Short-term cast immobilisation is effective in reducing lesion propagation in a surgical model of equine superficial digital flexor tendon injury.
ABSTRACT Larger superficial digital flexor tendon (SDFT) injuries have a poorer prognosis than smaller lesions. During the inflammatory phase enlargement of the initial lesion is frequently noted, with biomechanical loading being recently proposed to play an important role.
To evaluate the effect of lower limb cast immobilisation on tendon lesion propagation in an equine model of surgically induced SDFT injury.
Core lesions were surgically induced in both front SDFTs of 6 young mature horses. At the end of surgery, one leg was randomly placed in a lower limb cast and the other leg (control) was bandaged for 10 days. Computerised ultrasonographic tissue characterisation performed at Days 10, 15, 21, 28, 35 and 42 allowed measurement of lesion length (cm) and width (expressed as a percentage of whole tendon cross-section). On Day 42 horses were subjected to euthanasia and both SDFTs were sectioned every centimetre to assess the lesion length macroscopically. Statistics were performed to compare cast vs. control legs with significance set at P<0.05.
When all time points were combined, lesion length was 19% shorter (P<0.0001) and lesion width 57% smaller (P = 0.0002) in the cast legs (6.13 ± 0.12 cm; 6.90 ± 0.64%) than in the control legs (7.30 ± 0.21 cm; 10.85 ± 1.22%). On Day 42 the lesion length on macroscopic evaluation was 19% shorter (P = 0.04) in the cast (7.00 ± 0.36 cm) than in the control legs (8.33 ± 0.33 cm).
Cast immobilisation for 10 days effectively reduced lesion propagation (length and width) compared to bandaging in an in vivo model of artificially-induced tendon lesions.
A short period of cast immobilisation during the early phase of tendon healing may be an easy and cost-effective way to reduce the initial enlargement of lesion size and hence to improve prognosis.
- SourceAvailable from: Jess G Snedeker[Show abstract] [Hide abstract]
ABSTRACT: REASONS FOR PERFORMING STUDY: Injuries in energy-storing tendons are common in both horses and man. The high prevalence of reinjury and the relatively poor prognosis for returning to preinjury performance levels warrant further research, for which well characterised models would be very helpful. OBJECTIVES: Given the clinical similarities in tendinopathy of energy-storing tendons, we hypothesised that a recently developed experimental model of equine tendon injury would display many of the characteristics of clinical tendinopathy and could therefore be of use for both species, thus providing comparative insight to the human condition and offering direct potential impact to equine medicine. STUDY DESIGN: In vivo experimental study. METHODS: Surgical lesions were created in the superficial digital flexor tendon (SDFT) of 6 horses. Clinical examination, as well as biochemistry, histology and immunohistochemistry were performed on the harvested samples at 6 weeks post surgery. RESULTS: Disrupted collagen fibres, increased glycosaminoglycan content, increased presence of tenocytes with plump nuclei, the scarcity of inflammatory cells, increased matrix metalloproteinase (MMP) activity and neovascularisation were observed and found to be consistent with clinical tendinopathy. CONCLUSION AND RELEVANCE: This model displays the key features of the most common human and equine degenerative tendon disorders and is therefore an appropriate, if still imperfect, model of tendinopathy.Equine Veterinary Journal 12/2012; · 2.29 Impact Factor
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ABSTRACT: Evidence for a standard x-ray study and cast immobilization in emergency department (ED) management and follow-up of children with bicycle spoke injury (BSI) is absent.The Journal of emergency medicine. 06/2014;
- Equine Veterinary Journal 01/2014; 46(1):4-9. · 2.29 Impact Factor