New surgical approach to the plantar fetlock joint through the digital flexor tendon sheath wall and suspensory ligament apparatus in cases of concurrent septic synovitis in two cattle.
Authors: Kofler J, Martinek B
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary When penetrating injuries cause concurrent infection of the digital flexor tendon sheath and fetlock joint in cattle, surgical access to the plantar pouch can be technically challenging using conventional approaches. Kofler and Martinek describe an innovative surgical technique in two cattle cases, creating a proximal approach to the plantar fetlock joint by making a 3 cm incision between the lateral suspensory ligament branches, which provided excellent visualisation of the plantar pouch whilst avoiding excessive soft tissue trauma. Both animals underwent aggressive lavage (5 litres of sterile saline intraoperatively, followed by daily irrigations for three days) following removal of the superficial and deep digital flexor tendons and fibrin debridement; notably, the joint capsule incisions were left open and managed with foam drainage to prevent premature sealing and ensure continued drainage of inflammatory material. Both cattle cleared the infection completely and recovered to full function without residual lameness, suggesting that this modified approach may be superior to conventional techniques for accessing deep plantar pathology whilst maintaining adequate drainage. For equine practitioners managing similar septic conditions in the distal limb, this approach offers a useful alternative when dealing with concurrent tenosynovitis and arthritis, particularly where plantar pouch involvement complicates conventional single-approach strategies.
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Practical Takeaways
- •This surgical approach provides effective access to the plantar fetlock joint pouch in cattle with concurrent tendon sheath and joint infections, avoiding blind dissection and allowing thorough fibrin clot removal
- •Leaving joint capsule incisions unsutured and using foam drainage for 3+ days of daily lavage appears critical for successful infection elimination in these severe cases
- •The technique bridges a gap in surgical options for cattle with penetrating wounds affecting both the tendon sheath and adjacent joint compartments
Key Findings
- •A novel surgical approach to the plantar fetlock joint was successfully created through an incision between the two lateral suspensory ligament branches in 2 cattle with concurrent septic tenosynovitis and arthritis
- •Combined treatment of infected digital flexor tendon sheath and fetlock joint using daily lavage for three days with 5L sterile saline eliminated infection in both cases
- •Both cattle recovered completely without residual lameness following the new surgical technique and intensive post-operative irrigation protocol