Ex vivo pilot study evaluating needle tenoscopy of the digital flexor tendon sheath and its suitability to assist palmar annular ligament transection

Background The digital flexor tendon sheath (DFTS) is a common site of pathology in the UK equine population, often necessitating tenoscopic exploration. Common intrathecal pathologies may lead to fetlock canal constriction. palmar/plantar annular ligament (PAL) surgically transected relieve constriction or facilitate surgical access and instrumentation. Objectives objectives this study were (1) establish whether diagnostic quality needle tenoscopy can be achieved proximal DFTS cadaver limbs; (2) determine if used safely guide PAL transection; (3) evaluate iatrogenic damage when undertaking transection. Study design Ex vivo experimental. Methods Six cadaveric limbs was performed via biaxial approach at base sesamoids. Access assessment DFTS, as well completeness tenoscopically guided transection recorded. Limbs dissected examined for completion Results Positioning cannula/obturator unit on first attempt 11/12 times. Laterally 16/24 medially 18/24 channels accessed. Images 12/24 11/24 following lateral medial approach, respectively. completely 4/6 with partial 1/6 limbs. superficial (SDFT) longitudinally lacerated instead one limb, other limited mild fibrillation intersesamoidean ligament. Main limitations sample size. Conclusions findings pilot suggest that live horse not recommended currently. While offered most further refinement necessary before could considered viable alternative traditional tenoscopy.