Outcome after lacerations of the superficial and deep digital flexor tendons, suspensory ligament and/or distal sesamoidean ligaments in 106 horses.
Authors: Jordana Mireia, Wilderjans Hans, Boswell Jane, Dewulf Jeroen, Smith Roger K W, Martens Ann
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Tendon and Ligament Laceration Outcomes in Horses This 14-year retrospective analysis of 106 horses with lacerations involving the superficial and deep digital flexor tendons, suspensory ligament, and/or distal sesamoidean ligaments revealed that whilst 82% of horses survived their injury, only 55% returned to their previous level of performance, with a further 27% managing reduced activity and 18% requiring euthanasia. Multivariate analysis identified the number of structures transected as the single most significant predictor of outcome, whereas traditionally monitored variables such as tendon sheath involvement, suturing technique, casting protocols, and which limb was affected showed no statistically significant correlation with returning to pre-injury function. Fetlock hyperextension emerged as the most clinically troublesome complication during recovery. For equine practitioners managing these challenging injuries, the critical message is that prognosis depends heavily on injury complexity rather than surgical technique or aftercare protocol, suggesting that clients should be counselled early based on the extent of structural damage rather than offered equivalent recovery expectations regardless of how many tissues are compromised.
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Practical Takeaways
- •Prognosis for return to previous activity depends heavily on injury complexity—single structure lacerations have better outcomes than multi-structure injuries; inform owners accordingly
- •Surgical technique variables (suturing method, casting) and sheath involvement don't significantly impact outcome, so focus repair decisions on anatomical factors rather than procedural variations
- •Monitor closely for fetlock hyperextension as the primary complication; this should guide rehabilitation and long-term management protocols
Key Findings
- •55% of horses returned to previous performance level, 27% returned to lower level, and 18% were euthanized following surgical repair
- •Number of structures transected was the most significant predictor of outcome in multivariate analysis
- •Tendon sheath involvement, tendon suturing method, casting, and limb affected showed no significant association with outcome
- •Fetlock hyperextension was the most significant postoperative complication observed