842 INFLAMMATION OF THE FLEXOR TENDONS. 



Zschokke describes a case in the horse, in which the sesamoid 

 ligaments were ossified. Roloff found the flexor perforatus changed 

 into cartilage. 



Knuckling at the fetlock may either be brought about by shortening 

 of tendons, in consequence of their cicatricial contraction, or of 

 contraction of muscles. In the first case, only the lower joints take 

 up the position of volar flexion ; when muscles are involved, the 

 knee-joint is also bowed over. All cicatricial tissue, whether in 

 tendons or elsewhere, is inclined to shrink, but excessive contraction 

 is only seen when the limb is rested and entirely relieved of weight. 

 Fig. 479, which is from a photograph, shows to what extent 

 shrinkage may occur. If weight is placed on the limb, even 

 occasionally, it never becomes so excessive. After contraction the 

 fibres of the tendon no longer run in a straight direction, but take 

 a tortuous course. 



On account of the peculiar character of the pathological processes, 

 tendinitis varies greatly in course and results. When caused by 

 strain, it is an aseptic process and nearly always produces permanent 

 distension at the seat of injury. Resorption of inflammatory 

 products may occur in eight to fourteen days when the case is 

 favourable, and when rest and early careful treatment are adopted, 

 but in most instances some thickening remains. Though lameness 

 may disappear in three to four weeks, the newly-formed tissue has 

 not the strength of normal tendon, and a point of less resistance 

 results, which explains the frequent relapses. Continuous severe 

 pain points to serious local change, and often causes knuckling ; the 

 prognosis therefore depends chiefly on the degree of pain. The 

 results of strains of the flexor tendons depend very largely on the 

 region involved ; the most serious being those which affect the flexor 

 perforans and its check ligament, in which complete resolution is 

 rare. Next comes the suspensory ligament. Inflammation of the 

 flexor perforatus is less troublesome; the animal's usefulness is not 

 impaired, even though considerable thickening remains. Needless 

 to say, the older the condition the less the chance of recovery ; when 

 lameness is of old standing the outlook is bad. In hacks, prognosis 

 is less favourable than in light van-horses. When the joints are 

 much shot-over, tenotomy is sometimes successful, but this depends 

 on whether the flexor tendons are adherent to one another or to 

 their lower sheaths. Adhesion of the flexor perforans to the perforatus 

 is always troublesome, though cure is not entirely out of the question. 

 Tendinitis occurring during infectious disease is more obstinate 

 than inflammation mechanically produced in otherwise sound animals, 



