Ligaments in horses are fibrous connective tissues that connect bones to other bones, providing stability and support to the skeletal structure. These structures are integral to maintaining joint function and facilitating movement. In equine anatomy, ligaments are involved in various functions, including supporting the limbs and allowing for efficient locomotion. Common ligaments in horses include the suspensory ligament, which plays a significant role in supporting the fetlock joint, and the nuchal ligament, which supports the head and neck. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, injury mechanisms, and rehabilitation of ligaments in horses.
Breit S, König HE.20 extremities of horses were used to investigate the synovial membrane of the distal interphalangeal joint and the navicular bursa. From each extremity five specimens were taken from the distal interphalangeal joint capsule, two further from the navicular bursa. Synovial villi were found near the articular cartilage as well as everywhere where the joint capsule did not form a tight periostal cover or was not connected with ligaments or tendons. Some lay between the articular surfaces of the phalanx media and phalanx distalis. Besides synovial villi and synovial folds "trabecular-like" cords o...
Moore RM, Schneider RK.Arthroscopy was performed in 1 carpal joint unilaterally in 27 horses and either in 2 carpal joints unilaterally or 1 carpal joint bilaterally in 7 horses. All horses were lame, but the cause of lameness could not be determined from radiographs. Twenty-seven carpi did not have radiographically visible abnormalities; the remaining 14 had only mild to moderate lucency or sclerosis of the radial facet of the third carpal bone. The primary abnormalities identified during arthroscopy included a crush fracture of the third carpal bone (7 carpi), an incomplete fracture of the third carpal bone in the...
Hogan PM, Bramlage LR.Medical records and lifetime race results were obtained for 61 Standardbred racehorses treated consecutively from 1985 to 1992 with transection of the accessory ligament of the superficial digital flexor tendon (AL-SDF) for tendinitis of one or both forelimbs. A clinical diagnosis of tendinitis was confirmed in all cases by ultrasonographic examination. After surgery, 50 (82%) horses raced and 42 (69%) completed 5 or more starts. Eight horses (13%) failed to start and/or complete 5 or more races due to a recurrence of tendinitis. Six (10%) horses did not start and/or complete 5 or more starts ...
Deane NJ, Davies AS.The most consistent published ideas on the function of the carpal joint of the horse concern the elasticity of the joint, and its limits to extension. Most of these are not well substantiated experimentally. Compression stress appears to be absorbed by the intercarpal ligaments as the carpal bones are separated by a wedge action during loading. Overextension is prevented by occlusion of dorsally located stop facets on the rows of carpal bones, and by the support of a stay apparatus.
Hawkins JF, Ross MW.Medical records of 40 racing Standardbreds with superficial digital flexor tendinitis that underwent transection of the accessory ligament of the superficial digital flexor (SDF) muscle (superior check desmotomy) were reviewed. Surgery was performed bilaterally in 32 horses and unilaterally in 8. Concurrent palmar annular desmotomy was performed in 8 horses in which tendinitis involved the distal metacarpal region and confinement of the deep and SDF tendons by the annular ligament was suspected. Follow-up information was obtained for 32 horses, by telephone, and racing results were available f...
Bowker RM, Linder K, Sonea IM, Holland RE.The sensory innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments [ligamenta sesamoidea collateralia (CSL) and ligamentum sesamoideum distale impar or distal sesamoidean impar (DS-impar) ligament] and the navicular bursa (podotrochlearis) was examined in the neonatal foal using immunocytochemistry. With antisera raised to substance P (SP) and human calcitonin gene-related peptide (CGRP), immunoreactive nerves were demonstrated to innervate the CSL and navicular bursa. Within CSL, and SP- and CGRP-like nerves were present in the synovial lining of the navicular...
Walmsley JP.Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cran...
Attenburrow DP, Goss VA.A case of acute destabilization of the right stifle joint associated with rupture of the anterior cruciate ligament and avulsion fracture of the tibial spine in a horse is reported. The diagnosis was obtained by scintigraphy and radiography. Post mortem investigations 6 weeks after injury demonstrated fibrillation of surface cartilage in regions unprotected by tibial menisci. No pathological change was demonstrated in the subchondral bone of the tibia in regions associated with loss of cartilage integrity.
Phillips TJ, Wright IM.Ten carpi from juvenile Thoroughbred horses were dissected in detail to record the anatomy of the palmar intercarpal ligaments (PICLs). These were found not to be substantially attached to the palmar carpal ligament. The lateral PICL was sited at the convergence of the palmar aspects of the third, fourth, intermediate and ulnar carpal bones and aligned predominantly in a proximodistal direction. The medial PICL had a large origin distally on the lateral aspect of the radial carpal bone (Cr) and attached to third (C3) and second (C2) carpal bones with apparently separate fibre orientations. Fib...
Becker CK, Savelberg HH, Barneveld A.The material properties of the accessory ligament of the deep digital flexor tendon (AL) of 21 forelimbs from horses between ages one day and 15 years were determined. The force (634-11416 N), failure stress (45-138 N/mm2), failure strain (7-24%) and tangent modulus (33-1639 MPa) are presented in relation to age. Tangent modulus did not indicate changes in elasticity due to age. The results demonstrate that complete ligament failures (CLF) of ALs of older horses (mean 7835 N) occur at lower forces than ALs of young adult horses (mean 8894 N). Sudden decreases, 'dips', in the force-time curves ...
Nixon AJ.Arthroscopic examination of the hip joint was performed in mature and juvenile horses, using a lateral approach and standard or long instruments depending on body weight. Nine hip joints were examined in three cadavers and four anesthetized horses. The lateral, cranial, and caudal regions of the femoral head and acetabulum were accessible, and, after distraction of the limb, the ligament of the head of the femur and the acetabular notch were also visible. In small horses, the medial regions of the hip joint were visible but were inaccessible in larger horses. Iatrogenic injury to the sciatic n...
Denoix JM.Conventional clinical examination remains of medical and economic value for diagnosis of soft tissue injuries in the equine athlete. This procedure requires concentration and rigor to establish the diagnosis, and, if possible, some experience to better evaluate the prognosis. None of the new imaging techniques can replace the physical examination, but each may provide additional information. These sophisticated methods are bringing considerable progress in the knowledge of locomotor injuries in the horse and a tremendous improvement in our ability to diagnose precisely lamenesses and limitatio...
Goodship AE, Birch HL, Wilson AM.Injury of the collagenous structures comprising tendons and ligaments, either from acute trauma or from repetitive strain lesions, results in protracted periods of disability. The resolution of such injuries often fails to restore the normal morphologic and functional characteristics of the structure and, therefore, either compromises the future performance of the individual or predisposes to an increased risk of recurrent injury.
Embertson RM.Congenital deformities of tendons and ligaments are not uncommon in foals. The vast majority of hyperextension deformities are treated successfully with exercise management and extended heel shoes. Successful treatment of contractural deformities depend on the site and severity of the deformity and on the appropriate use of medical, physical, and, possibly, surgical therapy.
Denoix JM.Tendons and ligaments of the equine distal limbs have a prominent anatomic, functional, and clinical importance. This article reviews the descriptive and topographic anatomy of these structures in details. Special information is given about the mechanical properties and functional anatomy of the flexor tendons, accessory ligaments, and third interosseous muscle, as well as about their roles during the standing position and gaits.
Palmer SE, Genovese R, Longo KL, Goodman N, Dyson S.The authors of this section represent a broad range of practice experience with horses that perform in rigorous and varied sport competitions. Each breed and performance application represent unique challenges of diagnosis and uncompromising demands on rehabilitated tendon injuries. This article will serve to guide, stimulate, and encourage veterinarians to apply scientific criteria to the evaluation of tendinitis therapy in the years to come so that we can arrive at a more valid consensus as to the "best" means of tendon and ligament injury management.
Rich FR, Glisson RR.In vitro failure modes and mechanical properties of the equine cranial cruciate ligament (CCL) were evaluated in 15 stifle joints from 10 ponies. Ponies were from 3 to 25 years of age and weighed from 122 to 208 kg. Femur-CCL-tibia specimens were mounted in 48 degrees of flexion, distracted until a 500-g tensile preload was achieved, and then tested by tensile loading to failure. Specimens failed by complete midsubstance CCL rupture (n = 9), combined tibial insertion avulsion fracture and midsubstance CCL rupture (n = 4), and combined femoral origin avulsion fracture and midsubstance CCL ruptu...
van den Belt AJ, Dik KJ, Barneveld A.Over a 2 year-period, the ultrasonographic localization and distribution of flexor tendinous and ligamentous injuries, the long-term follow-up, and the outcome were studied in 101 Dutch Warmblood horses (DW) with a mean age of 8.7 years and in 71 Standardbred racehorses (ST) with a mean age of 5.2 years. The ratio between forelimb and hind limb flexor tendonitis/desmitis in the DW-group was 4:1 and in the ST-group group 4:3. In the DW-group, tendonitis/desmitis of the suspensory ligament (32%), the superficial digital flexor tendon (29%), the distal carpal check ligament (17%) of the forelimb ...
Bowker RM, Rockershouser SJ, Linder K, Vex KB, Sonea IM, Caron JP.The innervation of the navicular bone (os sesamoideum distale) and its suspensory ligaments (ligamenta sesamoidea collateralia) (CSL) or proximal suspensory ligament and the ligamentum sesamoideum distale impar or the distal sesamoidean impar ligament (DS-impar ligament) was examined using combined anatomical techniques of silver impregnation and immunocytochemistry. Silver impregnation studies revealed an abundance of nerve fibres present in both the CSL and DS-impar ligament with the latter having relatively more nerve fibres. These silver-impregnated nerves coursed parallel to and were asso...
Zamos DT, Honnas CM, Hoffman AG.Arthroscopic examination of structures within the plantar pouch of the tarsocrural joint was accomplished via portals in both the plantaromedial and plantarolateral aspects of the joint. Flexion and extension of the tarsus while examining the joint through either portal allowed observation of the proximal and plantar aspects of the lateral and medial trochlear ridges, the trochlear groove, the caudal aspect of the distal tibia, and the deep digital flexor tendon (DDFT) in its sheath. From a plantarolateral portal, the plantar talocalcaneal ligament and the plantar aspect of the lateral malleol...
Keg PR, Barneveld A, Schamhardt HC, van den Belt AJ.To answer the question whether it is possible to differentiate, by means of a high plantar nerve block in the hind limb, flexor tendon lameness from a suspensory ligament lameness, mid-plantar tendinitis or desmitis was induced with collagenase in five Standardbred horses in two trials. Before the induction of lameness, and on the fourth (D4) and fourteenth day (D14) after the induction of lameness the horses were evaluated subjectively (clinical lameness score), objectively (ground reaction force (GRF) measurements), and ultrasonographically. Clinical evaluation and GRF measurements were also...
Williams J, Miyabayashi T, Ruggles A, Yamamoto J, Takiguchi M.A 2.5-year-old female Thoroughbred horse was referred to the veterinary teaching hospital for right front limb lameness of 1 year duration. Physical examination and diagnostic nerve blocks failed to localize the origin of the lameness. Scintigraphy with 99mTc-MDP suggested increased radionuclide uptake in the palmar metacarpal soft tissues of the right front limb. Ultrasonographic examination revealed hypoechoic lesions in the superficial digital flexor tendon and the suspensory ligament, suggesting tendinitis and desmitis. Combined imaging modalities improved detection and characterization of...
Dik KJ, Boroffka S, Stolk P.Ultrasonography was used with 6 normal cadaver forelimbs of Dutch Warmblood horses to delineate the ultrasonographic anatomy of the palmar pastern region, with emphasis on the proximal digital annular ligament. Using a 5.5 MHz sector scanner, the thin proximal digital annular ligament was not visible on offset sonograms. Only if the digital sheath in the normal limb was distended was the distal border of this ligament outlined. In all normal limbs the palmarodistal thickness of the combined skin-proximal digital annular ligament layer in the mid-pastern region was 2 mm. The flexor tendons and ...
Nixon AJ, Cummings JF.Serial sections of bone and soft tissue from the metacarpophalangeal joints of 2 mature and 2 immature horses were evaluated for substance P immunoreactive sensory nerve fibers. Formalin-fixed specimens were sectioned, either nondemineralized or demineralized with formic acid or EDTA. Rabbit antiserum to substance P (SP) was used in the streptavidin-biotin-peroxidase complex method for immunolocalization of SP antigen, and staining with 3,3'-diaminobenzidine was used for permanent identification of SP fibers. Abundant sensory nerve fibers were identified in the joint capsule, synovial membrane...
Wood AK, Sehgal CM, Polansky M.Sonographic observations were made of the image mean gray scale (MGS) of the flexor tendons and ligaments in the left and right metacarpal regions of each of 10 clinically normal horses. In images made in the dorsal and sagittal planes, the MGS was measured at multiple sites in the superficial digital flexor tendon (SDFT), deep digital flexor tendon (DDFT), accessory ligament (AL), and suspensory ligament (SL), and at single sites in the medial and lateral limbs of the SL, and the palmar ligament. Relative sonographic brightness of each tendon and ligament was calculated by dividing the value ...
Koblik PD, Freeman DM.Current clinical magnetic resonance (MR) imaging studies provide almost no useful signal from normal tendon and have no clear advantage over other imaging modalities in the evaluation of tendon injuries. The authors believe that tendon MR signal may be T2-limited, and, if so, could be enhanced by short echo time (TE) pulse sequences. The relationship of tendon signal intensity and tendon infrastructure conspicuity to TE was assessed at three different field strengths. Methods: Magnetic resonance imaging studies were performed on samples of normal equine tendon at 3 different field strengths wi...
van den Belt AJ, Keg PR, Kik KJ, Barneveld A.An in vitro study was carried out to define the correlation between the dose and distribution of intratendinous fluid injections in the different flexor tendons/ligaments of the palmar/plantar, metacarpal/metatarsal region of the horse. Injection of 0.1-0.2 ml resulted in a local intratendinous fluid depot showing minimal abaxial spreading and more extensive proximodistal expansion. If 0.3-0.5 ml was injected the abaxial spreading remained minimal but the proximodistal expansion increased significantly, the depots in the axial proximal, mid and distal region flowing together. Also minimal peri...
Wright IM.The 118 horses diagnosed as suffering from navicular disease by prospective criteria were treated by desmotomy of the ligamenta sesamoidea collateralia (navicular suspensory desmotomy). Three techniques were used and a standard post-operative programme was followed with clinical and radiological evaluations at 6-monthly intervals for periods of 6-36 months after surgery. At 6 and 36 months after treatment, 76% and 42.9% of horses were sound respectively. The clinical features of age, period of lameness, severity of lameness and angular limb deformities adversely affected response to surgery. T...
Nixon AJ, Sams AE, Ducharme NG.An endoscopically assisted technique for internally dividing the palmar or plantar annular ligament was developed in six cadaver limb specimens and two anesthetized horses. Under arthroscopic view, a slotted cannula was inserted into the digital sheath through a stab wound proximal to the annular ligament and advanced through the fetlock canal superficial to the flexor tendons with the slot oriented toward the fibers of the annular ligament. Division of the annular ligament by 90-degree tipped open and guarded blades was observed and verified by direct arthroscopic view. At necropsy, complete ...
van den Belt AJ, Becker CK, Dik KJ.The clinical and ultrasonographic features of desmitis of the accessory ligament of the deep digital flexor tendon (carpal check ligament) are reported in a series of 24 horses. Lameness associated with the carpal check ligament especially was found in Warmblood riding horses ranging in age from 6 to 18 years with a mean age of 11.3 years. The most striking clinical feature was a firm, painful swelling medially and laterally in the proximal and/or mid metacarpal region, corresponding with the dorsoproximal-palmarodistal oblique direction of the carpal check ligament. Sonographically swelling o...
Kotani H, Taura Y, Sakai A, Tsuka T, Kageyama Y, Nakaichi M.In this study antemortem evaluation of equine flexor tendons--the superficial digital flexor tendon and the deep digital flexor tendon--using magnetic resonance (MR) images was performed. Postmortem flexor tendons were used to prepare the slice positions, coil and body positions for MR imaging. It was possible by this method to take antemortem MR images of equine limbs that distinguished features as well as postmortem images described in previous studies. The total time of antemortem scanning was about 40 min. This study is the first to report antemortem MR images in horses.
Collard XR, Danse EM, Rombouts JJ.The treatment of acute complete (grade III) tears of the lateral ligaments of the ankle has generated much controversy in the medical literature. Functional treatment has become the standard treatment as it has been shown that there is no significant difference in long term results whatever the treatment (operative repair and cast, cast alone, or early controlled mobilization). Functional treatment includes only a short period of protection by tape bandage or brace and allows early weight-bearing. Major trauma with avulsion of bone and severe ligamentous damage on both medial and lateral sides...
Vilar JM, Rivero MA, Arencibia A, Morales I, Pinedo M.The authors propose a standard protocol of ultrasonographic exploration of the tarsal region in transversal and longitudinal planes, with the aim to spread with an accurate location of the anatomical structures. For this study, 10 adult horses of different races and ages (ranged 5-10 years) were used, with the characteristic of not having suffered any kind of tarsic pathology. The equipment was a real time ultrasound machine with a 7.5 mHz lineal transducer. Some different anatomical structures in this region of the hind-limb such as the tendons, ligaments, muscles and articular components wer...
Van Wulfen KK, Bowker RM.To localize substance P (SP) and neurokinin A (NKA) and their receptors in the insertion of the distal sesamoidean impar ligament (DSIL), deep digital flexor tendon (DDFT), and dorsal hoof wall of healthy feet of horses. Methods: 18 healthy feet from horses. Methods: Samples from the dorsal hoof wall and insertion of the DSIL and DDFT of 10 feet were processed for immunocytochemical analysis, using rabbit polyclonal antisera raised against SP and NKA. Tissue sections from 8 feet were incubated with 125-labeled SP to localize tachykinin receptors and their specificity and with control solutions...
Ellis KL, Giancola S.Rehabilitation for tendon/ligament injury requires a multimodal approach to reduce pain, restore range of motion, improve proprioception/neuromotor control, and improve strength/endurance. Multiple tools are available to accomplish these goals. The rehabilitation program must be tailored to the individual patient regardless of injury type in order to return the horse to full athletic activity and reduce the risk of reinjury.
Symons J.Pressure boots are applied to hind limbs of showjumping horses with the intent to enhance jumping form. Manufacturers claim acupressure points enhance proprioception of hind limbs. With this increased awareness, horses are expected to retract their hind limbs to clear jump rails. This research aimed to investigate a more direct, mechanical effect of pressure boots on hind limb biomechanics. Cadaveric hind limbs ( = 6) were mechanically loaded in axial compression (3 cycles at 0.25 Hz, displacement control ~3300 N) with (2 trials) and without (2 trials) a pressure boot applied. During mechanica...
Nicoll RG, Wood AK, Martin IC.Observations were made in dorsal and sagittal planes of the ultrasonographic mean gray scale of the flexor tendons and ligaments of the metacarpal regions of 5 Thoroughbred geldings, during weight bearing and nonweight bearing. In images made when the horses were nonweight bearing, the mean gray scale of the superficial and deep digital flexor tendons and accessory ligament was significantly reduced, but that of the interosseous medius muscle (suspensory ligament) was not. When relaxed, collagen fiber bundles in the tendons and ligaments acted as diffuse, rather than specular, reflectors of ul...
Becker CK, Savelberg HH, Buchner HH, Barneveld A.To evaluate posttrauma biomechanical behavior of the scar attributable to desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT), compared with the histomorphologic and ultrasonographic appearance. Methods: 5 Standardbred trotters. Methods: Gross appearance, length, cross-sectional area (CSA), in vitro material properties, and ultrasonographic and histomorphologic features were studied 6 months after desmotomy. Tensile tests were conducted, with forces and elongation simultaneously recorded. Surgically treated limbs were compared with nontreated contralateral limbs. Re...
Kirkpatrick CJ, Ernst NS, Trumble TN.There are limited radiographic-guided injection techniques of the insertion of the distal interphalangeal joint (DIPJ) collateral ligaments. The objective of this study was to develop and evaluate a palmar/plantar radiographic-guided injection of the collateral ligament insertion in cadavers. Fifty limbs were used to develop the technique and 24 additional limbs were used to evaluate accuracy. An 18 G, 9 cm spinal needle was placed in the depression between the palmar digital neurovascular bundle and arch of the ungular cartilage with dorsodistal advancement towards the distal phalanx collat...
Honnas CM, Snyder JR, Meagher DM, Ragle CA.Traumatic disruption of the suspensory apparatus is a catastrophic injury in the horse. Although this injury has been described in the adult, little information is available in the foal. This paper describes 3 foals with metacarpophalangeal joint instability caused by traumatic disruption of the suspensory apparatus. Two foals had biaxial proximal sesamoid fractures in a single forelimb, and 1 foal had avulsion of the distal sesamoidean ligaments in 1 forelimb plus biaxial proximal sesamoid fractures in the other forelimb. The foals with single forelimb involvement were managed with splints, a...
Denoix JM.Equine diagnostic sonography was initially used for the diagnosis and documentation of tendon injuries. Since 1990, this technique, along with radiography, has become an indispensable imaging procedure for the diagnosis of equine joint injuries. Sonography provides precise diagnostic information on the synovial membrane and fluid, the articular cartilage, subchondral bone and joint margins, the ligaments and menisci, and the anatomical structures involved in periarticular swelling or enlargement. Improvements in ultrasound machines and better superficial and deep image resolution allow us to e...
Peitzmeier MD, Koontz ZD, Lynch TM, Hughes FE, Slone DE.This retrospective study provides long-term results of medial patellar ligament (MPL) desmoplasty in horses with intermittent upward fixation of the patella (UFP) that were treated at a single referral hospital over a 7-year period. Follow-up interviews were conducted with owners, trainers, or referring veterinarians using a standardized questionnaire. Overall, 71% of horses returned to their intended use with only 18% at a higher level. Recurrence of UFP was noted in 33% of cases. Satisfaction with the procedure was generally low, with only 50% of owners being completely satisfied. Further in...
David F, Laverty S, Marcoux M, Szoke M, Celeste C.To report a tenoscopic technique using monopolar electrosurgery to transect the accessory ligament of superficial digital flexor muscle (AL-SDFM) and outcome in 33 horses. Methods: Case series. Methods: Horses (n=33). Methods: Medical files and surgery video recordings of horses that had AL-SDFM desmotomy performed by tenoscopy with monopolar electrosurgical electrodes were reviewed. Results: Of 33 horses, 24 were Standardbred racehorses with surgery performed bilaterally for superficial digital flexor tendonitis and 9 horses had flexural deformity. Severe (n=6) and mild (6) intrathecal hemorr...
Hellige M, Warnken T, Puff C, Feige K.An 8-year-old Warmblood gelding presented with a history of progressive ataxia for 6 weeks. Intra- and intervertebral ratios measured from lateral radiographs of the cervical spine were within normal limits. Computed tomographic myelography of the cervical spine revealed focal compression of the dorsal and the ventral contrast column as well as a ventral displacement of the spinal cord within the spinal canal due to a bulging of soft tissue attenuating material in the dorsal half of the intervertebral junction of C6 and C7. Post-mortem histopathological examination confirmed chondroid metapla...
Breit S, Stiglhuber A, König HE.Striking synovial structures were taken and their surface was investigated by scanning electron microscopy. Depending where the probes were taken from, the stratum synovial was arranged in a different way. The synovial intima seems to miss under the tendon of the long/commune extensor muscle, the collateral ligaments and the sesamoidean collateral ligaments. That is why the subsynovial tissue forms the superficial layer. The surface of the probes taken sidewards to the tendon of the extensor muscle and of the synovial fold, which is situated between the metacarpus/metatarsus and the proximal p...
Beinlich CP, Nixon AJ.In this study, the radiographic and histologic appearance of lateral palmar intercarpal ligament (LPICL) avulsion in the horse was characterized. Thirty-seven horses with radiographic evidence of avulsion fragments originating from the medial palmar aspect of the ulnar carpal bone were examined. The dorsolateral to palmaromedial projection was useful for evaluating the size and shape of the avulsed bone fragment, and the dorsopalmar projection added information on the relative proximity of the fragment to its fracture bed. Radiographic features that differentiated LPICL avulsion from subchondr...
Driver AJ, Barr FJ, Fuller CJ, Barr AR.Tearing of the medial palmar intercarpal ligament (MPICL) has been recognised as a cause of lameness in the Thoroughbred, but diagnosis is difficult due to the nonspecific clinical signs, and can be achieved only by performing arthroscopy on the mid carpal joint (MCJ). It would be beneficial to be able to image the MPICL using ultrasonography to determine whether pathology is present in the ligament in order to aid diagnosis and prognosis. Objective: To determine whether the MPICL could be imaged using ultrasound from the dorsal aspect of the MCJ, and to describe the technique and normal ultra...
Pohlin F, Edinger J, Jenner F, Egerbacher M.To describe the anatomic and histologic features of the collateral ligaments (CLs) of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in cadaveric limbs obtained from nonlame horses and to compare the histologic findings with the ultrasonographic appearance of the CLs. Methods: Medial and lateral CLs of the MCP and MTP joints of 28 limbs (16 forelimbs and 12 hind limbs) from 9 adult nonlame horses euthanized for reasons unrelated to the study. Methods: 26 limbs of 8 horses were examined by ultrasonography immediately after euthanasia. Postmortem gross and histologic examinat...
Schade J, de Souza AF, Vincensi LC, Müller TR, Fonteque JH.The objective of this study was to evaluate and compare the sonographic characteristics of the digital flexor tendons and ligaments of the palmar/plantar of the metacarpal and metatarsal regions in gaited horses, as well as to establish normal reference ultrasound values for Mangalarga Marchador (MM) and Campeiro breeds. Transverse sonographic images were obtained of 50 adult and healthy horses from the MM (n = 25) and Campeiro (n = 25) breeds. The images were taken in six metacarpal/metatarsal zones, and the following measurements were taken: transverse area, circumference, dorsopalmar/planta...
Major MD, Grant BD, White KK, Ratzlaff MH, Gallina AM, Crawley GR.Mechanical properties of equine suspensory apparatus preparations and three braided synthetic prostheses were evaluated in vitro. Force versus displacement plots and failure modes were recorded from single load-to-failure testing in 18 cadaver limbs before and after replacement of each suspensory apparatus with a prosthesis. Mean load at failure, energy to failure, and stiffness values of polytetrafluoroethylene (PTFE) prostheses were lower than those of the suspensory apparatus and aramid prosthesis. The PTFE prosthesis failed by elongation or rupture of the prosthesis. Mechanical properties ...
Harrison LJ, May SA.A three-month-old foal was presented with subluxation of the proximal interphalangeal joint in both forelimbs. The condition, which was considered to represent an unusual manifestation of breakdown of the suspensory apparatus, appeared to have developed as a consequence of extreme overexertion, 10 days previously. This had resulted in rupture of the palmar supporting structures of the joint; namely, the superficial distal sesamoidean ligament, the insertion of the superficial digital flexor tendon and the palmar joint capsule. Severe laxity of the flexor tendons had been present in the neonata...
Lischer ChJ, Bischofberger AS, Fürst A, Lang J, Ueltschi G.Lameness in horses due to pain originating from the proximal metacarpal/metatarsal region remains a diagnostic challenge. In cases of obvious lameness the pain can be localised to this region by diagnostic anaesthesia. Because a variety of disorders can cause lameness in this region different imaging modalities including radiography, ultrasonography and scintigraphy should be used to arrive at an accurate diagnosis. Even though a precise anatomic-pathologic diagnosis can still be an enigma, because not only bone and joints, but also soft tissue structures including the proximal suspensory liga...
van der Harst MR, Rijkenhuizen AB.The prognosis of ruptured collateral ligaments of the metacarpophalangeal or metatarsophalangeal joint in horses is usually considered to be poor, especially for future athletic performance. The main problem is the development, due to joint instability, of osteoarthritis, which may result in persistent lameness. In this paper a surgical technique is described in which joint stabilisation is realised by using a polypropylene mesh as a substitute for the ruptured ligaments, with the subsequent application of a cast for 7 weeks. The technique was successfully performed in 2 horses with ruptured l...
Hauser ML.The diagnostician should be familiar with the normal ultrasound appearance (size, shape, position, and textural quality) of each structure examined. With these factors as reference points, one can describe lesions in the structure involved, the precise location and extent of the lesions, and the degree of structural compromise that is manifested. Documentation of lesions of tendons and ligaments enables one to make an accurate diagnosis and a more precise prognosis. Serial examination during the healing phases allows for a more accurate prediction as to when the structure in question can withs...
Kofler J, Kneissl S, Malleczek D.Clinical, magnetic resonance imaging (MRI) and computed tomography (CT) findings of acute desmopathy of the lateral collateral sesmoidean (navicular) ligament (CSL) in a 13-year-old Hanoverian mare are presented. On admission to the clinic the horse showed a grade 5/6 left front-limb lameness at the walk, pain on coffin joint manipulation, and coffin joint effusion. Despite a positive palmar digital nerve block, radiographs and ultrasonography did not indicate reasons for the severe clinical signs. However, MRI revealed damage to the CSL and bone marrow oedema of the navicular bone (NB), where...
Whitton RC, Kannegieter NJ, Rose RJ.To examine the relationship between medial palmar intercarpal ligament (MPICL) tearing and postoperative performance in racing horses. Methods: The postoperative performance of 42 horses in which the midcarpal joint was examined arthroscopically was followed prospectively. Intra-articular variables examined were the severity of MPICL tearing, subchondral bone damage and articular cartilage damage. Using a scoring system based on the class of race and the position in the race, a mean score was calculated for up to five races before and after surgery. The preoperative score was subtracted from t...
Beinlich CP, Nixon AJ.To clarify the diagnosis of avulsion of the lateral palmar intercarpal ligament (LPICL), correlate avulsion of this ligament with lameness, determine the prevalence of avulsion of the LPICL in a hospital population, and evaluate the response to surgical removal of the avulsion fragment in horses. Methods: Retrospective study. Methods: 37 horses with avulsion of the LPICL. Methods: Medical records and radiographs of horses with avulsion of the LPICL were reviewed; follow-up information was obtained from race records and from owners via a telephone survey. Results: Of 6,418 horses evaluated for ...
Whitton RC, McCarthy PH, Rose RJ.To describe in detail the structure of the medial palmar intercarpal ligament (MPICL), the lateral palmar intercarpal ligament (LPICL), and a dorsomedial intercarpal ligament (DMICL) of the equine midcarpal joint. Methods: Dissections of equine midcarpal joints. ANIMALS AND SAMPLE POPULATION: Ten carpal joints from eight thoroughbred horses. Methods: Detailed dissections of the midcarpal joint were performed, with particular attention paid to the MPICL, the LPICL, and the DMICL. The attachments and dimensions of these structures were recorded, as well as their behavior during joint movement. R...
Stiglhuber A, Breit S, König HE.The equine fetlock joint cavity shows ten pouches. The dorsal recess, which is oriented to the proximal side, is separated from those three pouches, which show to the distal direction, by several capsular folds. These folds are documented by means of sagittal sections through the fetlock joint. A medial/lateral recess is covered by the deep part of the collateral ligament of the fetlock joint. The collateral ligaments as well as the sesamoidean collateral ligaments are closely connected with the joint capsule, from which two capsular folds are separated. Between the part of the sesamoidean col...
Lacitignola L, De Luca P, Imperante A, Tommasa SD, Crovace A.The aim of this study was to evaluate the use of a single-portal endoscopic desmotomy of the PAL with the use of Arthrex - Centerline™. Ten horse distal front limbs from horses free of PAL disease were prepared for tenoscopy of the digital flexor tendon sheath (DFTS). A dual-port endoscopic desmotomy with a hook knife was performed in 5 specimens (Group A) and single port Arthrex-Centerline™ Desmotomy was performed in another 5 specimens (Group B). The performing time, judgments of the surgeon, number of blade passages, and gross anatomy were evaluated. The performing time and surgeon judg...
