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马腕部屈肌腱鞘的临床和腱鞘镜检查结果评估

Evaluation of clinical and tenoscopic findings in the carpal flexor sheath of horses.

作者信息

Zetterström Sandra M, Johansson Bengt C, Carmalt James L

出版信息

Am J Vet Res. 2017 Jul;78(7):840-846. doi: 10.2460/ajvr.78.7.840.

DOI:10.2460/ajvr.78.7.840
PMID:28650233
Abstract

OBJECTIVE To evaluate clinical and tenoscopic findings in a large group of horses undergoing surgery of the carpal flexor sheath (CFS) and determine whether any of the presurgical clinical signs were associated with tenoscopic findings. ANIMALS 242 horses that had undergone diagnostic and therapeutic tenoscopy of the CFS because of aseptic tenosynovitis. PROCEDURES Medical and tenoscopic video records (when available) of 242 horses undergoing tenoscopy of the CFS at a single equine clinic between January 2005 and June 2014 were reviewed. Tenoscopic findings were categorized as present or absent, and tears in the deep digital flexor tendon (DDFT) were subjectively graded according to severity. Logistic regression analysis was used to examine whether presurgical clinical findings were associated with intraoperative tenoscopic findings. RESULTS 242 horses (411 limbs) were evaluated by use of tenoscopy. An exostosis was detected in 228 horses (379 limbs) and was often multipartite. Most exostoses were found medial to, or within, the sagittal plane at the caudal margin of the scar on the distal physis of the radius. Effusion in the CFS was associated with tears in the DDFT. Other presurgical clinical findings were not predictive of intrathecal findings. CONCLUSIONS AND CLINICAL RELEVANCE Synovial effusion was predictive of DDFT lesions within the CFS but was not predictive of the severity of lesions. Further studies will be necessary to determine whether any tenoscopic findings are associated with reduced athletic performance and to assess the effect of surgical intervention in affected horses.

摘要

目的 评估一大群接受腕屈肌腱鞘(CFS)手术的马匹的临床和腱鞘镜检查结果,并确定术前任何临床体征是否与腱鞘镜检查结果相关。动物 242 匹因无菌性腱鞘炎接受 CFS 诊断性和治疗性腱鞘镜检查的马匹。方法 回顾了 2005 年 1 月至 2014 年 6 月期间在一家单一的马诊所对 242 匹接受 CFS 腱鞘镜检查的马匹的医学和腱鞘镜视频记录(如有)。腱鞘镜检查结果分为存在或不存在,对指深屈肌腱(DDFT)的撕裂根据严重程度进行主观分级。采用逻辑回归分析来检查术前临床结果是否与术中腱鞘镜检查结果相关。结果 使用腱鞘镜检查评估了 242 匹马(411 个肢体)。在 228 匹马(379 个肢体)中检测到骨赘,且通常为多部分的。大多数骨赘位于桡骨远端骨骺瘢痕尾缘矢状面内侧或其内部。CFS 中的积液与 DDFT 的撕裂相关。其他术前临床结果不能预测鞘内检查结果。结论和临床意义 滑膜积液可预测 CFS 内的 DDFT 病变,但不能预测病变的严重程度。需要进一步研究以确定任何腱鞘镜检查结果是否与运动性能下降相关,并评估手术干预对受影响马匹的效果。

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