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影响马远端肢体伸肌腱撕裂伤预后的因素。对156例病例(1994 - 2003年)的回顾性研究。

Factors affecting outcome of extensor tendon lacerations in the distal limb of horses. A retrospective study of 156 cases (1994-2003).

作者信息

Mespoulhès-Rivière C, Martens A, Bogaert L, Wilderjans H

机构信息

Dierenkliniek De Morette, Asse, Belgium.

出版信息

Vet Comp Orthop Traumatol. 2008;21(4):358-64.

Abstract

Distal limb lacerations are common injuries in horses, with a better prognosis reported for extensor tendons lacerations compared to flexor tendons lacerations. The objective of the present study was to determine the influence of type and location of injury, modalities of treatment and post surgical complications on the outcome of extensor tendon lacerations. The medical records of 156 horses surgically treated for extensor tendon lacerations over a 10-year period were analysed retrospectively. Information was obtained for 124 horses with a minimum of 18 months follow-up. Statistical analysis was performed on 129 horses (five horses were euthanatized during hospitalization) in order to determine factors affecting outcome. Seventy-four percent of the horses returned to soundness, 17% had moderate gait impairment and 9% remained lame. Approximately 60% of the sports horses returned to an equal or higher level of performance, and 17.5% returned to a lower level. In the multivariate statistical analysis, the only significant factor that favourably influenced outcome was complete suture of the wound. A significant association could not be detected between outcome and absence of a functional extensor tendon, The most important post-surgical complication was extensive scarring of the wound. The present results report outcome of extensor tendon lacerations in a large number of horses and outline the importance of primary wound healing in order to avoid major scarring with potential functional consequences.

摘要

四肢远端撕裂伤是马匹常见的损伤,与屈肌腱撕裂伤相比,伸肌腱撕裂伤的预后较好。本研究的目的是确定损伤类型和部位、治疗方式及术后并发症对伸肌腱撕裂伤预后的影响。回顾性分析了10年间156例接受伸肌腱撕裂伤手术治疗的马匹的病历。获取了124例至少随访18个月的马匹的信息。对129匹马(5匹马在住院期间实施了安乐死)进行了统计分析,以确定影响预后的因素。74% 的马匹恢复健康,17% 有中度步态障碍,9% 仍有跛行。约60% 的运动马恢复到同等或更高的运动水平,17.5% 恢复到较低水平。在多变量统计分析中,对预后产生有利影响的唯一显著因素是伤口的完全缝合。在预后与伸肌腱功能缺失之间未发现显著关联。最重要的术后并发症是伤口广泛瘢痕形成。本研究结果报告了大量马匹伸肌腱撕裂伤的预后情况,并概述了一期伤口愈合的重要性,以避免出现可能产生功能后果的严重瘢痕形成。

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