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跗关节深部指深屈肌腱病变与远侧腱病的存在有关。

Deep digital flexor tendon lesions in the pastern are associated with the presence of distal tendinopathy.

机构信息

Gail Holmes Equine Orthopedic Research Center, College of Veterinary Medicine, Colorado State University, Fort Collins, Colorado, USA.

出版信息

Equine Vet J. 2022 May;54(3):502-512. doi: 10.1111/evj.13470. Epub 2021 Jun 28.

Abstract

BACKGROUND

Correct diagnosis and characterisation of deep digital flexor tendon (DDFT) lesions in equine athletes allows targeted treatment and improved prognostication.

OBJECTIVES

To assess the prevalence and character of pathological change within the DDFT in the pastern with concurrent tendon injury distally. It is hypothesised that tendon lesions in the pastern will be associated with tendinopathy within the hoof capsule.

STUDY DESIGN

Retrospective descriptive case series.

METHODS

Cases with DDFT lesions in the pastern and magnetic resonance imaging (MRI) or ultrasonography of the foot were evaluated retrospectively. Lesion location and type were recorded. Odds ratios were calculated to determine the associations between more distal tendinopathy and the presence of different DDFT lesion types in the pastern.

RESULTS

Thirty-four MRI scans of 33 horses and 64 ultrasonographic exams of 58 horses were analysed. Lesion location and type were recorded. Distal DDFT lesions were found in 75% (95% CI: 66.0-84.0) of total cases of pastern DDF tendinopathy and in 97% (95% CI: 91.6-100.0) of cases with core lesions of the DDFT in the pastern. A core lesion in the pastern was significantly more likely (OR = 20.7, 95% CI: 2.2-191.0; P = .008) to be associated with injury in the foot than other types of pastern lesion.

MAIN LIMITATIONS

MRIs of the foot were not obtained on all included limbs which did not allow for fully inclusive evaluation of DDFT lesions distal to the navicular bone.

CONCLUSIONS

DDFT pathological change in the pastern, particularly core lesions, is associated with additional tendinopathy within the hoof capsule. When a DDFT lesion is found in the pastern, further imaging of the tendon within the foot is indicated to direct appropriate treatment and improve prognostication.

摘要

背景

在马运动员中,正确诊断和描述深部指屈肌腱(DDFT)损伤,可实现针对性治疗并改善预后。

目的

评估伴附远侧腱损伤的球节内 DDFT 的病理改变发生率和特征。假设球节内腱病变与蹄匣内腱病有关。

研究设计

回顾性描述性病例系列研究。

方法

对 DDFT 球节内病变且有足部磁共振成像(MRI)或超声检查的病例进行回顾性评估。记录病变位置和类型。计算比值比(OR),以确定更远处的腱病与 DDFT 球节内不同病变类型之间的关系。

结果

分析了 33 匹马的 34 次 MRI 扫描和 58 匹马的 64 次超声检查。记录了病变位置和类型。DDFT 球节内病变见于 75%(95%CI:66.0-84.0)的 DDF 球节腱病病例和 97%(95%CI:91.6-100.0)的 DDFT 球节核心病变病例。球节内核心病变与足部损伤的相关性显著更高(OR=20.7,95%CI:2.2-191.0;P=0.008)。

主要局限性

并非所有纳入的肢体都获得了足部 MRI,因此无法对跗骨后 DDFT 完全进行病变评估。

结论

球节内 DDFT 的病理改变,尤其是核心病变,与蹄匣内的其他腱病相关。当在球节内发现 DDFT 病变时,应进一步对足部肌腱进行成像,以指导适当的治疗并改善预后。

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