الفهرس 
Introduction
Anatomical ConsiderationOnly 14 pages are availabe for public view
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Abstract
Literature lacks sufficient information regarding anatomical features and surgical approach of the superior check ligament (SCL) and inferior check ligament (ICL) in donkeys. We hypothesized that desomotomy techniques of horses may not be applicable in donkeys due to species differences. This study aimed to explore the anatomical and morphometric features and surgical approaches of desmotomy of SCL and ICL in donkeys (Equus asinus). The present study was conducted on four donkeys’ cadavers (n = 4) and twelve clinically healthy adult donkeys (Equus asinus) (n = 12) of both sexes (6 males and 6 females), aged 3 – 4 years and weighing 120 - 150 kg, with no orthopedic abnormalities. The animals were divided into three group. group (A) (n = 4) to determine the anatomy and the morphometric measurements of inferior check ligament (ICL) and superior check ligament (SCL) in normal donkeys, group (B) involved six donkeys (n = 6) used for exploration of surgical exposure of the SCL (3 donkeys, n = 3) and ICL (3 donkeys, n = 3) for desmotomy and group (C) involved 6 donkeys (n = 6) used for conducting of modified techniques for SCL (n = 3) and ICL (n = 3) desmotomy to make comparisons with values between donkeys and horses cited in the literature in order to provide the practicing veterinarian on the racetrack.
The SCL originates from the caudomedial surface of the radius at its distal extremity and inserts or attaches to the craniomedial aspect of the SDFT. The total length of the SCL is (9.76 ± 0.43 cm). Cross section shapes of SCL are thin at attached part, triangular/oval in the connecting part and in the fused part becomes thicker and triangular distally. The SCL thickness increases distally and after its fusion with the tendon, the CSA decrease gradually.
The ICL originates from the palmar fibrous joint capsule of the carpus, courses distally between the suspensory ligament (SL) and the deep digital flexor tendon (DDFT) and inserts on the dorsal surface of the DDFT in the mid-metacarpal region. The total length of the ICL is (9.62 ± 0.64 cm). Cross section profiles of ICL are thin and flat in attached part, more elongated in the connecting part and has a C-shape in the fused part because it wraps the DDFT dorsally, medially and laterally. The CSA 0f the ICL decreases gradually distally. Finally, the ligament become thinner and its fibers blend with the tissue of the DDFT in a manner like the Chinese dualism symbol (Yin and Yang).
1.1 mg / kg 2 % xylazine HCl (Xyla-Ject, ADWIA Co., SAE, Egypt) and 2.2 mg / kg 5 % ketamine HCl (Ketamine, Sigma-tec Pharmaceutical Industries, SAE, Egypt) were used intravenous to induce anesthesia. Ten ml of 2 % lidocaine HCL (Dibucaine, Sigma-Tec Pharmaceutical Industry Co., Egypt) were infiltrated subcutaneously at the anticipated incision site.
The SCL desmotomy (SCLD) was performed successfully in donkeys by applying the following steps: 1) the chestnut was about 5cm away from the incision. 2) The length of the cut incision about 7-8 cm on the caudal medial aspect of the radius. 3) Subcutaneous blood vessels, which required careful dissection and ligation before transection; such as a) the main cephalic vein which should be carefully dissected and retracted caudally away from the incision site of the antebrachial fascia and b) take care of the cephalic vein branches which penetrate the antebrachial fascia that should be first transected between double ligations before opening of the antebrachial fascia. 4) At last, the SCL was identified (2.89 ± 0.85 cm) above the carpal joint and 8-9 cm distal to the chestnut.
The ICL desmotomy (ICLD) was applied easily when compared to the SCL desmotomy. It was better to be performed laterally over the deep digital flexor tendons with an incision began from the middle of the metacarpal bone and extending proximally just distal to the carpal joint. The paratenon was incised, the deep digital flexor tendon had to be first identified and isolated from the superficial flexor tendon, the ICL was recognized, elevated and the transection of the ICL was performed successfully in all donkeys.
We suggest a modified technique for SCL and ICL desmotomy had the same steps which were applied in surgical exposure of the SCL and ICL desmotomy but there was a last and a new additional step. The additional step includes the detection of the proximal end of the SCL by the tenotome through the antebrachial fascia just caudal to the radius and 4-5 cm above the carpal joint. Puncture incision was made at the anticipated site with scalpel. The tenotome was introduced at this point and transect the SCL distally. Polypropylene material piece (3 × 1 cm) was inserted in the incision just caudal to the radius and finally the antebrachial fascia was closed by simple interrupted sutures using 2 – 0 polyglactin 910.
In the modified technique for ICL desmotomy, an additional step was performed after the ICL was severed with sharp scalpel. The cutting bud of the ICL was covered by polypropylene material and fixed by four interrupted sutures with 2-0 polygalactin 910 and the covered ligamentous bud was then returned in situ.