at the junction between ovoid and bilobed portions at the level of the proximal phalanx was established in 13/20 (65%) horses that underwent MRI examination of the frontlimb digital flexor tendon sheath. Return to previous level of work was poor in this subset of horses with only three of 13 (23%) horses returning to previous level of work and one horse still in rehabilitation.Conclusions and Clinical Relevance: Standing low-field MRI represents a potentially useful diagnostic tool to evaluate digital flexor tendon sheath distension especially when evaluating the DDFT at the proximal phalanx where the tendon progresses from ovoid to bilobed. Prognosis of lesions of the DDFT at the proximal phalanx appears less favorable than previously reported causes of tendon sheath distension.

Transthecal Digital Nerve Block

1998 ◽  
Vol 23 (4) ◽  
pp. 490-493 ◽  
Author(s):  
N. S. SARHADI ◽  
J. SHAW-DUNN
Keyword(s):  
Methylene Blue ◽  
Nerve Block ◽  
Flexor Tendon ◽  
Proximal Phalanx ◽  
Proximal Part ◽  
Tendon Sheath ◽  
Areolar Tissue ◽  
Digital Nerve ◽  
Flexor Tendon Sheath ◽  
Digital Nerve Block

Injection studies using methylene blue and latex were used in 60 digits from 40 cadavers to study how anaesthetic fluid injected into the flexor tendon sheath might spread around the proximal part of the finger. The injected solution escaped from the flexor tendon sheath around the vincular vessels which are present near the base and head of the proximal phalanx. Outside the digital canal, the dye flowed smoothly through the perivascular loose areolar tissue and spread alongside the main digital vessels and nerves and their palmar and dorsal branches.

Dorsal Approach to Transfer of the Flexor Digitorum Brevis Tendon

2011 ◽  
Vol 101 (4) ◽  
pp. 297-306 ◽  
Author(s):  
Ricardo Becerro de Bengoa Vallejo ◽  
Marta Elena Losa Iglesias ◽  
Juan Carlos Prados Frutos ◽  
Miguel Fuentes Rodriguez ◽  
Kevin T. Jules
Keyword(s):  
Flexor Tendon ◽  
Proximal Phalanx ◽  
Tendon Sheath ◽  
Cadaveric Study ◽  
Flexor Digitorum Longus ◽  
Dorsal Approach ◽  
Hammer Toe ◽  
Flexor Digitorum Brevis ◽  
Flexor Tendon Sheath ◽  
Flexor Digitorum

Background: Transposition of the flexor digitorum longus tendon has been widely reported for the correction of flexible claw and hammer toe deformities. Only transposition of the flexor digitorum brevis tendon has been reported in the literature in a cadaveric study that used the dorsal and plantar approach. A search of the literature revealed no reports of transposition of the flexor digitorum brevis tendon for treatment of these conditions through a unique dorsal cutaneous incision. We performed a cadaveric study to determine whether the flexor digitorum brevis tendon is long enough to be transferred to the dorsum of the proximal phalanx of the toe from its lateral or medial aspect through a unique dorsal cutaneous incision. Methods: Transposition of the flexor digitorum brevis tendon was attempted in 156 toes of cadaveric feet (52 each second, third, and fourth toes) through a unique dorsal incision. Results: The flexor digitorum brevis tendon was long enough to be successfully transposed in 100% of the second, third, and fourth toes by the dorsal incision approach. Conclusions: Transfer of the flexor digitorum brevis tendon to the dorsum of the proximal phalanx can be performed for the correction of claw and hammer toe deformities, especially in the second, third, and fourth toes. The meticulous longitudinal incision of the flexor tendon sheath to expose the flexor digitorum brevis tendon is essential to the success of the procedure. (J Am Podiatr Med Assoc 101(4): 297–306, 2011)

scholarly journals Tenoscopic Debridement or Surgical Repair for Longitudinal Tears of the Equine Deep Digital Flexor Tendon Within the Digital Flexor Tendon Sheath?

2018 ◽  
Vol 3 (2) ◽  
Author(s):  
Daniel Castillo ◽  
Neal Ashton
Keyword(s):  
Surgical Repair ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Performance Outcomes ◽  
Bottom Line ◽  
Improved Outcomes ◽  
Previous Level ◽  
Flexor Tendon Sheath ◽  
Multiple Variables ◽  
Quality Evidence

<strong>PICO question</strong><br /><p>In horses with longitudinal tears of the deep digital flexor tendon within the digital flexor tendon sheath, is surgical repair as effective as tenoscopic debridement alone for returning to previous level of performance?</p><strong>Clinical bottom line</strong><br /><p>Current literature on the efficacy of surgical repair or tenoscopic debridement is limited. Criteria to define and evaluate performance outcomes is not uniform and confounded with multiple variables, merely representing low quality evidence that is difficult to draw meaningful conclusions from. However, the literature suggests tenoscopic debridement alone has been associated with improved outcomes. A more definitive conclusion cannot be made until higher quality evidence is made available on this topic.</p><p> </p><img src="https://www.veterinaryevidence.org/rcvskmod/icons/oa-icon.jpg" alt="Open Access" /> <img src="https://www.veterinaryevidence.org/rcvskmod/icons/pr-icon.jpg" alt="Peer Reviewed" />

Epithelial inclusion cyst of the equine digital flexor tendon sheath: diagnosis by ultrasonography and magnetic resonance and successful treatment by tenoscopy

2019 ◽  
Vol 88 (6) ◽  
pp. 320-326 ◽  
Author(s):  
Z. Joostens ◽  
L. Vanslambrouck ◽  
H. De Cock ◽  
T. Mariën
Keyword(s):  
Magnetic Resonance ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Good Prognosis ◽  
Inclusion Cyst ◽  
Flexor Tendon Sheath ◽  
Dense Mass ◽  
Epithelial Inclusion Cyst ◽  
Distal Aspect

A six-year-old warmblood horse was presented with a longstanding frontlimb lameness with mild digital flexor tenosynovitis and swelling of the distomedial pastern. Ultrasonography and magnetic resonance revealed a dense mass lesion in the distal aspect of the digital flexor tendon sheath, with a partial lamellar architecture, absence of internal vascularization and adjacent smooth pressure osteolysis of the middle phalanx. After surgical excision, histopathology confirmed an epithelial inclusion cyst. Epithelial inclusion cysts, also known as keratinizing or follicular cysts, are expansile benign mass-like lesions of aberrant epidermal tissue. In the horse, they are known to occur in cutaneous and several non-cutaneous tissues. In the digital flexor tendon sheath, they have rarely been described. Given their often chronic presentation in this location, they may appear as an atypical dense mass on imaging, uncommon for cystic lesions. Complete tenoscopic removal, even for larger masses, is achievable and considered curative with good prognosis for return.

Radiographic Correlation of Hallux MP Fusion Position and Plate Angle

2009 ◽  
Vol 30 (9) ◽  
pp. 873-876 ◽  
Author(s):  
J. Thaddeus Leaseburg ◽  
James K. DeOrio ◽  
Shane A. Shapiro
Keyword(s):  
Weight Bearing ◽  
Proximal Phalanx ◽  
Case Series ◽  
Statistical Correlation ◽  
Titanium Plate ◽  
Care Needs ◽  
Retrospective Case ◽  
Level Of Evidence ◽  
Lower Correlation ◽  
Proper Weight

Background: This study assessed the variability of plate bend in regard to final metatarsophalangeal (MP) fusion angles and toe-to-floor distance. We hypothesized that the final MP angle, the angle of the proximal phalanx to the floor, and the weightbearing toe-to-floor distance would be dictated solely by the magnitude of the bend in the plate. Materials and Methods: This is a retrospective analysis of 35 sequential patients who underwent MP fusion with a low-contour titanium plate. Postoperative weightbearing radiographs were analyzed for plate angle, MP fusion angle, the angle of the proximal phalanx to the floor, and the weightbearing toe-to-floor distance. Results: We found statistical correlation between plate angle and MP angle and between plate angle and the angle of the proximal phalanx to the floor. However, there was low correlation between plate angle and with toe-to-floor distance. In addition, we noted many outliers, which resulted in higher or lower correlation of the MP angle to the expected plate angle and, thus, a relationship between angles that was far from linear. Conclusion: Care needs to be taken when relying solely on the bend in the plate to determine the final position of the toe in MP fusions. Although the association between plate bend and MP angle and proximal phalanx to floor angle was strong, the association between the bend in the plate and weight bearing toe-to-floor distance was variable. This could result in the toe hitting the shoe or the need to vault over the toe. Therefore, the surgeon must match the plate to each patient's anatomy to ensure proper weight bearing toe-to-floor distance and not rely on plate angle exclusively. Level of Evidence: IV, Retrospective Case Series

The Sesamoids of the Metacarpo-Phalangeal Joint of the Thumb: An Anatomical and Clinical Study

1989 ◽  
Vol 14 (2) ◽  
pp. 244-247
Author(s):  
J. D. GIBEAULT ◽  
P. SABA ◽  
H. HOENECKE ◽  
A. GRAHAM
Keyword(s):  
Clinical Study ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Volar Plate ◽  
Histological Studies ◽  
Anatomical Dissection ◽  
Flexor Tendon Sheath

Two unusual cases of injury to the sesamoids of the M.P. joint of the thumb are described. An anatomical dissection of the M.P. volar plate region, including the sesamoids, was undertaken to delineate the details of the sesamoids’ relationship to the M.P. joint, flexor tendon, flexor tendon sheath and capsule of the joint. Histological studies were carried out to demonstrate a tendinous extension of the muscles that attach to the sesamoids.

Sign in / Sign up

Export Citation Format

Share Document