Equis ISSN 2398-2977

Accessory ligament DDFT: desmotomy

Synonym(s): Distal check desmotomy, desmotomy of accessory ligament of DDFT, inferior check ligament desmotomy

Contributor(s): Andy Bathe, Dallas Goble, Chris Whitton, Graham Munroe

Introduction

  • Permits effective lengthening of the deep digital flexor tendon and axial realignment of the distal limb.
  • Normal anatomy and function:
    • Distal, or inferior, check ligament arises from palmar carpal ligament to insert on the deep digital flexor tendon in mid-distal metacarpus.
    • The check ligament supports the digit via the deep digital flexor, and prevents over-extension of the muscle bellies.

    Corrective shoeing as well as deep digital flexor tenotomy is a necessity.

Uses

Advantages

  • Established technique.
  • Medial or lateral approach.
  • Simple procedure.

Disadvantages

  • May be insufficient for severe flexural deformities, (dorsal hoof angle >90°).
  • Some residual scar tissue may persist that reduces value as a show horse.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good: >80% return to expected use.
  • Hoof deformity should grow out over period of 4-6 months.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Caldwell F J & Waguespack R W (2011) Evaluation of a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon in horses. Vet Surg 40 (3), 266-271 PubMed.
  • Walmsley E A, Anderson G A & Adkins A R (2011) Retrospective study of outcome following desmotomy of the accessory ligament of the deep digital flexor tendon for type 1 flexural deformity in Thoroughbreds. Aust Vet J 89 (7), 265-268 PubMed.
  • Yiannikouris S et al (2011) Desmotomy of the accessory ligament of the deep digital flexor tendon in the forelimb of 24 horses 2 years and older. Vet Surg 40 (3), 272-276 PubMed.
  • Tnibar A, Christophersen M T & Lindegaard C (2010) Minimally invasive desmotomy of the accessory ligament of the deep digital flexor tendon in horses. Equine Vet Educ 22 (3), 141-145 VetMedResource.
  • Becker C K et al (1998) Long-term consequences of experimental desmotomy of the accessory ligament of the deep digital flexor tendon in adult horses. Am J Vet Res 59 (3), 347-351 PubMed.
  • Savelberg H H, Buchner H H & Becker C K (1997) Recovery of equine forelimb function after desmotomy of the accessory ligament of the deep digital flexor tendon. Equine Vet J Suppl (23), 27-29 PubMed.

Other sources of information

  • McIlwraith C W, Nixon A J & Wright I W (2015) Desmotomy of the Accessory Ligament of the Deep Digital Flexor (Inferior Check Ligament). In: Diagnostic and Surgical Arthroscopy in the Horse. 4th edn. Mosby Elsevier, UK. pp 370-372.


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