Case report: Block recession calcaneoplasty of the calcaneal tuber for treating lateral superficial digital flexor tendon luxation in a dog

Abstract

A 4-year-old, intact, female, Collie was presented with 5 month history of right hindlimb lameness. Lateral luxation of the superficial digital flexor tendon (SDFT) was diagnosed on the basis of the clinical, radiographic and ultrasonographic finding. Intraoperatively, shallow right calcaneal tuber was observed. Block recession calcaneoplasty with retinaculum repair using anchor screw were performed to manage SDFT luxation. Additionally, temporary restraining pin was placed on lateral aspect of the calcaneal tuber. The patient demonstrated mild lameness at 2 weeks postoperatively and improved to normal limb function at 12 weeks postoperatively. As the gold standard of surgical techniques for SDFT luxation has not yet been reported, block recession calcaneooplasty may be an alternative surgical option for patients with calcaneal morphologic abnormalities causing SDFT luxation.

Surgical Repair of Luxation of the Superficial Digital Flexor Tendon in Dogs Using a Calcaneal Chondroplastic-like Technique—Three Cases

“…A more recent case report described a block recession calcaneoplasty of the calcaneal tuber with retinaculum repair using an anchor screw and a temporary restraining pin for treating lateral SDF tendon luxation in a dog. In these studies, clear evidence of bone deformity was not observed in the radiographic images, but a flattened calcaneal groove was observed intraoperatively [17,18].…”

“…It is our opinion that in all dogs with SDF tendon luxation and predisposed factors (obesity, misalignment, and hyperactivity), not only in patients with calcaneal dysplasia, the deepening of the groove can give greater stability to the tendon and promote the healing of the retinaculum, which otherwise would be continuously stressed. In the literature, a period of postoperative immobilizations ranging from 4 to 8 weeks order to avoid surgical treatment failure is recommended [2,[4][5][6][7]17,18] and, recently, colleagues have observed that the limb immobilization of 6 weeks or longer did not significantly affect surgical outcomes [13]. Contrary to what is suggested by the literature, all three of our patients did not need a postoperative immobilization of the tarsal joint following SDF tendon luxation repair because the deepening of the groove ensures tendon stability.…”

“…Surgical treatments have focused on repair, reinforcement, and protection of the retaining tissue during healing and not on the correction of any underlying anatomical defect to the shape of the calcaneal groove. Recent reports have reported that if the groove of the calcaneus is intraoperatively observed to be shallow or absent, with a distolateral slant, it can be useful to perform block recession calcaneoplasty of the calcaneal [17] or tuber abrasion calcaneoplasty [18] in order to deepen the groove of the calcaneal tuberosity, analogously to the surgical treatment of the patellar luxation. A calcaneal chondroplastic-like technique could also be useful in these subjects who do not show significant structural changes in calcaneal tuberosity, as it would allow us to keep the tendon along the groove waiting for the healing of the repaired soft tissues.…”