Optimising management of digital flexor tendon sheath pathology (LVS25)

Digital flexor tendon sheath (DFTS) injuries are a common cause of lameness in both pleasure and performance horses. These conditions range from manica flexoria tears and tendon tears to intrathecal infections and adhesions, each posing unique diagnostic and therapeutic challenges.

In this session, we’ll explore a modern, evidence-based approach to optimising management of DFTS pathology. Topics include clinical presentation, diagnostic analgesia, advanced imaging (including ultrasound, contrast tenography, MRI, and CT tenography), and when to pursue tenoscopy. We'll also compare conservative versus surgical treatment strategies and review post-treatment rehabilitation and performance outcomes.

Through real-life case studies and surgical videos, delegates will gain confidence in diagnosing subtle injuries, selecting appropriate therapies, and improving prognostic conversations with clients.

• Describe the key anatomical and functional features of the digital flexor tendon sheath and its relevance to clinical pathology.
• Recognise common and uncommon clinical presentations of DFTS disorders and differentiate them from adjacent synovial or soft tissue pathologies.
• Select and interpret appropriate diagnostic modalities.
• Formulate evidence-based treatment plans tailored to the type and severity of pathology, including when to use conservative therapies vs. tenoscopic surgery.
• Understand the principles of tenoscopic intervention, including surgical indications, techniques, and intraoperative decision-making.
• Develop appropriate rehabilitation protocols and deliver realistic prognostic advice based on current outcome data.

Speakers

Andy Fiske-Jackson, BVSc MVetMed DipECVS FHEA MRCVS, Associate Professor in Equine Surgery - Royal Veterinary College

Presented at LVS 2025

Friday, 21 November 2025, 15:50-16:40, Equine Referral Theatre