Functional anatomy of tendons and ligaments in the distal limbs (manus and pes).
ABSTRACT Tendons and ligaments of the equine distal limbs have a prominent anatomic, functional, and clinical importance. This article reviews the descriptive and topographic anatomy of these structures in details. Special information is given about the mechanical properties and functional anatomy of the flexor tendons, accessory ligaments, and third interosseous muscle, as well as about their roles during the standing position and gaits.
- SourceAvailable from: Jorge U Carmona[Show abstract] [Hide abstract]
ABSTRACT: Las lesiones de tendones y ligamentos son frecuentes en caballos. Las estructuras más afectadas son el tendón digital flexor superficial (SDFT) y el ligamento suspensor (LS). La forma clínica de estas patologías generalmente es crónica y de naturaleza degenerativa. Los tratamientos comúnmente empleados no producen curación definitiva del problema. Una gran mayoría de pacientes recaen o no vuelven a recuperar su capacidad atlética inicial. El avance del conocimiento molecular de la fisiopatología de las tendinopatías y desmopatías del hombre, caballo y otros animales ha permitido evidenciar la presencia de citocinas catabólicas, las cuales posiblemente sean responsables del trastorno general observado en estas patologías. El objetivo actual del tratamiento de estos problemas es la regeneración y no la reparación (cicatriz) del tejido lesionado. En el caballo se han descrito tratamientos experimentales y clínicos novedosos. Estos tratamientos incluyen la inyección de aspirados de médula ósea, células madre mesenquimales, factores de crecimiento recombinantes como el factor de crecimiento insulínico tipo I y plasma rico en plaquetas (también llamado concentrado autólogo de plaquetas), entre otros. Los resultados observados han sido prometedores cuando estas novedosas terapias han sido empleadas. Sin embargo, al igual que lo que sucede con otros tratamientos, es necesario realizar más investigaciones para demostrar que su uso clínico puede ser efectivo y seguro en caballos.Archivos de Medicina Veterinaria 12/2010; 43(3):203-214. DOI:10.4067/S0301-732X2011000300002
- [Show abstract] [Hide abstract]
ABSTRACT: There is limited knowledge about the interpretation of alterations in the distal sesamoidean impar ligament (DSIL) detected using magnetic resonance imaging (MRI) and their correlation with histopathology. There would be: 1) a correlation between histopathology and MRI findings; and 2) a relationship between MR abnormalities at the origin and the insertion of the DSIL, between insertion and body; and origin and body. Fifty limbs from 28 horses were examined using high-field MRI and histopathology. MR abnormalities of the DSIL, its origin on the navicular bone and its insertion on the distal phalanx were graded. Sections of the axial third of the DSIL were examined histologically and graded according to fibre orientation, integrity of fibroblasts, collagen architecture and vascularity. Associations between MRI and histology findings were tested by Spearman rank correlation and Chi-squared tests. There were significant correlations between the presence of a cystic structure in the distal third of the navicular bone, or a distal border fragment, or increased signal intensity in fat suppressed images at the insertion of the DSIL on the distal phalanx and the histological grade of the body of the DSIL. There were significant associations between a cystic structure in the distal third of the navicular bone and the presence of either a distal border fragment or entheseous new bone at the insertion of the DSIL, swelling of the DSIL and increased signal intensity in the DSIL in fat suppressed images; between distal elongation of the flexor border of the navicular bone and the presence of one or more distal border fragments and between swelling of the body of the DSIL and irregularity of its palmar border or increased signal intensity in fat suppressed images in the DSIL. The presence of a cystic structure in the distal third of the navicular bone detected using MRI, a distal border fragment or increased signal intensity at the insertion of the DSIL are suggestive of significant alterations in the infrastructure of the DSIL.Equine Veterinary Journal 05/2010; 42(4):332-9. DOI:10.1111/j.2042-3306.2010.00068.x
- [Show abstract] [Hide abstract]
ABSTRACT: Although track surfaces are a risk factor of tendon injuries, their effects on tendon loading at high speed are unknown. Using a noninvasive ultrasonic technique, it is now possible to evaluate the forces in the superficial digital flexor tendon (SDFT) in exercise conditions. To compare the effects of an all-weather waxed track (W) vs. a crushed sand track (S), on the SDFT loading in the trotter horse at high speed. Two trotter horses were equipped with the ultrasonic device (1 MHz ultrasonic probe, fixed on the palmar metacarpal area of the right forelimb). For each trial, data acquisition was made at 400 Hz and 10 consecutive strides were analysed. In each session, the 2 track surfaces were tested in a straight line. The speed was imposed at 10 m/s and recorded. The right forelimb was also equipped with a dynamometric horseshoe and skin markers. The horse was filmed with a high-speed camera (600 Hz); all recordings were synchronised. Statistical differences were tested using the GLM procedure (SAS; P < 0.05). Maximal tendon force was significantly lower on W compared with S. In addition to maximal force peaks around mid-stance, earlier peaks were observed, more pronounced on S than on W, at about 13% (horse 2) and 30% (both horses) of the stance phase. Comparison with kinematic data revealed that these early peaks were accompanied by plateaux in the fetlock angle-time chart. For high tendon forces, the tendon maximal loading rate was significantly lower on W than on S. CONCLUSIONS AND POTENTIAL CLINICAL RELEVANCE: The all-weather waxed track appears to induce a lesser and more gradual SDFT loading than crushed sand. The SDFT loading pattern at high speed trot suggests proximal interphalangeal joint movements during limb loading.Equine Veterinary Journal 03/2009; 41(3):257-61. DOI:10.2746/042516409X394445