Alternative surgical treatment for synovial ganglion cyst of the digital tendon sheath in one horse

Summary

# Editorial Summary A 6-year-old Highland pony presented with acute severe lameness of the left foreleg accompanied by digital flexor tendon sheath (DFTS) effusion and focal swelling at the fetlock; ultrasound and contrast tenography revealed a synovial ganglion cyst communicating with the DFTS just proximal to the lateral sesamoid bone. Rather than pursuing traditional en bloc cyst resection, the clinicians employed a minimally invasive tenoscopic approach, enlarging the communication defect in the DFTS wall and debriding the cyst lining under direct visualisation. The horse returned to soundness and full work within 8 months post-operatively with no recurrent lameness, demonstrating that endoscopic management offers a viable and potentially safer alternative to open surgical techniques. This approach carries significant advantages over conventional resection, particularly in avoiding the tissue trauma, neurovascular complications, and prolonged recovery associated with extensive soft tissue dissection in the sensitive fetlock region. For practitioners encountering similar cases, tenoscopic treatment merits consideration as a first-line surgical option, offering equivalent clinical outcomes with reduced morbidity and faster rehabilitation timelines.

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Key Findings

• •Tenoscopic debridement and enlargement of DFTS wall defect successfully treated a synovial ganglion cyst with communication to the digital flexor tendon sheath
• •Horse returned to work without lameness 8 months post-operatively following minimally invasive surgical approach
• •Contrast tenography confirmed ultrasonographic suspicion of communication between cyst and synovial cavity

Conditions Studied