Equestrian Clearance
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It is very hard to detect the severity or progression of tendon damage by visually examining or palpating the limb, ultrasound will be necessary to determine this. Veterinary involvement becomes necessary in more acute cases. Phenylbutazone is a popular choice for initial nonsteroidal anti-inflammatory (NSAID's) therapy and does not affect the natural repair process. Corticosteroids are also used to decrease inflammation, oedema and adhesions between the tendon and sheath. It has been shown that the use of steroids for the treatment of tendon damage could cause a negative effect. Injection into the tendon has been shown to cause collagen fibre necrosis, fibrocyte death and dystrophic calcification, resulting in a decrease in tendon strength (Henninger; 1994).
Marr et al (1993) suggested that intra-lesional treatment with a glycosaminoglycan polysulphate (PSGAG), an inhibitor of inflammatory and degradative enzymes, may enhance the quality of tendon repair, reducing the re-injury rate of the treated tendons. Gaughan et al (1991) tested sodium hyaluronan (an anti-inflammatory, adhesion limiting drug,) and found an enhanced healing of the tendon along with reduced adhesion formation.
Surgery can provide another option for tendon repair in severe cases. Splitting of the injured tendon aims to increase the drainage of blood and unwanted fluids from the core of the tendon. This method of treatment improves the healing rate and appearance of the tendon as long as performed in the early stages of injury. There are other surgical methods that aim to reduce the strain on the SDFT. A superior check ligament desmotomy cuts the fibrous band joining the SDFT muscle to the forearm, increasing the SDFT's stretch ability. This can prove beneficial if scar tissue has formed within the tendon decreasing its elasticity.
Tendons will benefit from immediate first aid, initially reducing swelling, stabilising the limb and restricting movement. Following this additional assistance from the vet will be needed to assess the severity and necessary action taken on the advice given.
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