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Here is a brief description of the tendon Fendi has lost (common/long (hind limb) digital extensor tendon). I suggest we all read the full page here, but her injury is the paragraph i underlined here.
Evaluating The Injury
The first step in evaluating a tendon laceration is determining the structures involved and the degree to which they are involved. Location on the leg is important.
Remember the tendon sheaths? Lacerations involving the tendon sheaths can be of special concern and need to be noted. If the laceration is in the area of a joint, there always is concern. (For the purpose of this article, we will focus on lacerations involving only the tendons.) If the nature of the laceration is sharp, the evaluation often is easier as the structures involved are well-defined vs. lacerations associated with a dull cutting and/or tearing where little defined structure remains.
When the flexor tendons are injured, there are some characteristic alterations in limb posture that occur depending on what structures are affected. Working from superficial to deep, if only the skin is involved, consider yourself and your horse extremely lucky. If the superficial digital flexor tendon is only partially involved, there generally is no alteration to posture. However, if the superficial digital flexor tendon is completely transected, the fetlock has lost some of its support structure and the fetlock will "drop" some or become closer to the ground when compared to the normal leg. This drop can be subtle, since the main fetlock support structure is the suspensory ligament. The important indicator is that the foot remains flat on the ground if only the superficial digital flexor tendon is
transected.
When the deep digital flexor tendon is lacerated, the toe often will "pop up" off the ground as the foot rocks back slightly on the heel. Remember that the deep digital flexor tendon courses down the back of the leg, gliding around the fetlock joint, all the pastern joints, and the coffin joint, to attach on the mid-bottom of the coffin bone (P3). It is this structure that yields the clinical sign of a ruptured or lacerated deep digital flexor tendon since it is the tension on the tendon that pulls and holds the foot flat on the ground. If the suspensory ligament is involved or transected, the fetlock's ability to support weight is greatly diminished, and the back of the fetlock significantly drops closer to or actually touches the ground.
On the other side of the leg are the extensor tendons, with the common digital extensor the main extensor tendon in the forelimb and the long digital extensor tendon the main extensor tendon in the hind-limb. A loss in the integrity of the extensor tendons has little effect on weight bearing, but does affect the ability of the horse to advance the limb properly during motion. Given that the extensor tendons course down the cannon bone, attaching to the dorsal (front) surface of the pastern (P1 and P2) and coffin bone, their effect is to extend the fetlock joint or pull the foot and pastern forward during movement.
So, a horse with a transected extensor tendon generally has trouble advancing the foot and will drag the toe, knuckling over onto the dorsal surface of the fetlock. Some horses quickly learn to "flip" the foot forward so that their weight-bearing surface is parallel to the ground as the foot lands.
I am attaching (not inserting) pictures before and after, PLEASE NOTE before pics are not for weak stomach..after pic is last one where she is sutured.
In these pics, we we were on day 3 of rehab (first week of June 2010), she was being medicated with bute, penicillin 2xday, tribrissen paste, in a pvc splint to support her weight the pvc is also attached to her hoof by drilling a hole in the hoof and wiring the splint to it, to be sure the hoof is & stays in forward position.
I will continue her story thoughout in date order..
I hope this will help save just one horse by posting.. I will also post a discussion about the amnion used to help her heal, truly amazing!!
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Replies to This Discussion
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Permalink Reply by Michelle C Em Walkin Ranch on
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These posts are from another blog..
June 12, 2010
Fendi was tangled in the bottom strand of our polyrope fence, she was in lots of clover, so no mud, the cut was very clean. She was also getting shocked the entire time she was caught, so we thank God that this happened during the day and was quickly found with our webcam, not sure she would have made thru a night or long period of time. We are also considering pulling the bottom line of polyrope out, With all the shots/meds, she pretty much thinks we are evil, the once sweet/loving girl is now scared to death. I have no doubt she'll come around with that, it just breaks my heart. I wish so badly we could just talk to them..
Fendi is staying with us, I will never trust a buyer to follow her restricted activites. The vet said it is possilbe she can be ridden lightly, but time will only tell for sure. He said she will easily carry a foal, so Fendi will be here as a broodmare. I will keep you all updated and post pictures as she progresses.
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June 13
Thank you all so much for your kind, thoughtful & heartfelt replies. It's so hard to post something so terrible but I knew with this wonderful network of such great people, you would all help me mentally and include Fendi in your prayers! I also wanted to post for furture reference, seeing as this is such a common injury, so we can see if our outcome is as good as we hope it will be. She has learned to get up/down just fine with her splint, I know she's walking on it really well because she moves very quickly to get away from us when we enter the stall with the dreaded shots/paste. We've had to add additional fans in her stall b/c our weather is super hot/muggy right now and they are both sweat covered, the additional fans help, but just another thing i'm worried about.. Fendi is such a fighter and has such a will to live, i know this will help her heal more than anything. Thank you all again, my friends! And I will continue to keep you updated.. Bless you all!!! -
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June 14
First splint change, skin is dieing off (expected) sutures are now out, possibly infection in the bone, will know when I speak with the vet later today.
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June 14 (after splint change) Bless her BIG heart, even in a splint she still wants to play.. This was right after the splint change this morning.
(taken off webcam sorry for bad quality)
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June 19
Well had her most recent splint change on Thursday, unfortunately the skin you saw in the last updated pic has all died off, which we did expect but it sure doesn't look pretty. We see no puss or sign of infection but continuing the antibiotics just to be safe and bute for the pain. Fendi wants out of that stall and not just to be hauled to the vet, she wants to play, which to me, is the best sign ever. She grunts/squeals, rears/bucks in the stall and is telling me I want to play with my friends!!!! I wish i could just explain. Annie is getting fed up with being stalled too, they are just used to the normal routine of being turned out each evening.. If we can get this skin to form back, she should be fine as long as she never has another injury on her cannon bone as this will break easy now after the trauma. Also, the good thing about the injury area is that it's in the front of her back leg under the hock, if you look at the picture/graph i posted in the beginning you will see she did not affect her blood flow, so we did get lucky there. I will keep you updated, next splint change will be on Sunday. Thanks again everyone for thinking of our Fendi..
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June 30
Thanks again everyone for your kind words, thoughts & prayers, they're working, so keep em coming!!!! (5th splint change). Still no infection, bone looks good altho will probably flake a piece off, which will be removed at a later date. The splint is the same pvc pipe cut in 1/2 & wired to a hole in her hoof to keep her hoof in correct position while healing. She has been off the penicilin shots for some time now, still on tribissen paste but only has a few more days of that. Fendi is still her loving, happy, want to have fun kind of girl, thanks to Trace..:) Not sure too many babies would deal with all the trauma this girl is taking in stride! We are now able to let her out in the middle of the barn for a while each day to move around a little more. I will get some updated pics of her this weekend & not just pics of her injury, she's grown a bunch & finally shedding out. Thanks again everyone & I'm going to upload the picture (not insert) for those of you with weak stomachs, I know it may look bad still but if you compare to the original injury you will see lots of PINK skin & how much it's closing up!! Woohoo go Fendi & my wonderful vet!!!!
(PIC ATTACHED) Still not pretty
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6 5th splint change.jpg, 1.9 MB
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July 1
Information a friend tells me about, I contact my vet and he thinks I'm insane!! The membrane that protects and nourishes fetal life offers a second chance for healing to a seriously injured yearling.
http://www.equisearch.com/horses_care/health/illnesses_injuries/eqa...
On July 1st my vet comes thru for me!!!!!!!!!!!!!!!!! (we foaled out 13 mares this year and threw all placentas away, didn't know I had such treasures)The post: Amnion is being frozen today, already cut into strips & will be applied on Wednesday.. Let the healing progress!!!!! So excited, I have the best vet ever!!! -
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July 5
Healing so well.. I'm so happy, I think i can get away with inserting this picture.. The amnion treatments begin tmrw.. I didn't like the way she is standing on her hoof now, pretty much standing on her heel, while we're changing the splint, but i know once this pvc pipe/splint is off the farrier will step in and do as much for her as we can
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July 7
Ok, 1st amnion applied todayalthough she's healed so much, at this point it can only help out w/proud flesh. The first picture I'm posting is the flake of the dead bone, this is what he knew would happen & what we were hoping would before the entire skin closed up, well got lucky & he simply cut off the dead part, as you will see it is very small (if you look at the last updated picture i posted, the exposed bone you see was actually this piece, the new bone was pushing it out)! Now our girl is SPLINT free...WOOHOO!!! She is like a newborn, down on her pastern & my vet believes a few days of her in the stall (can't turn out anymore for a few days) will build up that muscle, he said it's just like a newborn does. She has yet to buckle over if we find she starts doing this, we will put the splint back on for a little longer. Fendi is about as good as she can get & with the prayers continuing will be out in the pastures soon..:) Thanks again everyone for your support!!!
LOOK NO BONE!!! :)
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July 15
I'm so sorry!! We just havent had the time to take pictures on these amnion applications. Our problem is the flies, after taking her dressing off as you can imagine they swarm to her injury. This is even after i've flysprayed her all over, flysprayed the ground/area we are working in, and having a fan blow on us, makes no difference they are still there.. I even tried to attract them to garbarge..lol Anyway, I know you all want to see so next time I'll have someone to help with a camera as we keep the flies off.
As you saw in the last pic, cannon bone is completely covered, now all the new/red skin you saw is all pink!!!!! The amnion is really excelling the healing. I can't wait for you all to see.. Fendi now has already learned to flip her hoof up, the farrier came out yesterday & trimmed her toe seeing as she's not been on it for a while & no turn out caused that toe to really grow out & was not allowing her to stand up off her pastern like she should, so immediately after he trimmed her toe, she is standing much better. When she has full weight on it, the weight still tends to be on her heal but with continued trimming & her building up those muscles she's still gonna even gait.. :) Last night was the first time she's been outside of the barn. We opened her & Annie up to a small runway/flat area to get them in some sun & fresh air. Needless to say they were in heaven & Annie is in heat..lol (Alen came up to visit with them). After a week of opening them up to this area the next phase will be turn out in the arena, but I want to take it slow as we all know Trace's fillies like to have fun..:) and I'm afraid she'll over do it. Sorry to write a book here & again I promise we'll get pics on her next dressing (in 2 days).. THE PRAYERS WORKED FOLKS & I THANK YOU ALL SO MUCH!!!! -
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July 18
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July 21Ok folks we were finally able to get a picture keeping the flies off of her long enough, Whatcha think?? We're so happy, it's closed up so much now that even the amnion strips are too big and we no longer have to stretch it to make it cover it all!!! You will see some surgical glue at the top part of her leg which is what we used to hold the amnion strip. I'm so happy our little girl is gonna be ok..Thinking maybe a week or two more of these applications and she may be done with that!!
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