Abstract：
BACKGROUND: Desmitis of the accessory ligament of the deep digital flexor tendon (ALDDFT) is a commonly reported injury. Despite the commonality of this injury, the literature is limited to small case series, with the reported success following treatment varying from 18% to 75%.
OBJECTIVE: To identify the prognosis and factors associated with a return to work following ALDDFT injury.
METHODS: Retrospective case series.
METHODS: Medical records of horses from four equine hospitals (January 2000 and December 2018) with a diagnosis of desmitis of ALDDFT were reviewed. Data retrieved included case detail, use, history, lameness treatment and follow-up. Success was defined as returning to work. Backward stepwise logistic regression was used to identify variables significantly associated with return to work.
RESULTS: Ninety-one horses were included. The mean age was 13.5 years (standard deviation 4.9 years). Thirty-four percent (28/91) of horses were sound at the initial presentation. Sixty-eight percent (62/91) of horses were managed using controlled exercise alone, 28% (29/91) were treated with intra-lesional injection, therapeutic ultrasound, extracorporeal shockwave therapy or desmectomy of the ALDDFT and 3% (3/91) were euthanased without treatment. Sixty-four percent (54/85) of horses returned to work. Horses that were lame at follow-up were less likely to return to work (odds ratio [OR] 107.93, 95% confidence interval [CI] 20.06-580.61, p < 0.001) than those that returned to soundness. Identification of adhesions on ultrasonography was also associated with having reduced odds for return to work when compared to horses without adhesions (OR 0.10, 95% CI 0.01-0.76, p = 0.03).
CONCLUSIONS: Retrospective nature of the study, the potential of selection bias with regards to follow-up.
CONCLUSIONS: Sixty-four percent (54/85) of horses returned to work following injury of the ALDDFT. Persistence of lameness and adhesion formation were significantly associated with a poor outcome.
OBJECTIVE: To identify the prognosis and factors associated with a return to work following ALDDFT injury.
METHODS: Retrospective case series.
METHODS: Medical records of horses from four equine hospitals (January 2000 and December 2018) with a diagnosis of desmitis of ALDDFT were reviewed. Data retrieved included case detail, use, history, lameness treatment and follow-up. Success was defined as returning to work. Backward stepwise logistic regression was used to identify variables significantly associated with return to work.
RESULTS: Ninety-one horses were included. The mean age was 13.5 years (standard deviation 4.9 years). Thirty-four percent (28/91) of horses were sound at the initial presentation. Sixty-eight percent (62/91) of horses were managed using controlled exercise alone, 28% (29/91) were treated with intra-lesional injection, therapeutic ultrasound, extracorporeal shockwave therapy or desmectomy of the ALDDFT and 3% (3/91) were euthanased without treatment. Sixty-four percent (54/85) of horses returned to work. Horses that were lame at follow-up were less likely to return to work (odds ratio [OR] 107.93, 95% confidence interval [CI] 20.06-580.61, p < 0.001) than those that returned to soundness. Identification of adhesions on ultrasonography was also associated with having reduced odds for return to work when compared to horses without adhesions (OR 0.10, 95% CI 0.01-0.76, p = 0.03).
CONCLUSIONS: Retrospective nature of the study, the potential of selection bias with regards to follow-up.
CONCLUSIONS: Sixty-four percent (54/85) of horses returned to work following injury of the ALDDFT. Persistence of lameness and adhesion formation were significantly associated with a poor outcome.
摘要：
背景：手指深屈肌腱（ALDDFT）的副韧带脱位是一种常见的损伤。尽管这种伤害很普遍，文献仅限于小案例系列，治疗后报告的成功率从18%到75%不等。
目的：确定ALDDFT损伤后恢复工作的预后和相关因素。
方法：回顾性病例系列。
方法：回顾了来自四家马医院（2000年1月和2018年12月）诊断为ALDDFTdesmitis的马的病历。检索到的数据包括案例详细信息，使用,历史,跛行治疗和随访。成功被定义为重返工作岗位。反向逐步逻辑回归用于识别与返回工作显着相关的变量。
结果：包括91匹马。平均年龄为13.5岁（标准差为4.9岁）。在最初的演讲中，有34％（28/91）的马是健全的。百分之六十八（62/91）的马匹仅通过控制运动进行管理，28%(29/91)采用皮损内注射治疗，治疗性超声，对ALDDFT进行体外冲击波治疗或行行经管切除术,3%(3/91)的患者在未治疗的情况下实施安乐死.64％（54/85）的马匹重返工作岗位。与那些恢复健康的马相比，在随访中跛脚的马不太可能重返工作岗位（比值比[OR]107.93，95%置信区间[CI]20.06-580.61，p<0.001）。与没有粘连的马相比，超声检查粘连的鉴定也与重返工作岗位的几率降低相关（OR0.10，95％CI0.01-0.76，p=0.03）。
结论：研究的回顾性性质，关于随访的选择偏差的可能性。
结论：64％（54/85）的马在ALDDFT受伤后重返工作岗位。跛行和粘连形成的持久性与不良预后显着相关。
目的：确定ALDDFT损伤后恢复工作的预后和相关因素。
方法：回顾性病例系列。
方法：回顾了来自四家马医院（2000年1月和2018年12月）诊断为ALDDFTdesmitis的马的病历。检索到的数据包括案例详细信息，使用,历史,跛行治疗和随访。成功被定义为重返工作岗位。反向逐步逻辑回归用于识别与返回工作显着相关的变量。
结果：包括91匹马。平均年龄为13.5岁（标准差为4.9岁）。在最初的演讲中，有34％（28/91）的马是健全的。百分之六十八（62/91）的马匹仅通过控制运动进行管理，28%(29/91)采用皮损内注射治疗，治疗性超声，对ALDDFT进行体外冲击波治疗或行行经管切除术,3%(3/91)的患者在未治疗的情况下实施安乐死.64％（54/85）的马匹重返工作岗位。与那些恢复健康的马相比，在随访中跛脚的马不太可能重返工作岗位（比值比[OR]107.93，95%置信区间[CI]20.06-580.61，p<0.001）。与没有粘连的马相比，超声检查粘连的鉴定也与重返工作岗位的几率降低相关（OR0.10，95％CI0.01-0.76，p=0.03）。
结论：研究的回顾性性质，关于随访的选择偏差的可能性。
结论：64％（54/85）的马在ALDDFT受伤后重返工作岗位。跛行和粘连形成的持久性与不良预后显着相关。
