Welch R D, Auer J A, Watkins J P, Baird A N
Department of Large Animal Medicine and Surgery, College of Veterinary Medicine, Texas A&M University, College Station 77843-4475.
J Am Vet Med Assoc. 1990 Jun 15;196(12):1992-4.
A 2-year-old Thoroughbred colt was referred for evaluation of effusion within the tarsal sheath and associated lameness of the right hind limb. Conservative treatment consisting of needle aspiration and pressure bandaging had been unsuccessful. Radiography of the right tarsus revealed proliferative periosteal reaction along the distal caudal border of the sustentaculum tali and medial aspect of the calcaneus. The owners elected conservative treatment, using a local injection of corticosteroid and pressure bandaging the tarsus. Five months later, the severity of the effusion and lameness had increased. Radiography revealed increased reactive bone along the sustentaculum tali and mineralization of the plantar tarsal ligament and tarsal sheath. Surgical exploration revealed fibrous adhesions between the medial aspect of the calcaneus and the flexor tendon and associated soft tissue mineralization. The adhesions were broken down and the reactive bone along the calcaneus was removed. The mineralized soft tissue within the tarsal sheath was excised. Five months after surgery, the horse was sound at the trot, with only minimal tarsal sheath effusion. The response to treatment for tarsal sheath effusion and lameness caused by bony changes of the sustentaculum tali is often unsatisfactory. After responding poorly to conservative treatment, the horse in this report had a favorable outcome to the surgical intervention of this condition.
一匹2岁的纯种马驹因跗关节腱鞘积液及右后肢相关跛行前来接受评估。包括针吸和加压包扎在内的保守治疗均未成功。右跗关节的X线检查显示，距骨支撑突远侧尾缘及跟骨内侧有增生性骨膜反应。马主选择了保守治疗，即局部注射皮质类固醇并对跗关节进行加压包扎。五个月后，积液和跛行的严重程度有所增加。X线检查显示距骨支撑突处反应性骨增加，跖侧跗韧带和跗关节腱鞘矿化。手术探查发现跟骨内侧与屈肌腱之间存在纤维粘连，并伴有软组织矿化。粘连被分解，跟骨处的反应性骨被切除。跗关节腱鞘内的矿化软组织被切除。术后五个月，这匹马在小跑时状态良好，跗关节腱鞘仅有少量积液。由距骨支撑突骨质改变引起的跗关节腱鞘积液和跛行的治疗反应通常不尽人意。在对保守治疗反应不佳后，本报告中的这匹马接受这种疾病的手术干预后取得了良好的效果。
