 Directed by  Professor Dr/ Mohammed Adel  prepared by / Fatma. A. shaban  &  Zeinab. A. Abd-Elazeem

 Def The tendon is the extension of muscle for attachment to bone. -Consist of: Fibrils Long bundles of collagen filaments Primary (1ry) fibre bundle (2 nd ) fibre bundle tertiary fibre bundle Tendon. *Collagen fibrils arranged in “Crimp” or “Zig- zag” (allows extensive intermolecular cross- linking to increase tensile strength.

It allows gliding of tendon in areas of abrupt directional change or flexion.  Paratenon elastic,loosely arranged areolar tissue surrounding the tendon. It allows gliding function where sheaths are not present

A. Superficial flexor tendon. B. Deep flexor tendon C. Suspensory ligament D. Common digital extensor tendon

 Def :- inflammation involving tendons surrounded by paratenon not synovial sheath.  N.B : *tendonitis in superficial digital flexor tendon (SDFT) is common injury in racing equine especially in forelimb. * SDFT of hindlimb is uncommon in all breads of horses.

 Position of tendonitis A. High bow just distal to the carpus. B. Middle bow in the middle 3 rd of the meta carpus. C. Low bow in the distal 3 rd of the meta carpus.  Severity of tendonitis: A. Acute tendonitis B. Chronic tendonitis.

 Primary cause A. Tendon trauma B. Over extension (overlaoding) C. Over use of tendon  Secondary cause A. Inadequate training and excessive muscle fatigue B. Abnormal congenital: 1. abnormal angulation of fetlock 2. Upright pastren(excessive pastren slope)

C) Improper shoeing and too long toes D)Inocordination between body weight and tendon strength

 Acute tendonitis

A. Diffuse swelling over the affected (SDFT) B. Circumscribed swelling distal to carpus in case of tendenitis of the DDFT C. Swelling in case of inflammation of suspensory ligament above level fetlock D. Marked heat and tendon pain E. The limb is held in fixed position F. Variable degree of lamness according severity of injury G. Dropping of the fetlock joint due to distruption of tendon

A. Fibrosis and hard swelling on the palmer/planter aspect B. The animal may be sound with mild work and became lame with hardwork C. Annular ligament constriction D. In advanced severe case knuckling over the fetlock joint.

 Clinical syptoms and physical examination  Diagnostic ultrasonography (appear as black line at site of tendonitis)  X ray or radiological examination 1. Increase the size area of tendon 2. Normally appear radioopaque but in this case appear radiolucent but in suppuration appear white due to presence of the pus

 Dealing with tendonitis in equine is one of extremely frustrating musculoskeletal problems for the equine trainer.  only 20% of race horses starts to or more times after injury  Graded prognosis

 Acute tendonitis: A. Application of hydrotherapy as ice or cold water therapy every 4 to 6 hours during the initial hours B. Administration of non steroidal-non inflammatory agents as phenyl butazone through interruption of prostaglandin C. Pressure bandage

 E) Tendon splitting of the core lesion  This technique which uses tentome (thin bladded scalpel ) to create vertical incision in the tendon.

 Pressure bandage  Tendon splitting  Tendon transplantation : transplantation of a portion of the lateral digital extensor tendon into SDF tendon. The graft act as organized scaffold for healing replacement to induce scar growth

 Superior check ligament desmotomy  Annular ligament desmotomy  Carbon fiber implantation : carbon suture coated with polyglycolic acid induces fibroblastic response.  Tendon Sheathing  neuroectomy  Corrective shoeing by using shoes with calcins  Too long toes of shoe

 Def : means inflammation involving tendon surrounded by a synovial sheath Or inflammation of both tendon and sheath

1. Strained tendon in synovial sheath.(Acute tenosynovitis). 2. Damaged mesotendon with loss of blood supply. 3. Constriction of annular ligament, secondary to “low bow” occurs in palmer or plantar fetlock area. 4. Infection. 5. Direct trauma.

1. Excessive synovial production called wind puffs 2. Lameness heat, fluid distention of involved sheath (Acute tenosynovitis). 3. Constriction of tendon in annular ligament with associated lameness

1. Hydrotherapy of the tendon similar to treatment of a bowed tendon 2. Drainage of sheath to relieve pressure 3. Injection of steroid or sodium hyaluronate to relieve inflammation and reduce secretion within the sheath ( #if the tendon has continued damage) 4. Application of bandage 5. Tendon splitting through the sheath 6. Annular ligament desmotomy. 7. In septic tendon sheath deal as septic arthritis