Royal Veterinary College, Hatfield, UK.
Rossdales Equine Hospital, Newmarket, UK.
Equine Vet J. 2024 Sep;56(5):936-943. doi: 10.1111/evj.14010. Epub 2023 Oct 2.
Desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) is a commonly reported injury. Despite the commonality of this injury, the literature is limited to small case series, with the reported success following treatment varying from 18% to 75%.
To identify the prognosis and factors associated with a return to work following ALDDFT injury.
Retrospective case series.
Medical records of horses from four equine hospitals (January 2000 and December 2018) with a diagnosis of desmitis of ALDDFT were reviewed. Data retrieved included case detail, use, history, lameness treatment and follow-up. Success was defined as returning to work. Backward stepwise logistic regression was used to identify variables significantly associated with return to work.
Ninety-one horses were included. The mean age was 13.5 years (standard deviation 4.9 years). Thirty-four percent (28/91) of horses were sound at the initial presentation. Sixty-eight percent (62/91) of horses were managed using controlled exercise alone, 28% (29/91) were treated with intra-lesional injection, therapeutic ultrasound, extracorporeal shockwave therapy or desmectomy of the ALDDFT and 3% (3/91) were euthanased without treatment. Sixty-four percent (54/85) of horses returned to work. Horses that were lame at follow-up were less likely to return to work (odds ratio [OR] 107.93, 95% confidence interval [CI] 20.06-580.61, p < 0.001) than those that returned to soundness. Identification of adhesions on ultrasonography was also associated with having reduced odds for return to work when compared to horses without adhesions (OR 0.10, 95% CI 0.01-0.76, p = 0.03).
Retrospective nature of the study, the potential of selection bias with regards to follow-up.
Sixty-four percent (54/85) of horses returned to work following injury of the ALDDFT. Persistence of lameness and adhesion formation were significantly associated with a poor outcome.
指深屈肌腱副韧带（ALDDFT）的黏液囊炎是一种常见的损伤。尽管这种损伤很常见，但文献仅限于小病例系列，治疗后的成功率从 18%到 75%不等。
确定 ALDDFT 损伤后重返工作岗位的预后和相关因素。
回顾性病例系列。
对四家马医院（2000 年 1 月至 2018 年 12 月）的患有 ALDDFT 黏液囊炎的马的病历进行了回顾。检索的数据包括病例详细信息、使用情况、病史、跛行治疗和随访情况。成功定义为重返工作岗位。采用向后逐步逻辑回归分析确定与重返工作岗位显著相关的变量。
91 匹马入选。平均年龄为 13.5 岁（标准差 4.9 岁）。34%（28/91）的马在初次就诊时表现正常。68%（62/91）的马仅接受控制性运动治疗，28%（29/91）的马接受了关节内注射、治疗性超声、体外冲击波治疗或 ALDDFT 松解术，3%（3/91）的马未经治疗而被安乐死。64%（54/85）的马重返工作岗位。随访时跛行的马重返工作岗位的可能性较小（优势比[OR]107.93，95%置信区间[CI]20.06-580.61，p<0.001），而那些恢复正常的马则较小。与没有粘连的马相比，超声检查发现粘连也与重返工作岗位的可能性降低相关（OR 0.10，95%CI 0.01-0.76，p=0.03）。
研究的回顾性性质，随访时可能存在选择偏倚。
64%（54/85）的马在 ALDDFT 损伤后重返工作岗位。跛行和粘连形成的持续存在与预后不良显著相关。
