Severed Extensor Tendon

[Swampskeeter]

Does anyone have any experience with severed extesor that runs down the front of cannon bone on hind leg?
If so did your horse become sound to ride?

[JoZ]

My friend's mare severed her extensor tendon in a wire fence accident. HUGE wound wrapping around her hind leg, bone exposed, tendon nowhere to be seen. We figured it was hopeless.

She was a yearling at the time and is now five and totally sound. It did not involve the hock joint at all and although the bone was exposed (injury happened overnight so we weren't sure how long it had been exposed), it never became infected and did not require surgery. I can't think of the name of the surgery but it would have involved scraping infected bone.

Lots and lots of bandage changes! Our vet used a sponge foam pad over the wound, anchored it with gauze, then rolled cotton, elastikon, vet wrap -- not sure that's the correct order but it definitely involved all those things!

[JB]

If you search on my name and "extensor" you might find my long posts on it :)

In short - yes, hind long extensor was severed, horse returned to full soundness. It actually has a high rate of successful healing. I'm a strong advocate of getting light exercise (ie turnout in small paddock) asap, as it's proven that tendons and ligaments heal most strongly when movement is involved, as that causes fibers to align instead of just being randomly scattered.

Several folks say you must cast the leg - that is not a must, but it may be a necessity depending on the specific situation. I kept my guy in a snug no-bow/track wrap standing wrap for months, done low to help minimize fetlock flexion. No cast.

Mine also involved a wound, and that was actually the worst of the situation, since it was deep, and a slice of skin ended up folded inward and had to be pulled out and cut off, creating a new fresh wound. Lots of bandage changes!

[JoZ]

JB's posts and experiences were my savior when my friend's filly was going through her injury. I remember one dialog where I said: But this filly's tendon is SEVERED!
JB: I know
Me: I mean, completely
JB: I know
Me: I don't even think we could find the ends
JB: I know
Me: And some of the tendon might be still out in the pasture!
JB: I know
Me: And her hoof is flopping
JB: I know

Well it wasn't exactly like that but pretty close! And she was right. What looked horrible and insurmountable... wasn't. It was messy and time-consuming but ultimately healed very well.

[NoExcuses]

I would have the horse seen at a facility that could do an indepth work-up, ultra sound. mri. There could be a few options for treatment. Not that any tendon injury is good, better the hind limb, better an extensor to a flexor, better a tendon to a ligament. So I think you are starting a little ahead. There is a process that has good results using a corrective shoe that helps hold the toe in the extended position. A small paddock will allow the horse to move as they are comfortable. The tendons tend to heal, without a joint involved you stand an even better chance of success. As the tendon heals you should work up a schedule with your vet to bring the heald tendon back into shape. Find a vet that works with a good corrective farrier.
Good Luck
I had a horse 18 months ago fracture his L front cannon. Through and through spiral fracture. He is 6 months into his rehab, bringing the bone and soft tissue back into work with excessive scaring. Keep an eye on the good leg if he is in a lot of pain and overloads the good foot. PS We are doing flat work with the fracture, and I would not completely rule out low jumping. He is not lame nor sore on palp. Don't give up

[JB]

:lol: :lol: :lol: :lol:

And more :lol: :lol: :lol: :lol:

Too funny! Yep, that's about how it went, IIRC :D

No, the tendon itself doesn't grow back. Scar tissue grows. Some how, that magical body knows how to make the ends meet again. I'd asked my vet "what happens to the ends of the tendon?" She didn't really know, hadn't had to deal with it before. The vet school said scar tissue.

Uhh, ok, but this was a tendon under pressure, and now one end of it has snapped back up around his hock, and the other is floating somewhere down around his fetlock. WTH? Trust me LOL

Ultrasound later showed really nicely connected scar tissue.

Oh, and btw, my same horse ruptured his peroneous tertius tendon. You know, the one that connects the stifle and the hock? Same leg too. Magic Body reconnected the 2 ends with scar tissue :D

[redsky]

Yes. My horse severed his extensor tendon 5 years ago. It was a horrific accident that also involved damage to his other hind leg. The vets were certain he would never be rideable again, but we proceeded with treatment in the hopes of having him as a pasture companion. He lived at the hospital for 1 month and was in bandages for several more once returning home. Within 18 months of the injury we were WTC and now, 5 years later, we are starting to jump again!

There is hope!

[BlueEyedSorrel]

I have a 22 year old QH mare who severed an extensor tendon on the right front cannon as a 6 year old. Apparently the entire front of her leg was laid open. The accident happened 8 months before I owned her. Yes my non-horsey parents bought their 14 year old daughter a horse coming off of 5 or 6 months stall rest WITHOUT DOING A VET CHECK :eek:. You know that old saying about God protecting fools and idiots....we are the proof:lol:

While the resulting scar is a little ugly, the injury never bothered her again and I rode her for 13 years before having to retire her due to hock arthritis. She was my heart horse and we did almost everything together: western pleasure, horsemanship, showmanship, some gymkhana events, huntseat, played around with cavaletti and ground poles, rode bareback around the pasture with her foal (now my current riding horse) following us.

BES

[McVillesMom]

Add me to those saying that torn extensor tendons have a very good prognosis for soundness. I haven't <knock wood> had to deal with it in my own horse, but those I've heard about have done very well. The key, as JB already said, is bandaging at the beginning to limit fetlock flexion, because they frequently want to knuckle over. After it's begun to scar in, they usually do very well.

[EqTrainer]

In case anyone is wondering, yes. JB's horse is rather special!

[DMK]

a wee nick to the extensor and then a bit more removed when it developed some necrotic tissue and the horse never took a lame step.

You know you have been around too many injured horses when you get to the barn ("he's cut, it's bad") and you are relieved when you see it because you know that as deep cuts to the leg go, front of the hind cannon is about as good as you can hope for. It's all about real estate, and in the land of bad real estate (legs) hind extensor injuries are like palm beach waterfront property!

[starkissed]

Yes, yes, and YES!

My horse who is now 7, severed the extensor in his right hind as a 2yr old. Got it caught in a wire fence.
The vet's on the case though he would never be more than a light trail horse (he was at a dressage barn)
Well he ended up being way more than that! He is perfectly sound, in fact probably within a few months he was great.

-stall rested for probably 5 weeks, wrapped. He did knuckle over a bunch at that point.
-Then he stopped knuckling over, but became lame a week or so later.
-He did need surgery to remove a piece of dead bone that had broken off and became infected. However the vet did that standing in the barn.

Only expensive part was the pricey pricey antibiotics for a long time. But after a couple weeks of the good stuff, he just went on SMZs.


I don't think it affects him at all- here are some shots of him in action:
http://s12.photobucket.com/albums/a225/Parellihorses/todd/?action=view&current=DSC_1402.jpg

and this photo is pretty cool because that's the hind leg he hurt!
http://s12.photobucket.com/albums/a225/Parellihorses/todd/?action=view&current=DSC00586.jpg

[JB]

In case anyone is wondering, yes. JB's horse is rather special!
LOL, that's "speshul" to you :lol:

[ddashaq]

My friend had a young mare that severed her extensor on a hind leg about 8 years ago. She had some serious bandages on for a month or so but it healed very well and she has never had a lame step on it since. She still jumps out of her pasture if the other horses are taken on a hack without her, so I would say that it is not a problem!

[rider25]

Same type of injury as decsribed by many of the posters. I evented him for several years at the novice level. Then he became a husband horse for about 6 years and now he is a beginner lesson horse. Still sound.

[jennywho]

Count me in as another successful extensor tear recovery. Our mare cut all the way through her extensor and 25% of her cannon on a three foot piece of smooth wire. I will echo the bandage changing, it was neverending and expensive - diapers work great. We did not cast the leg, instead welded a door hinge to her shoe and then took a piece of iron (thinner than rebar) and made a brace that attached to the door hinge. We could still change the bandage and give her support. The biggest problem was proud flesh, but she was 100% sound at the end of the very long ordeal.

[Grataan]

The good thing about hind extensor tendons is that you don't really "need" them like you do a flexor. Prognosis depends partly on how high up it was severed and how committed you are to after care.

Like everyone has said, if you are diligent and follow directions you will probably be pleasantly surprised.

[JB]

In the beginning, when Rio's wound was fresh, with all the seepage and whatnot, it was $$, since sheet cotten was one of the better things I used. Fortunately, insurance covered all that, plus al lthe vetrap.

once the wound wasn't so fresh, I went to using feminine pads, topped with gauze, both taped with surgical tape to the leg, and then I used a nobow and a track wrap. The latter 2 are obviously re-usable - just washed a lot LOL

I found the shape/texture/etc of a nobow was MUCH more useful in creating a snug wrap to limit fetlock movement. I never got the same results with a pillow or quilted wraps.

[Swampskeeter]

Thanks Guys!!
My mare slid and fell into a T post. (Nylon twine type electric wire that breaks easily, Capped T posts until we get perminent fence up). DH saw it Right after it happened so she got Immediate attention.

She is cut to bone on one spot that is were the extensor was severed, and a flap above that. Both are smack on front of cannon bone. No joints affected. I have a great Vet clinic and farrier/blacksmith. Vet did suture the flaps of skin. Hope they hold. Pressure wrap changed every over day. Pen G (5 Days)and bute (4 days). Stall rest for two weeks.

So far the wound looks great, sutures are holding. She is pretty stable on it now. ankle does not flop. She did knukle over a few times when I was getting her to the barn after it happened. Vet recommended the stall rest until the skin starts healing well as to not rip sutures out. Then start on an exercise program.

I have delt with some nasty wounds in the past (used to work for an AQHA breeder), so am used to wrapping and Doctoring.

The one I delt with before had NO skin left on the front of cannon bone:eek: That was a yearling and she became sound.
But that was alot of brain cells ago, so I apprciate the input here:)

[Swampskeeter]

JB I will have to look up your story when I have more time.
Must get back to work;)

[JumpWithPanache]

I am finally on the uphill side of the LH extensor tendon fraying from (we think) turnout boot tension complicated with a nasty blister. What started out rather benign ended up being a pit down to the tendon with black necrotic subcutaneous tissue and frayed off tendon ends getting spit out of the wound. So not as serious of course as a severed tendon, but we didn't understand what was going on for about a two months. She was totally sound, stayed in work, and we thought it was just a really nasty blister. Not until it turned black (practically overnight) and she came back sore from a horse show did we start to investigate deeper. Did twice daily bandages changes with Derma-Gel, telfa pad, super-absorbant pad, roll guaze, no-bows, and standing wrap. It kept the wound clean but the pit got deeper and more tendon was visible as it was spitting out chunks of tendon. So we tried something different: amnion. The amnion acts as a skin graft and lets the wound do what it needs to do in order to start healing. She spent probably two months on SMZs, until the wound was completely covered over by subcutaneous tissue. Then she oculd come off the SMZs but we are continuing to but amnion across the wound. In two months of use the wound has gone from a two inch diameter flesh wound with about a half inch by one inch pit down to tendon to a quarter sized later of healthy tissue that is gradually growing skin across. Her wound has had a ten times better response with the amnion treatment than it did with the bandaging routine. Best of all, if you can find some amnion, it's free!

[JoZ]

SwampSkeeter, I know every wound is different but don't be surprised or dismayed if the stitches don't hold. Depending on the shape/type of wound it might not be that critical. Our vet "stitched" my friend's filly with great big four-inch-long stitches just to keep the whole mess somewhat together. They didn't hold. It didn't really matter in the long run.

My TB mare got a wire cut last summer that is RIGHT on the front of the hock joint -- no joint, tendon or bone involvement or exposure, just a big piece of skin and muscle ripped. I am STILL trying to get that healed. It is down to a cut the size of a quarter as opposed to one the size of a grapefruit but still... a cut. Front of cannon bone is so much "better".

Since my friend's filly's accident, 90% of the wire fence on this property has been replaced. My TB ran headlong into that 10%. Sigh. :no:

[JB]

SwampSkeeter, I know every wound is different but don't be surprised or dismayed if the stitches don't hold. Depending on the shape/type of wound it might not be that critical. Our vet "stitched" my friend's filly with great big four-inch-long stitches just to keep the whole mess somewhat together. They didn't hold. It didn't really matter in the long run.
Yep. The lower leg is such a high-tension area that unless the leg is kept REALLY still (like casted) it's very hard to get stitches to stay. In this particular injury, Rio's stitches started coming apart in about 4 days. He also sliced his LH cannon area open as a weaner, and those stitches came apart as well.

[Swampskeeter]

I understand they might not hold.
But she said even if one holds it will help the healing. So today is day 6. I change wraps tonight. Will see how it looks.
The thing I will dread will be dealing with proud flesh when that time comes.
JoZ, That is why I don't have "wire" Just A freak thing she had to get tangled in the darn post! I "thought" we were being pretty safe. But I know as well as anyone "shit happens".

JB I could not find your thread.

[JB]

I had the best luck with Panalog on the wound when the PF started developing.

swamp, my thread might be gone by now :( I know my original one is long-gone, but I was hoping my several subsequent long posts on it, in response to others who were going through it, might be around :(

[CHS]

I have a 6yo large pony who did that. It was horrible. He's now 100% sound for anything. He's got nasty scars but that's all.

[Duramax]

My MIL's gelding severed his as a 3 year old. After the initial stall rest and intense wrapping he was turned out for about a year and then broken with no noticeable lameness. He is 9 now and aside from a white scar and very slight lump on the front of his hind cannon, you can't tell that he ever did it. His did not require surgery, just intense wrapping. The vet clinic made up a splint to help stabilize the lower leg as it healed.

She witnessed him do it and it was a very disconcerting thing to see- on the short walk into the barn to wait for the vet he would flop over onto the front of his fetlock when he walked. :dead:

[Swampskeeter]

Okay guys right now I am feeling lucky. Day 6 and stitches are still holding. It really looks good, better than I thought it would at this point:)
I do have pics, but am not sure about posting them.
Okay DH is home and yapping at me must go.

[Swampskeeter]

Some sutures are starting to blow. But still looks decent.

[JB]

LOL, not surprised, but keep on pluggin'! :)

the downside to those sutures popping so soon is you deal with a fresh-ish wound again. Don't freak out if it starts to look worse again.

[starkissed]

Hang in there! She will probably be in the stall for quite a while. I forget how long mine was in a stall for, but I think almost 2 months. He did knuckle over and there wasn't much to do about it. Just hope that the tendon will eventually adhere to the bone.

[JB]

One should do whatever it takes to avoid knuckling over. It's more than just about keeping things (more) still to allow reattachment. It's about not having the fetlock joint capsule tear, which happened to my guy.

[Swampskeeter]

JB, So the knuckling over caused the joint capsule to tear?
Did it happen right away?

I figured it would get worse before it got better. Some of the stitches are still holding well so every little bit helps. The ones that are holding are on the not as deep cut above the deep cut. If that makes any sense.

As for knuckling over, she is really pretty stable on it (after the initial getting into barn when it first happened. But she did not freak out just had to walk her carefully). Did knuckle over once last week when I moved her to a different stall. Just caught that toe on the edge of the stall mat when going through the stall door. She is just a 4 yr old, but luckily she is pretty darn quiet. I can tell she would LIKE to go play though:sadsmile:
I keep someone in the barn with her all the time to try to keep her happy.

[JB]

Any time a joint hyperflexes, particularly if done while weighted, there's a great risk of tearing the joint capsule.

It's unknown whether the tearing occured at the time of the accident (or while waiting for the vet to come, I wasn't there until after the vet got there), or during some early antics on his part. There was enough overall leg swelling, combined with constant wrapping, that it wasn't discovered until later.

My boy was a just-turned 5yo and he too was pretty darn quiet, so you're in luck :)

FWIW, I started letting him out into an enclosed, attached run, maybe 30x60, while I cleaned his stall twice a day, within about 3 weeks. I think at week 2 or so I started taking him out to hand graze for 30 minutes or so. I do think the fact that he knew he'd get SOME out time, early on, helped. Within 2 months I was letting him have free access to that attached run all day, locked in his stall at night. At 3 months he also had free access to a ring-sized paddock during the day, and then run/stall at night. At 4 months he had it all, by himself, 24x7.