Recent Developments in the Treatment of Digital Flexor Tendon Core Lesions

摘要

Tendon damage is an all too common occurrence in horses involved in athletic endeavours. The most common of these injuries affects the weight-bearing digital flexor tendons, which lie on the palmar aspect of the metacarpus. Not only do these injuriesequate to a high level of wastage in performance horses (Williams, et al., 2001) but have a high prevalence of reinjury (Pool, 1996; Herthel, 2001). The function of the digital flexor tendons is to support the metacarpophalangeal joint and act as a spring, storing elastic energy for use in efficient locomotion. When a horse gallops the a tendon will extend by 16% (Stephens et al., 1989), which is equivalent to the failure limit seen in vitro experiments (between 10 and 20%) (Goodship et al., 1994; Wilson et al., 2002; Manetti et al., 1999). While immature tendons seem have the ability to adapt to the stresses they are subjected to, mature tendons appear to lose this ability (Smith et al., 1999 & 2002a). It is in mature tendons that continual use at close to their limit - a result of rigorous training - causes progressive degeneration of the of the tendon matrix, eventually culminating in failure of the tendon (Smith et al., 2002a).