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马浅屈肌副韧带(近端止动韧带)的电外科关节镜下离断术

Electrosurgical tenoscopic desmotomy of the accessory ligament of the superficial digital flexor muscle (proximal check ligament) in horses.

作者信息

David Florent, Laverty Sheila, Marcoux Marcel, Szoke Mihaly, Celeste Christophe

机构信息

School of Agriculture, Food Science and Veterinary Medicine, University College Dublin, Dublin, Ireland.

出版信息

Vet Surg. 2011 Jan;40(1):46-53. doi: 10.1111/j.1532-950X.2010.00770.x. Epub 2010 Dec 23.

Abstract

OBJECTIVE

To report a tenoscopic technique using monopolar electrosurgery to transect the accessory ligament of superficial digital flexor muscle (AL-SDFM) and outcome in 33 horses.

STUDY DESIGN

Case series.

ANIMALS

Horses (n=33).

METHODS

Medical files and surgery video recordings of horses that had AL-SDFM desmotomy performed by tenoscopy with monopolar electrosurgical electrodes were reviewed.

RESULTS

Of 33 horses, 24 were Standardbred racehorses with surgery performed bilaterally for superficial digital flexor tendonitis and 9 horses had flexural deformity. Severe (n=6) and mild (6) intrathecal hemorrhage was the most common intraoperative complication. Large intrathecal vessels including the nutrient artery were successfully electrocoagulated and AL-SDFM transection was completed. Clear/serosanguinous drainage from skin incisions was observed for 4.3±3.3 days (mean, SD). Protracted wound drainage for >4 days occurred in 10 horses, principally in the group treated for flexural deformities (P=.01).

CONCLUSIONS

Sixty-four AL-SDFM were transected under tenoscopic observation using monopolar electrodes. Electrocoagulation of large intrathecal vessels, including the nutrient artery, was possible in all cases and allowed completion of desmotomy. Postoperative wound care was similar to routine tenoscopy in most (70%) horses. Aseptic protracted wound drainage was observed in 30% of horses (principally those with flexural deformity), and led to a prolonged hospitalization.

摘要

目的

报告一种使用单极电外科技术横断指浅屈肌副韧带(AL-SDFM)的关节镜技术及33匹马的治疗结果。

研究设计

病例系列。

动物

马(n = 33)。

方法

回顾通过关节镜使用单极电外科电极进行AL-SDFM离断术的马的病历和手术录像。

结果

33匹马中,24匹是标准赛马,因双侧指浅屈肌腱炎接受手术,9匹马有屈肌畸形。严重(n = 6)和轻度(6例)鞘内出血是最常见的术中并发症。包括营养动脉在内的大鞘内血管成功电凝,AL-SDFM横断完成。皮肤切口有清亮/血清样引流物的情况持续4.3±3.3天(均值,标准差)。10匹马出现伤口引流时间延长超过4天,主要在治疗屈肌畸形的组中(P = 0.01)。

结论

在关节镜观察下使用单极电极横断了64条AL-SDFM。在所有病例中均能对包括营养动脉在内的大鞘内血管进行电凝,从而完成离断术。大多数(70%)马术后伤口护理与常规关节镜检查相似。30%的马(主要是有屈肌畸形的马)出现无菌性伤口引流时间延长,导致住院时间延长。

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