Comparison of four techniques for synoviocentesis of the equine digital flexor tendon sheath: A cadaveric study

2012 ◽  
Vol 25 (03) ◽  
pp. 178-183 ◽  
Author(s):  
M. Oosterlinck ◽  
F. Pille ◽  
A. Valère ◽  
A. Martens ◽  
M. Jordana
Keyword(s):  
Methylene Blue ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Median Number ◽  
Digital Nerve ◽  
Sesamoid Bone ◽  
Injection Point ◽  
Injection Techniques ◽  
Flexor Tendon Sheath ◽  
Successful Technique

Summary Objective: To compare four different techniques for synoviocentesis of the equine digital flexor tendon sheath (DFTS). Methods: Fifteen inexperienced operators performed each of the following injection techniques on two cadaveric limbs: Proximal (at the proximal recess of the DFTS), Axial (axial to the proximal sesamoid bone), Base (at the base of the proximal sesamoid bone), and Distal (at the pastern). The number of attempts needed before the needle was assumed to be correctly positioned into the DFTS was recorded and 10 ml of methylene blue was injected. The limbs were dissected to determine the presence of methylene blue in the DFTS, the distance between the needle entrance point and the lateral palmar or plantar (digital) nerve, the degree of subcutaneous leakage and the distance between the border of the leakage zone and the lateral digital nerve. Results: The Axial (29/30) and Distal (25/30) approaches had the highest numbers of successful injections. The median number of attempts was highest for the Axial approach. The distances from the injection point and from the border of the leakage zone to the lateral digital nerve were longer for Distal and Axial approaches. Clinical relevance: In the hands of inexperienced operators, the Axial approach was the most successful technique for injection of the equine DFTS. Sparse subcutaneous leakage and larger distance to the nerve when using this technique might decrease the risk of inadvertent palmar or plantar digital nerve desensitisation when performing DFTS analgesia.

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.

scholarly journals Flexor Tendon Sheath Ganglions: Results of Surgical Excision

Hand ◽  
2007 ◽  
Vol 2 (3) ◽  
pp. 94-100 ◽  
Author(s):  
Peter J. L. Jebson ◽  
Edwin E. Spencer
Keyword(s):  
Telephone Interview ◽  
Flexor Tendon ◽  
Surgical Excision ◽  
Tendon Sheath ◽  
Additional Patient ◽  
Dominant Hand ◽  
Digital Nerve ◽  
A2 Pulley ◽  
Flexor Tendon Sheath

The purpose of our study was to review the clinical features and determine the results following surgical excision of a flexor tendon sheath ganglion. A retrospective analysis of 24 consecutive patients (25 ganglions) who underwent excision of a painful flexor tendon sheath ganglion by the same surgeon was performed. The patient's medical and operative records were reviewed. Each patient was invited to return for an evaluation, which consisted of a clinical interview, completion of a questionnaire, and physical examination. Those patients that were unable to return underwent a detailed telephone interview. Sixteen patients returned for a clinical evaluation, while eight patients underwent a telephone interview. There were 15 women and nine men, with an average age of 43 years (range, 21–68 years). The dominant hand was involved in 15 patients. The long finger was most commonly involved (11 cases). The ganglion arose from the A1 pulley in 13 cases, between the A1 and A2 pulleys in three cases, and from the A2 pulley in nine cases. At an average follow-up of 18.5 months (range, 5–38 months), all of the patients were satisfied with their final result. No patient developed a recurrence and all returned to their previous functional level. There were two minor complications that resolved uneventfully; one patient experienced mild incisional tenderness, while an additional patient experienced transient digital nerve paresthesias. We conclude that surgical excision is a simple, safe, and effective method for treating a painful ganglion of the digital flexor tendon sheath.

Anatomical Demonstration of the Nerve-Supply to the Flexor Tendon

1991 ◽  
Vol 16 (1) ◽  
pp. 92-93 ◽  
Author(s):  
C. M. PESSON ◽  
T. P. FINNEY ◽  
C. J. DEPAOLO ◽  
E. J. DABEZIES ◽  
M. L. ZIMNY
Keyword(s):  
Flexor Tendon ◽  
Tendon Sheath ◽  
Nerve Supply ◽  
Digital Artery ◽  
Digital Nerve ◽  
Nerve Fibres ◽  
Flexor Tendon Sheath ◽  
Transverse Branch

A dissection of four unembalmed human fingers demonstrated a branch from the digital nerve which enters the flexor tendon sheath at the same place as the transverse branch of the digital artery. We conclude that this branch supplies the nerve fibres found within the vinculum.

scholarly journals Response of three digital anesthetic technics in horses with forelimb hoof lameness

2017 ◽  
Vol 69 (4) ◽  
pp. 793-801
Author(s):  
S.L. Dau ◽  
M.S. Azevedo ◽  
F.D. De La Corte ◽  
K.E. Brass ◽  
M. Gallio ◽  
...  
Keyword(s):  
Flexor Tendon ◽  
Tendon Sheath ◽  
Interphalangeal Joint ◽  
Navicular Bone ◽  
Digital Nerve ◽  
Distal Interphalangeal Joint ◽  
Time Points ◽  
Flexor Tendon Sheath ◽  
Distal Interphalangeal ◽  
Over Time

ABSTRACT The presented study aimed to assess objectively the response of distal interphalangeal joint (DIJ), navicular bursa (NB) and deep digital flexor tendon sheath (DDFTS) anesthesia in horses with forelimb hoof lameness; and evaluate if the presence of radiographic abnormalities on navicular bone could interfere on blocks’ results. Fifteen horses with lameness improvement above 70% after palmar digital nerve (PDN) block were selected for this study. Blocks were assessed separately on five consecutive trials at seven different time-points. The fifth trial was performed to evaluate the influence of exercise on preexisting lameness. Most of horses (73.33%) presented pain related to the podotrochlear apparatus based on clinical and lameness exam and blocks’ responses. NB and DIJ anesthesia differed on the frequency of horses with lameness improvement above 70% only at 10min (p=0.03), and both differed from DDFTS block until 30’(p<0.05). The blocks’ response was variable along the time and the highest means for NB, DIJ and DDFTS were observed at 5-10 minutes (’), 15-20’ and 10-15’ respectively.Exercise had low interference on lameness intensity since no improvement above 50% was observed and an increase on lameness intensity over time was identified in seven horses. Variable grades of navicular bone radiographic lesions were observed in 14 horses, although these lesions had no interference on blocks’ response (p>0.05). The NB and DIJ blocks had similar responses and both were superior to DDFTS anesthesia, coincident with a major prevalence of podotroclear apparatus abnormalities in this equine population.

scholarly journals Surgery for ganglia of the flexor tendon sheath

2013 ◽  
Vol 5 (1) ◽  
pp. 6
Author(s):  
Vilhjalmur Finsen ◽  
Øyvind Håberg ◽  
Grethe Elisabeth Borchgrevink
Keyword(s):  
Nerve Injury ◽  
Flexor Tendon ◽  
Tendon Sheath ◽  
Digital Nerve ◽  
General Satisfaction ◽  
Flexor Tendon Sheath ◽  
Results Of Surgery

There are very few reports in the literature on the results of surgery for ganglia of the flexor tendon sheaths of the digits. We reviewed 24 patients operated for flexor tendon sheath ganglia 8 (3-11) years previously. Two operations were for recurrences and one of these recurred again. There was one permanent digital nerve injury and one patient complained of cold sensibility. VAS (0=best; 100=worst) for mean general complaints from the hand was remembered as 51 before surgery and was 5 at review. Mean pain at review was reported as VAS 4 and general satisfaction with the operation as VAS 3. All stated that they would have consented to surgery if they had known the outcome in advance. We conclude that the results of surgery are good, although complications do occur.

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.

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.

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