Utilização de Plasma Rico em Plaquetas (PRP) e terapia por ondas de choque extracorpóreas no tratamento de ruptura concomitante dos tendões flexores digitais superficial e profundo : relato de caso

Abstract

In recent decades, equine veterinary medicine has advanced significantly in the search for effective therapies for musculoskeletal injuries, which represent a major challenge in the management of equine athletes. Among the main orthopedic conditions are injuries to the flexor apparatus, which severely compromise the animal's biomechanics and athletic career, especially in cases of complete tendon rupture. Given this context, the present study aimed to report the therapeutic strategies and clinical results in a 5-yearold Mangalarga Marchador stallion, weighing 450 kg, that suffered concurrent total rupture of the superficial digital flexor tendon (SDFT) and deep digital flexor tendon (DDFT) in the right hindlimb due to a severe accident with an aluminum plate during a horseback ride in Tobias Barreto (SE). Initial medical evaluation occurred late, 15 days post-trauma. Due to the severity of the condition and the compromised mechanical support of the limb, evidenced by grade 4 lameness, fetlock hyperextension, and toe elevation during weight-bearing at the initial clinical examination, management consisted of a multimodal approach. The protocol combined orthopedic support with a fishtail shoe, a single intralesional injection of autologous Platelet-Rich Plasma (PRP), and Extracorporeal Shock Wave Therapy (ShockWave), along with a progressive physical therapy program. The strategy based on mechanotransduction stimulation proved effective in inducing angiogenesis, analgesia, and the parallel organization of new collagen fibers, allowing clinical discharge at 6 months with the animal's return to routine activities and a discreet residual gait alteration. In conclusion, the combined use of biological and physical therapies with orthopedic support is a viable alternative for the rehabilitation of severe tendon injuries in horses.