Department of Pathobiology and Population Medicine, College of Veterinary Medicine, Mississippi State University, Mississippi State, Mississippi, USA.
Vet Surg. 2024 Apr;53(3):503-512. doi: 10.1111/vsu.14065. Epub 2023 Dec 22.
To determine the ability to completely transect the equine accessory ligament of the deep digital flexor tendon (AL-DDFT) via an ultrasonographically-guided, percutaneous looped thread desmotomy using FiberWire suture as a cutting device.
Ex-vivo study.
A total of 24 normal equine distal forelimb specimens.
Under ultrasonographic guidance, a Jamshidi needle was placed between the suspensory ligament and the AL-DDFT, and between the AL-DDFT and the deep digital flexor tendon, through two stab incisions. FiberWire suture was fed through the needle and looped around the AL-DDFT. Using a sawing motion, the ligament was transected, and the suture exited through the lateral incision. Surgical sites were dissected and assessed for completeness of transection, iatrogenic injuries, and suture remnants. Descriptive statistics were reported.
The procedure met the successful criteria in 18/24 (75%) of the limbs. The median surgical time was 11 min (range 7-25). No suture failure or suture remnants were noted in any of the specimens. Complications included iatrogenic injury to the medial and lateral neurovascular bundles in 4/24 and 1/24 specimens, respectively.
Complete transection of the AL-DDFT was achieved in 22/24 (92%) of the specimens; however, the neurovascular bundles were injured in 5/24 (21%) of the specimens.
A percutaneous looped thread desmotomy of the AL-DDFT can be studied as an alternative technique for use in equine models prior to its clinical use in patients. Additional studies are required to evaluate efficacy and safety in anesthetized or standing horses.
通过超声引导下经皮环形线切断术，使用 FiberWire 缝线作为切割装置，确定完全切断马的副深屈肌腱（AL-DDFT）的能力。
离体研究。
总共 24 个正常马的远侧前肢标本。
在超声引导下，通过两个刺切口，将 Jamshidi 针置于悬韧带和 AL-DDFT 之间，以及 AL-DDFT 和深屈肌腱之间。将 FiberWire 缝线穿过针并环绕在 AL-DDFT 周围。通过锯切运动，切断韧带，缝线从外侧切口穿出。对手术部位进行解剖，评估切断的完整性、医源性损伤和缝线残留。报告描述性统计数据。
18/24（75%）条肢体的手术符合成功标准。中位数手术时间为 11 分钟（范围 7-25 分钟）。在任何标本中均未发现缝线失败或缝线残留。并发症包括 4/24 和 1/24 标本的内侧和外侧神经血管束的医源性损伤。
22/24（92%）标本的 AL-DDFT 完全切断；然而，5/24（21%）标本的神经血管束受损。
AL-DDFT 的经皮环形线切断术可以作为一种替代技术在临床应用于患者之前在马模型中进行研究。需要进一步的研究来评估麻醉或站立马的疗效和安全性。
