Tenosynovitis of the carpal sheath of the digital flexor tendons associated with tears of the radial head of the deep digital flexor: observations in 11 horses.

Summary

# Editorial Summary: Radial Head Deep Digital Flexor Tears and Carpal Sheath Disease Until Minshall and Wright's 2012 case series, tears of the radial head of the deep digital flexor tendon had not been documented in the equine literature, yet this injury presents with a recognisable clinical and diagnostic pattern worthy of inclusion in the differential diagnosis for carpal sheath distension. The authors reviewed 11 cases identified retrospectively, examining clinical presentation, ultrasonographic appearance, and tenoscopic findings to characterise this previously undescribed lesion. All affected horses displayed lameness associated with carpal sheath effusion, and ultrasonography and direct visualisation confirmed the presence of radial head tears with disrupted tissue herniated into the sheath space. Tenoscopic removal of the extruded torn tissue yielded consistently positive outcomes, with every horse returning to its pre-injury level of work postoperatively. For practitioners managing horses with distended carpal sheaths and lameness of unclear origin—particularly when conventional imaging reveals no obvious primary tendon pathology—this work demonstrates that radial head involvement should be considered, and that minimally invasive tenoscopic debridement offers a reliable surgical solution with excellent functional prognosis.

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Key Findings

• •Tears of the radial head of the DDF cause lameness and carpal sheath distension in horses
• •All 11 cases showed consistent clinical, ultrasonographic, and tenoscopic diagnostic features
• •Tenoscopic removal of disrupted tissue resulted in clinical resolution in all cases
• •All 11 horses returned to pre-injury levels of work post-operatively

Conditions Studied