Ingle-Fehr J E, Baxter G M
Department of Clinical Sciences, Colorado State University Veterinary Teaching Hospital, Fort Collins 80525, USA.
Vet Surg. 1998 Nov-Dec;27(6):561-7. doi: 10.1111/j.1532-950x.1998.tb00532.x.
To describe endoscopic approaches to the calcaneal bursa and clinical findings in 2 horses with calcaneal bursitis.
Cadaver evaluations and retrospective case reports.
12 cadavers and 2 adult horses.
Cadaver specimens of the calcaneal bursa were evaluated with a rigid arthroscope and gross dissection to determine the endoscopic appearance of anatomic structures located within the bursa. The site(s) for placement of the arthroscope and instrument(s) was determined based on cadaver dissection and endoscopic examination.
Placement of the arthroscope 1 cm dorsal to the superficial digital flexor tendon (SDFT) and 1 cm distal to the medial or lateral aspect of the SDFT retinaculum allowed consistent examination of the tuber calcis, proximal aspect of the long plantar ligament, calcaneal tendon of the gastrocnemius muscle inserting on the tuber calcis, SDFT and the proximal and distal extent of the bursa. Lesions observed and treated with use of endoscopy included local bone necrosis of the proximoplantar aspect of the tuber calcis and damage of the origin of the long plantar ligament in one horse. Mild disruption of the superficial digital flexor tendon and long plantar ligament were observed and debrided in another horse.
Endoscopic exploration of the calcaneal bursa is clinically feasible to treat infectious and noninfectious bursitis and to help identify the cause(s) of undiagnosed bursitis or lameness associated with the calcaneus, superficial digital flexor tendon, tendon of the gastrocnemius muscle, and the long plantar ligament.
An endoscopic approach to the calcaneal bursa is recommended whenever possible to decrease complications associated with surgery in this region and improve the diagnosis of infectious and non-infectious calcaneal bursitis.
描述2例跟腱黏液囊炎马的跟腱黏液囊内镜检查方法及临床发现。
尸体评估和回顾性病例报告。
12具尸体和2匹成年马。
使用硬式关节镜和大体解剖对跟腱黏液囊尸体标本进行评估,以确定黏液囊内解剖结构的内镜外观。根据尸体解剖和内镜检查确定关节镜和器械的放置部位。
将关节镜置于浅屈肌腱(SDFT)背侧1 cm、SDFT支持带内侧或外侧1 cm远侧,可对跟骨结节、长跖韧带近端、止于跟骨结节的腓肠肌跟腱、SDFT以及黏液囊的近端和远端进行一致的检查。通过内镜观察并治疗的病变包括一匹马跟骨结节跖侧近端局部骨坏死以及长跖韧带起点损伤。在另一匹马中观察到浅屈肌腱和长跖韧带轻度断裂并进行了清创。
跟腱黏液囊内镜探查在临床上对于治疗感染性和非感染性黏液囊炎以及帮助确定与跟骨、浅屈肌腱、腓肠肌肌腱和长跖韧带相关的未确诊黏液囊炎或跛行原因是可行的。
建议尽可能采用跟腱黏液囊内镜检查方法,以减少该区域手术相关并发症,并改善感染性和非感染性跟腱黏液囊炎的诊断。