Treatment of septic common digital extensor tenosynovitis by complete resection in seven horses.
Authors: Booth Todd M, Abbot John, Clements Antony, Singer Ellen R, Clegg Peter D
Journal: Veterinary surgery : VS
Summary
# Common Digital Extensor Tendon Septic Tenosynovitis: Complete Resection for Chronic Cases Penetrating wounds leading to septic tenosynovitis of the common digital extensor (CDET) tendon sheath present a significant clinical challenge, particularly when initial surgical interventions fail. This seven-case series evaluated complete intrathecal resection of the CDET coupled with sheath ablation in horses with chronic septic tenosynovitis, five of which had already undergone unsuccessful previous surgery; the interval from initial injury to definitive resection ranged from one to twenty-two weeks. All surgical wounds achieved closure within six weeks, with six horses healing by primary intention (utilising closed suction, Penrose, or passive drainage systems) and one by second intention, following which all animals received postoperative antimicrobial therapy, bandaging, and physiotherapy. At mean follow-up of 26.4 months, all six horses with long-term data returned to their previous athletic performance level without residual lameness or gait abnormalities. Complete CDET resection appears a viable salvage technique for managing refractory septic tenosynovitis when antimicrobial and conservative surgical approaches have been exhausted, offering realistic prospects for return to full function despite the loss of a major digital extensor.
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Practical Takeaways
- •Complete tendon resection is a viable option for chronic septic tenosynovitis of the CDET when conservative or previous surgical treatments have failed, offering good long-term functional outcomes
- •Horses can return to full athletic function despite complete removal of the common digital extensor tendon, suggesting this structure is not essential for normal limb function
- •Aggressive surgical intervention with proper wound management and postoperative physiotherapy should be considered early rather than attempting multiple conservative approaches
Key Findings
- •Complete surgical resection of the affected common digital extensor tendon and sheath ablation successfully treated 7 horses with septic tenosynovitis
- •6 of 7 surgical wounds healed primarily; 1 healed by second intention
- •All 6 horses followed up (mean 26.4 months) returned to their pre-injury athletic performance level without lameness or gait abnormality
- •5 horses had previously undergone unsuccessful surgery before radical resection