Topic:Suspensory Ligament
The suspensory ligament in horses is a critical component of the equine musculoskeletal system, primarily responsible for supporting the fetlock joint and absorbing shock during movement. This ligament extends from the back of the knee or hock down to the sesamoid bones and continues into the pastern. Injuries to the suspensory ligament, such as strains or tears, are common in performance horses and can significantly affect their mobility and performance. Diagnosis typically involves clinical examination, ultrasonography, or MRI to assess the extent of the injury. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, function, injury mechanisms, and treatment options related to the suspensory ligament in horses.
Risk factors for injury to the superficial digital flexor tendon and suspensory apparatus in Thoroughbred racehorses in New Zealand. To investigate risk factors for injury to the superficial digital flexor tendon (SDFT) and suspensory apparatus (SA) of the forelimbs in Thoroughbred racehorses in New Zealand. Methods: Poisson and negative binomial regression, with exposure time represented by cumulative training days for each horse, were used to relate explanatory variables to the incidence rate (IR) of cases of inflammation of the SDFT (n=51), and injuries involving the SA (n=48) in a population of 1,571 commercially- trained racehorses over 554,745 study days. Only the first occurrence of an injury for any one horse was el...
Ultrastructural and immunocytochemical evaluation of the effects of extracorporeal shock wave treatment in the hind limbs of horses with experimentally induced suspensory ligament desmitis. To evaluate the effects of extracorporeal shock wave therapy (ESWT) on affected ligaments in the hind limbs of horses with experimentally induced suspensory ligament desmitis by use of ultrasonographic, ultrastructural, and immunocytochemical techniques. Methods: 10 horses. Methods: Suspensory ligament desmitis was induced in both hind limbs of each horse by use of 2 collagenase injections (administered 2 weeks apart) in each suspensory ligament. Two weeks after the second injection, the right hind limb of each horse was treated with ESWT (3 treatments at 3-week intervals); the left hind limb ...
Musculoskeletal responses of 2-year-old Thoroughbred horses to early training. 4. Morphometric, microscopic and biomechanical properties of the digital tendons of the forelimb. To determine the weight, volume, density and cross-sectional area (CSA) of the digital flexor tendons, common digital extensor tendon (CDET) and suspensory ligament (SL) of the forelimb of young Thoroughbred horses in early training, and to assess the response to a training programme of known parameters of superficial digital flexor tendon (SDFT) tissue at mid-metacarpal level. Methods: The tendons of seven 2-year-old Thoroughbred horses in training were inspected, transected into segments of known length, and compared with those from seven untrained horses matched for age, sex and breed. The ...
Influence of support boots on fetlock joint angle of the forelimb of the horse at walk and trot. Support boots are thought to reduce tension on the superficial digital flexor tendon (SDTF) of the horse and are frequently recommended for horses convalescing after tendonitis, but evidence of their effectiveness is conflicting. Objective: To document the effects of 4 different types of support boots on fetlock joint angle in comparison to the unprotected fetlock. Methods: In 26 horses, the kinematics of the forelimb fetlock joint angle was measured at walk and trot on a treadmill when wearing 3 different types of support boots and 1 protective boot, as well as without boots. As outcome param...
Effects of injury to the suspensory apparatus, exercise, and horseshoe characteristics on the risk of lateral condylar fracture and suspensory apparatus failure in forelimbs of thoroughbred racehorses. To assess concurrently the effects of moderate ligamentous suspensory apparatus injury (MLSAI), racing-speed exercise, and horseshoe characteristics on risk of catastrophic suspensory apparatus failure (SAF) or metacarpal condylar fracture (CDY) in forelimbs of racehorses. Methods: Cadavers of 301 Thoroughbred racehorses (108 with SAF, 33 with CDY and 160 control horses). Methods: A cross-sectional epidemiologic study was used to describe distributions and relationships between MLSAI, exercise, and horseshoe variables. Logistic regression was used to assess potential risk factors for developin...
Use of magnetic resonance imaging identify suspensory desmitis and adhesions between exostoses of the second metacarpal bone and the suspensory ligament in four horses. Four horses were examined because of chronic forelimb lameness. In all horses, the cause of the lameness was localized to the metacarpus by means of physical examination and diagnostic anesthesia, and radiography of the affected limb revealed a small exostosis of the second metacarpal bone. Magnetic resonance imaging revealed suspensory desmitis in the region of this exostosis in all 4 horses. In addition, an abnormal area of low signal intensity, suggestive of an adhesion, was seen between the exostosis and the suspensory ligament. In all horses, an adhesion between the suspensory ligament an...
Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse. Proximal suspensory desmitis (PSD) is diagnosed with increasing frequency in horses and radial pressure wave therapy (RPWT) is a widely used therapy for painful orthopaedic conditions in man and dogs. There are, however, few published data as to the outcome of its use in PSD. Objective: To evaluate the use of RPWT in the treatment of chronic or recurrent PSD in the horse, an injury which carries a poor prognosis for return to athletic function with conservative management alone. Objective: RPWT and controlled exercise improves the prognosis of chronic or recurrent PSD in the horse when compare...
Prevalence of superficial digital flexor tendonitis and suspensory desmitis in Japanese Thoroughbred flat racehorses in 1999. Overstrain injuries to the superficial digital flexor tendon (SDFT) and suspensory ligament (SI) are among the most common musculoskeletal injuries which contribute to the considerable wastage of racing Thoroughbreds. Many epidemiological studies have demonstrated the prevalence of and risk factors for tendon injury when racing but have not included those injuries sustained during training. However, since tendon injury during training is seen commonly in clinical practice, it is appropriate to determine the overall prevalence of tendon injury sustained during both training and racing. Objectiv...
The effects of extracorporeal shock-wave therapy on the ultrasonographic and histologic appearance of collagenase-induced equine forelimb suspensory ligament desmitis. Extracorporeal shock-wave therapy (ESWT) may stimulate healing of desmitis in multiple species. The objective of this study was to evaluate the ultrasonographic and histologic appearance of collagenase-induced suspensory ligament (SUL) desmitis in untreated ligaments and ligaments treated with ESWT in horses. Four mature horses had SUL desmitis induced in both forelimbs. Beginning 3 weeks after induction of the lesions, one ligament per horse was treated 3 times at 3-week intervals with ESWT. The percent lesion, echogenicity and fiber alignment scores of the SULs were evaluated at 3-week inter...
Biomechanical investigation of the association between suspensory ligament injury and lateral condylar fracture in thoroughbred racehorses. Objective-To determine whether partial transection of the medial branch of the suspensory ligament (MBSL) alters equine third metacarpal bone (MC3) condylar surface strains and forelimb, distal joint angles in a manner consistent with promotion of lateral condylar fracture. Study Design-In vitro biomechanical experiment. Sample Population-Right forelimbs from 7 Thoroughbred horse cadavers. Methods-Lateral and medial MC3 condylar, dorsal and abaxial, bone surface strains and distal joint angles were measured both before and after partial transection of the MBSL during in vitro axial limb compre...
Force- and moment-generating capacities of muscles in the distal forelimb of the horse. A detailed musculoskeletal model of the distal equine forelimb was developed to study the influence of musculoskeletal geometry (i.e. muscle paths) and muscle physiology (i.e. force-length properties) on the force- and moment-generating capacities of muscles crossing the carpal and metacarpophalangeal joints. The distal forelimb skeleton was represented as a five degree-of-freedom kinematic linkage comprised of eight bones (humerus, radius and ulna combined, proximal carpus, distal carpus, metacarpus, proximal phalanx, intermediate phalanx and distal phalanx) and seven joints (elbow, radiocarp...
Evaluation of a stochastic Markov-chain model for the development of forelimb injuries in Thoroughbred racehorses. To evaluate a Markov-chain model for the development of forelimb injuries in Thoroughbreds and to use the model to determine effects of reducing sprint distance on incidence of metacarpal condylar fracture (CDY) and severe suspensory apparatus injury (SSAI). Methods: Weekly exercise and injury data for 122 Thoroughbreds during racing or training. Methods: Weekly data were used to construct a Markov-chain model with 5 states (uninjured [UNINJ], palpable suspensory apparatus injury [PSAII, SSAI, CDY, and lost to follow-up [LOST]). Transition probabilities between UNINJ and PSAI were estimated as...
Effect of perineural anesthesia on the ultrasonographic appearance of equine palmar metacarpal structures. The purpose of this study was to describe ultrasonographic changes of the equine palmar metacarpal area attributed to the infiltration of local anesthetic solution and to determine whether these changes were noted immediately or at 24 h. The palmar metacarpal region of one forelimb in each of six horses was examined ultrasonographically with a 10-MHz linear array transducer and a 7.5-MHz curvilinear transducer. Transverse and longitudinal images were recorded at 5-cm intervals distal to the accessory carpal bone. High and low palmar and palmar metacarpal nerve blocks were performed with a 2% m...
Medial patellar ligament splitting for the treatment of upward fixation of the patella in 7 equids. To describe a surgical technique for splitting the proximal third of the medial patellar ligament (MPL) in horses and ponies with upward fixation of the patella (UFP), and to report outcome. Methods: Prospective clinical study. Methods: Four horses and 3 Shetland ponies. Methods: With ultrasound guidance, the proximal third of the MPL was split by percutaneous use of a no. 15 scalpel blade. The rationale for this surgical procedure was to induce a localized desmitis with subsequent ligament thickening. No anti-inflammatory drugs were administered, and horses and ponies were exercised the day a...
Calculated forelimb flexor tendon forces in horses with experimentally induced superficial digital flexor tendinitis and the effects of application of heel wedges. To calculate forces in the flexor tendons and the influence of heel wedges in affected and contralateral (compensating) forelimbs of horses with experimentally induced unilateral tendinitis of the superficial digital flexor (SDF) tendon. Methods: 5 Warmblood horses. Procedure-Ground reaction force and kinematic data were obtained during a previous study while horses were trotting before and after induction of tendinitis in 1 forelimb SDF and after application of 6 degrees heel wedges to both forehooves. Forces in the SDF, deep digital flexor (DDF), and the suspensory ligament (SL) and strain i...
Effects of superior check desmotomy on flexor tendon and suspensory ligament strain in equine cadaver limbs. To measure the effects of transection of the accessory ligament of the superficial digital flexor (SDF) muscle (superior check desmotomy) on flexor tendon and suspensory ligament (SL) strain in vitro. Methods: In vitro experimental biomechanical investigation. ANIMALS USED: Ten equine cadaver forelimbs. Methods: The effects of superior check desmotomy were determined using equine cadaver forelimbs secured in a servocontrolled hydraulic testing machine. Strain sensors were used to measure strain on the superficial and deep digital flexor tendons and SL, and a goniometer was used to measure join...
Model formulation and determination of in vitro parameters of a noninvasive method to calculate flexor tendon forces in the equine forelimb. To describe a method to calculate flexor tendon forces on the basis of inverse dynamic analysis and an in vitro model of the equine forelimb and to quantify parameters for the model. Methods: 38 forelimbs of 23 horses that each had an estimated body mass of > or = 500 kg. Methods: Longitudinal limb sections were used to determine the lines of action of the tendons. Additionally, limb and tendon loading experiments were performed to determine mechanical properties of the flexor tendons. Results: The study quantified the parameters for a pulley model to describe the lines of action. Furthermo...
Sensitivity analysis and application to trotting of a noninvasive method to calculate flexor tendon forces in the equine forelimb. To test the sensitivity to measurement and modeling errors of a method for noninvasive calculation of flexor tendon forces in the equine forelimb and to calculate tendon forces for Dutch Warmblood horses during trotting. Methods: A normative set of kinematic and ground-reaction force (GRF) data obtained from horses during trotting in another study. Methods: Forces in the flexor tendons were calculated from the data set before and after addition of fixed relative and absolute errors. Amount of error was based on normal accuracy of the variables. A similar analysis was performed for a measure of...
Risk factors for and outcomes of noncatastrophic suspensory apparatus injury in Thoroughbred racehorses. To evaluate effects of toe grabs, exercise intensity, and distance traveled as risk factors for subclinical to mild suspensory apparatus injury (SMSAI) in Thoroughbred racehorses and to compare incidence of severe musculoskeletal injury (MSI) in horses with and without SMSAI. Methods: Nested case-control study. Methods: 219 Thoroughbred racehorses racing or in race training. Methods: Racehorses were examined weekly for 90 days to determine incidence of suspensory ligament injury and monitor horseshoe characteristics. Every horse's exercise speeds and distances were recorded daily. Conditional ...
Treadmill exercise-induced tendon hypertrophy: assessment of tendons with different mechanical functions. The equine superficial digital flexor tendon (SDFT) functions as an energy store during high-speed gaits reducing the energetic cost of locomotion. To enable the SDFT to function effectively, the appropriate mechanical properties are essential. We tested the hypothesis that the SDFT does not undergo gross hypertrophy in response to high-intensity exercise whereas tendons not involved in energy storage undergo adaptive hypertrophy. Two groups (n = 6) of Thoroughbred fillies were trained at high-intensity on a high-speed equine treadmill for 5 months (short-term study) or 18 months (long-term st...
Results of physical inspection before races and race-related characteristics and their association with musculoskeletal injuries in Thoroughbreds during races. To estimate the relative risk of injury among horses deemed to be at increased risk of injury on the basis of prerace physical inspection findings and to examine the association of injury during races with race-related characteristics. Methods: Cohort study. Methods: 2,187 Thoroughbred horses that started 3,227 races in Kentucky. Methods: All race starts for which a horse was deemed to be at increased risk of injury on the basis of prerace physical inspection findings and a random sample of race starts for which horses were not deemed at increased risk of injury were included in the study. Fin...
Apical fracture of the proximal sesamoid bone in standardbred horses: 43 cases (1990-1996). To determine whether fracture fragment dimensions, suspensory ligament damage, and racing status at the time of injury were associated with outcome in Standardbred horses with apical fracture of the proximal sesamoid bone. Methods: Retrospective study. Methods: 43 Standardbred racehorses. Methods: Medical records, racing records, and radiographs were reviewed, and ultrasonographic findings were scored. Measurements of the fractured portion of the proximal sesamoid bone were made. Results: Seventy-four percent (32/43) of horses were pacers, and 26% (11/43) were trotters. Statistical differences...
The effect of orthopaedic shoeing on the force exerted by the deep digital flexor tendon on the navicular bone in horses. This study quantifies both the intended effect of orthopaedic shoeing to decrease the load on the navicular bone and the eventual undesired effects on gait performance. The compressive force exerted by the deep digital flexor tendon on the navicular bone and on the quality of the trot and redistribution of forces over the flexor tendons and the suspensory ligament were studied as a function of orthopaedic shoeing in 12 sound Dutch Warmblood horses. A modified CODA-3 gait analysis system and a force plate were used to quantify objectively the load on the lower limb. The quality of the trot was ...
Endoscopy of the navicular bursa: a new technique for the treatment of contaminated and septic bursae. A technique for evaluation of the navicular bursa using a 4 mm 25 degrees inclined view arthroscope is described. This allows examination of the palmar/plantar surface of the navicular bone, the insertions of the navicular suspensory, T and impar ligaments, the bursal synovium and the dorsal surface of the deep digital flexor tendon. The technique was used in 16 horses with punctures of the navicular bursa. Procedures facilitated by the technique were bursal lavage, removal of pannus, synovial resection and debridement of lesions on the palmar/plantar surface of the bone and in the deep digita...
Histological study of the innervation of the suspensory ligament of the forelimb of the horse. The innervation pattern of the interosseus muscle of the forelimb was studied in two ponies and two horses. The nerves of the suspensory ligament were studied histologically after neurectomy of the ulnar and median nerve branches proximal to the carpal joint. The results demonstrated that the interosseus muscle is innervated by the deep branch of the lateral palmar nerve which emerges at the level of the midcarpal region and contains fibres from the ulnar and the median nerve. These findings provide evidence that an ulnar nerve block proximal to the accessory bone would fail to anaesthetise th...
Effects of training on collagen fibril populations in the suspensory ligament and deep digital flexor tendon of young thoroughbreds. To determine the effect of a specific galloping exercise regimen on collagen fibril mass-average diameters (MAD) in the deep digital flexor tendon (DDFT) and suspensory ligament (SL) of young Thoroughbreds. Methods: 12 Thoroughbred fillies, 21 +/- 1 (mean +/- SD) months old. Methods: 6 horses underwent a specific 18-month treadmill training program involving galloping exercise. The remaining 6 horses served as controls, undertaking low-volume walking exercise over the same period. Sections were excised from the midpoint of the DDFT and SL, and small strips were dissected from central and perip...
Superficial digital flexor tendonitis in thoroughbred race horses: outcome following non-surgical treatment and superior check desmotomy. This study documents the results of non-surgical treatment and treatment by superior check desmotomy in Thoroughbred racehorses with superficial digital flexor (SDF) tendonitis. Methods: A prospective study was made of 124 thoroughbred racehorses with unilateral or bilateral SDF tendonitis. Methods: The flexor tendons were assessed by physical and ultrasonographic examination before treatment, and the lesions detected in affected tendons were characterised according to lesion type, length and cross-sectional area. Ninety three horses were managed non-surgically and 31 by superior check desmoto...
Racing-related factors and results of prerace physical inspection and their association with musculoskeletal injuries incurred in thoroughbreds during races. To describe and compare data from Thoroughbreds that sustained musculoskeletal injuries while racing with data from matched control horses. Methods: Matched case-control study. Methods: 216 Thoroughbreds that sustained a musculoskeletal injury while racing and 532 horses from the same races that were not injured. Methods: Data regarding racing history, race-entrant characteristics, racing events determined by analysis of videotapes of races, and results of prerace physical inspections were determined for all horses. Injured horses were compared with control horses by using conditional logistic...
Recovery of equine forelimb function after desmotomy of the accessory ligament of the deep digital flexor tendon. The recovery process of the equine locomotor system after desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT) was investigated by studying the movement patterns and joint moments in 6 horses before and 10 days and 6 months following surgery. Using a modified CODA-3 system the joint angles and angular velocities of the lower limb were assessed in the operated forelimb as before the operation. Simultaneously ground reaction forces were measured and joint moments calculated. At 10 days and 6 months after the operation the carpal joint started to bend earlier in the sta...