Large Animal Surgery, Veterinary Clinical Studies, School of Veterinary Medicine, University College Dublin, Dublin 4, Ireland.
Equine Vet J. 2012 Sep;44(5):570-5. doi: 10.1111/j.2042-3306.2011.00513.x. Epub 2011 Dec 5.
Larger superficial digital flexor tendon (SDFT) injuries have a poorer prognosis than smaller lesions. During the inflammatory phase enlargement of the initial lesion is frequently noted, with biomechanical loading being recently proposed to play an important role.
To evaluate the effect of lower limb cast immobilisation on tendon lesion propagation in an equine model of surgically induced SDFT injury.
Core lesions were surgically induced in both front SDFTs of 6 young mature horses. At the end of surgery, one leg was randomly placed in a lower limb cast and the other leg (control) was bandaged for 10 days. Computerised ultrasonographic tissue characterisation performed at Days 10, 15, 21, 28, 35 and 42 allowed measurement of lesion length (cm) and width (expressed as a percentage of whole tendon cross-section). On Day 42 horses were subjected to euthanasia and both SDFTs were sectioned every centimetre to assess the lesion length macroscopically. Statistics were performed to compare cast vs. control legs with significance set at P<0.05.
When all time points were combined, lesion length was 19% shorter (P<0.0001) and lesion width 57% smaller (P = 0.0002) in the cast legs (6.13 ± 0.12 cm; 6.90 ± 0.64%) than in the control legs (7.30 ± 0.21 cm; 10.85 ± 1.22%). On Day 42 the lesion length on macroscopic evaluation was 19% shorter (P = 0.04) in the cast (7.00 ± 0.36 cm) than in the control legs (8.33 ± 0.33 cm).
Cast immobilisation for 10 days effectively reduced lesion propagation (length and width) compared to bandaging in an in vivo model of artificially-induced tendon lesions.
A short period of cast immobilisation during the early phase of tendon healing may be an easy and cost-effective way to reduce the initial enlargement of lesion size and hence to improve prognosis.
较大的指浅屈肌腱 (SDFT) 损伤比较小的病变预后更差。在炎症期，常可观察到初始病变的扩大，最近有生物力学负荷被提出在其中发挥重要作用。
评估下肢管型固定对手术诱导的 SDFT 损伤马模型中腱病传播的影响。
在 6 匹年轻成熟马的前 SDFT 中均进行了核心病变的手术诱导。手术结束时，随机将一条腿置于下肢管型中，另一条腿（对照）包扎 10 天。在第 10、15、21、28、35 和 42 天进行计算机超声组织特征评估，测量病变长度（cm）和宽度（表示为整个肌腱横截面积的百分比）。在第 42 天，马匹被安乐死，对两条 SDFT 进行每厘米分段以宏观评估病变长度。使用统计学方法比较管型与对照腿，P<0.05 为差异有统计学意义。
当所有时间点合并时，管型腿的病变长度短 19%（P<0.0001），病变宽度小 57%（P=0.0002），为（6.13±0.12 cm；6.90±0.64%），而对照腿为（7.30±0.21 cm；10.85±1.22%）。在第 42 天，宏观评估的病变长度在管型腿中短 19%（P=0.04），为（7.00±0.36 cm），而对照腿为（8.33±0.33 cm）。
与包扎相比，在人工诱导的腱病动物模型中，管型固定 10 天可有效减少病变的传播（长度和宽度）。
在肌腱愈合的早期阶段，短时间的管型固定可能是减少病变大小初始增大的一种简单且经济有效的方法，从而改善预后。
