[Murat KUTAY]

Digital Tendon Rupture or Laceration

Anatomy

The digits (toes) have three tendons
Two tendons are located on the bottom of the bones (deep digital flexor and superficial flexor tendons) and these serve to flex the toes
The flexor tendons are more important than the extensors
Another tendon goes to each toe on the top side of the digit and it extends the digits

Causes of digital tendon rupture

Laceration from a sharp object such as sharp metal, broken glass, sharp instruments (knives, scissors etc)
In some animals the signs of a lacerated tendon (other than a skin wound) is not obvious at the time of initial examination, as the tendon has not been completely severed; if this is not corrected with surgery, the tendon may tear completely in the future resulting in obvious clinical signs of a “sprung toe”
Excessive hyperextension of the digit resulting in a tear of the digital flexors

Diagnosis

The diagnosis of tendon rupture is based on physical examination
A digit that has rupture of the digital flexor tendons will stick up more than normal; the result is that the pad does not assume a weight-bearing position, which the result may be sores on the digit because the pad is not contacting the ground when walking and running
Take note of the middle digit that has torn superficial and deep digital flexor tendons; the toe nail rides high in this toe

Take note of the small laceration (dog stepped on broken glass) just in front of the large metatarsal pad

Treatment options

No treatment is an option, but for the best function of the toe, surgery should be done
Surgery involves making an incision over the area to expose the ruptured tendons
In the photo below, an incision behind the large metatarsal pad was made as the tendon retracted beneath the metatarsal pad

In the photo below a suture has been placed in the lacerated tendon which will be reattached back to the digit

The ruptured tendon is sutured together with a locking-loop suture pattern
In order to keep the toe in flexion, thereby taking pressure off of the repaired tendon, a mattress suture is placed in the digital pad to the metatarsal (hind limb) or metacarpal (front limb) pad; this suture is removed after about 4 weeks
After surgery a cast is applied to support the tendon repair for 2 months
If the initial surgery is unsuccessful a podoplasty can be performed which involves removing the skin between the large metacarpal or metatarsal pad and the digital pads and suturing pads together

Healing

Generally healing of a tendon takes about 2 months

Postop care

Protect the cast from getting soiled or wet – a plastic bag should be put on the foot when going outside
Check the toes to make sure that there is no associated swelling

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