Tenosynoviotomy for sepsis of the digital flexor tendon sheath in 9 horses

To describe a tenosynoviotomy technique for treatment of sepsis of the digital flexor tendon sheath (DFTS) in horses and report long-term outcome.

Case series.

Horses (n = 9).

Horses were positioned in lateral recumbency with the affected limb uppermost. A linear incision was made just lateral to the mesotenon beginning 5 cm proximal to the apices of the proximal sesamoid bones, extending 2 cm distal to the bifurcation of the superficial digital flexor tendon (SDFT). The incision was continued through the skin, subcutaneous tissue, palmar/plantar annular ligament, and DFTS. Tenotomy of the distal lateral branch of the SDFT was also performed. The site was thoroughly debrided, lavaged, and packed with gauze and allowed to heal by second intention. Follow-up was obtained via owner telephone interview.

Mean surgery time was 32 minutes (range, 10-64 minutes). Systemic antibiotics were administered postoperatively (range, 11-46 days; mean, 23 days). Mean hospitalization was 11 days (range, 0-49 days). Follow-up was available for 7 (70%) horses. One year postoperatively, 5 (71%) horses were serviceable for their intended use, and 2 (29%) had been euthanatized. Of 5 survivors, 3 returned to ridden exercise, 1 was retired as a broodmare, and 1 was a broodmare. All owners were satisfied with the cosmetic appearance of the surgery site.

Open drainage via tenosynoviotomy, performed as a salvage procedure, represents a feasible treatment for DFTS sepsis.