General points: - 25 - 30% of UK population >15 years old - >50% ponies and horses exercise into their 20s - generally less exercise with ageing and type and frequency changes - Under recognition of clinical conditions including lameness - BUT lameness is the most likely condition to be reported - Usually arthritis or hoof abnormalities (laminitis) - Soft tissue injuries are less common and can be missed - Does age affect likelihood of treatment? - More likely to elect for noninvasive and conservative treatments? - Major soft tissue injuries - Accessory ligament of the DDFT desmitis - Digital flexor tendon sheath injuries especially of DDFT - Suspensory ligament desmopathies - Superficial digital flexor tendonitis - Trauma to soft tissue structures following wounds.
ALDDFT desmitis (inferior check ligament) - Desmitis quite common in the forelimb - Rare in hindlimb - Desmitis - Acute injury alone - Secondary to previous severe SDF tendonitis - Adhesions between adjacent structures - Chronic severe desmitis ALDDFT leading to flexural deformities - Probably age related degeneration in forelimb - Hindlimb ALDDFT desmitis less age related but more unusual presentations - Ultrasonography essential for diagnosis - Treatment in acute cases early aggressive anti-inflammatory measures - Compression bandaging - Ultrasound physiotherapy - Box rest and controlled walking - Correct foot imbalance - Treatment in chronic cases may involve surgical desmotomy.
Digital flexor tendon sheath injuries: - Not uncommon in the older pony, Cob type and larger sport horse - Often hindlimb and occur at grass - Commonly associated with damage to internal structures - DDFT - Focal tear in central region or lateral edge longitudinal tear - SDFT - Marginal tears quite rare - manica flexoria more common - Secondary annular ligament thickening - Primary acute tenosynovitis - Treatment depends on the specific diagnosis but initial medical therapy is common.
DDFT injuries in pastern: - Tendonitis is uncommon but occasionally in forelimbs of older sports horses - Medical therapy similar to other tendon injuries.
Annular ligament syndrome: - Acute lameness with acute PAL desmitis without tenosynovitis - Primary tenosynovitis with secondary PAL thickening - Chronic syndrome with multi-factorial causes - Subcutaneous fibrosis in region of PAL - Treatment depends on precise identification of the aetiology of the syndrome.
Suspensory ligament: - Old injuries especially branch and body - Suspensory desmitis in older horses at grass - Chronic breakdown injuries in suspensory ligament - Conservative and medical management similar to suspensory apparatus injuries in younger horses - Surgical techniques are much less likely to be used.
Superficial digital flexor tendonitis: - Recurrence of old injuries especially in racehorses - SDFT tendonitis in older animals usually at grass - Proximal metacarpal lesions - Rupture of SDFT in forelimb of aged horses.
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