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Home / Equine Research Bank / Vet Surg / Dorsal-to-palmar branch neuroanastomosis in horses undergoin...
Veterinary surgery : VS2024; 53(4); 671-683; doi: 10.1111/vsu.14075

Dorsal-to-palmar branch neuroanastomosis in horses undergoing palmar digital neurectomy does not reduce neuroma formation or improve outcome.

Abstract: Chronic foot pain, a common cause of forelimb lameness, can be treated by palmar digital neurectomy (PDN). Complications include neuroma formation and lameness recurrence. In humans, neuroanastomoses are performed to prevent neuroma formation. The aim of the study was to evaluate the outcome of horses undergoing dorsal-to-palmar branch neuroanastomosis following PDN. Methods: Retrospective case series. Methods: Eighty-five horses with PDN and dorsal-to-palmar branch neuroanastomosis. Methods: Medical records for horses undergoing this procedure at two hospitals between 2015 and 2020 were reviewed. Palmar and dorsal nerve branches of the PDN were transected and end-to-end neuroanastomosis was performed by apposition of the perineurium. Follow-up was obtained from medical records and telephone interviews. Success was defined as resolution of lameness for at least one year. Results: Lameness resolved following surgery in 81/85 (95%) horses with 57/84 (68%) sound at one year. Postoperative complications occurred in 19/85 (22%) cases. The main limitations of the study were an incomplete data set, inaccurate owner recall, and variations in procedure. Conclusions: Compared to previous studies, this technique resulted in similar numbers of horses sound immediately after surgery, a comparable rate of postoperative neuroma formation but a higher recurrence of lameness rate at 1 year postoperatively. Conclusions: End-to-end neuroanastomosis of the dorsal and palmar branches of the PDN does not reduce the rate of neuroma formation in horses. Long-term outcome was less favorable compared to previously reported PDN techniques.
© 2024 American College of Veterinary Surgeons.
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Publication Date: 2024-02-15 PubMed ID: 38361406DOI: 10.1111/vsu.14075Google Scholar: Lookup
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  • Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research article explores the use of dorsal-to-palmar branch neuroanastomosis during palmar digital neurectomy (PDN) in horses. However, it concluded that this technique did not reduce neuroma formation or significantly improve post-operative outcomes.

Objective and Methodology

  • The study aimed to evaluate the effects of a dorsal-to-palmar branch neuroanastomosis in horses undergoing palmar digital neurectomy (PDN), a procedure meant to alleviate chronic foot pain and lameness.
  • The researchers examined the medical records of 85 horses who had undergone PDN with dorsal-to-palmar branch neuroanastomosis at two different hospitals between 2015 and 2020.
  • The nerves involved in the PDN were transected and end-to-end neuroanastomosis was performed via perineurium apposition to potentially prevent neuroma formation, a common postoperative complication.
  • The success of the procedure was measured based on the resolution of lameness for at least one year postoperatively.

Results

  • Post-surgery, lameness was no longer present in 95% of the horses. However, only 68% of these horses remained sound after one year.
  • Post-operative complications occurred in 22% of the surveyed cases.
  • The study faced limitations such as incomplete data set, inaccuracies due to owner recalls, and procedural variations.

Conclusions

  • The research found no significant reduction in the rate of neuroma formation with the use of end-to-end neuroanastomosis of the dorsal and palmar branches of the PDN.
  • The long-term outcomes of the technique were less favorable compared to those reported with traditional PDN techniques. Furthermore, it resulted in a higher recurrence of lameness one year postoperatively.
  • Thus, despite the initial successful resolution of lameness in the majority of horses, the procedure failed to deliver improved results in the long term, making its effectiveness questionable as a solution for chronic foot pain and lameness in horses.

Cite This Article

APA
Whisenant KD, Foucaud M, Mariën T, Levine D, Richardson DW, Stefanovski D, Scherrer NM, Engiles JB, Ortved K. (2024). Dorsal-to-palmar branch neuroanastomosis in horses undergoing palmar digital neurectomy does not reduce neuroma formation or improve outcome. Vet Surg, 53(4), 671-683. https://doi.org/10.1111/vsu.14075

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 53
Issue: 4
Pages: 671-683

Researcher Affiliations

Whisenant, Katrijn D
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Foucaud, Mathieu
  • EquiTom Equine Clinic, Lummen, Belgium.
Mariën, Tom
  • EquiTom Equine Clinic, Lummen, Belgium.
Levine, David
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Richardson, Dean W
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Stefanovski, Darko
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Scherrer, Nicole M
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Engiles, Julie B
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.
Ortved, Kyla
  • Department of Clinical Studies, University of Pennsylvania, New Bolton Center, Kennett Square, Pennsylvania, USA.

MeSH Terms

  • Animals
  • Horses
  • Horse Diseases / surgery
  • Retrospective Studies
  • Neuroma / veterinary
  • Neuroma / surgery
  • Lameness, Animal / surgery
  • Male
  • Female
  • Forelimb / surgery
  • Forelimb / innervation
  • Anastomosis, Surgical / veterinary
  • Anastomosis, Surgical / methods
  • Treatment Outcome
  • Foot Diseases / veterinary
  • Foot Diseases / surgery
  • Neurosurgical Procedures / veterinary
  • Neurosurgical Procedures / methods
  • Neurosurgical Procedures / adverse effects

References

This article includes 29 references
  1. Maher O, Davis DM, Drake C. Pull‐through technique for palmar digital neurectomy: forty‐one horses (1998‐2004). Vet Surg 2008;37(1):87‐93.
    doi: 10.1111/j.1532-950x.2007.00352.xgoogle scholar: lookup
  2. Jackman BR, Baxter GM, Doran RE, Allen D, Parks AH. Palmar digital neurectomy in horses 57 cases (1984‐1990). Vet Surg 1993;22(4):285‐288.
  3. Matthews S, Dart AJ, Dowling BA. Palmar digital neurectomy in 24 horses using the guillotine technique. Aust Vet J 2003;81(7):402‐405.
    doi: 10.1111/j.1751-0813.2003.tb11545.xgoogle scholar: lookup
  4. Gutierrez-Nibeyro SD, Werpy NM, White NA. Outcome of palmar/plantar digital neurectomy in horses with foot pain evaluated with magnetic resonance imaging: 50 cases (2005–2011). Equine Vet J 2015;47(2):160‐164.
    doi: 10.1111/evj.12262google scholar: lookup
  5. Dabareiner RM, White NA, Sullins KE. Comparison of current techniques for palmar digital neurectomy in horses. Proc Annu Conv AAEP 1997;43(January):231‐232.
  6. Cummings JF, Fubini SL, Todhunter RJ. Attempts to prevent equine post neurectomy neuroma formation through retrograde transport of two neurotoxins, doxorubicin and ricin. Equine Vet J 1988;20(6):451‐456.
    doi: 10.1111/j.2042-3306.1988.tb01573.xgoogle scholar: lookup
  7. Said AH, Khamis Y, Mahfouz MF, Hegazy A. Clinicopathological studies on neurectomy in equids. Equine Vet J 1984;16(5):442‐446.
    doi: 10.1111/j.2042-3306.1984.tb01972.xgoogle scholar: lookup
  8. Fubini SL, Cummings JF, Todhunter RJ. The use of intraneural doxorubicin in association with palmar digital neurectomy in 28 horses. Vet Surg 1988;17(6):346‐349.
    doi: 10.1111/j.1532-950x.1988.tb01030.xgoogle scholar: lookup
  9. Fürst AE, Lischer CJ. Foot. Equine Surgery 2019:1576‐1579.
  10. Turner AS, Trotter GW, Powers BE. Evaluation of tissue adhesive to contain axonal regeneration in horses. Vet Surg 1995;24(4):308‐314.
    doi: 10.1111/j.1532-950x.1995.tb01335.xgoogle scholar: lookup
  11. Bramlage LR, Gabel AA, Kuhn WE. Evaluation of stainless steel nerve caps for palmar digital neurectomy. Vet Surg 1982;11(9):1689‐1699.
    doi: 10.1017/cbo9781107415324.004google scholar: lookup
  12. Tate LP Jr, Evans LH. Cryoneurectomy in the horse. J Am Vet Med Assoc 1980;177(5):423‐426.
    doi: 10.1080/01425690701737481google scholar: lookup
  13. Schneider RK, Mayhew IG, Clarke GL. Effects of cryotherapy on the palmar and plantar digital nerves in the horse. Am J Vet Res 1985;46(1):7‐12.
    doi: 10.1080/01425690701737481google scholar: lookup
  14. Haugland LM, Collier MA, Panciera RJ, Bellamy J. The effect of CO2 laser neurectomy on neuroma formation and axonal regeneration. Vet Surg 1992;21(5):351‐354.
    doi: 10.1111/j.1532-950x.1992.tb01710.xgoogle scholar: lookup
  15. Martins RS, Siqueira MG, Heise CO, Yeng LT, de Andrade DC, Teixeira MJ. Interdigital direct neurorrhaphy for treatment of painful neuroma due to finger amputation. Acta Neurochir 2015;157(4):667‐671.
    doi: 10.1007/s00701-014-2288-1google scholar: lookup
  16. Vlot MA, Wilkens SC, Chen NC, Eberlin KR. Symptomatic neuroma following initial amputation for traumatic digital amputation. J Hand Surg Am 2018;43(1):86.e1‐86.e8.
    doi: 10.1016/j.jhsa.2017.08.021google scholar: lookup
  17. Maslow JI, LeMone A, Scarola GT, Loeffler BJ, Gaston RG. Digital nerve management and neuroma prevention in hand amputations. Hand 2022;18:838‐844.
    doi: 10.1177/15589447211065074google scholar: lookup
  18. Barbera J, Albert-Pamplo R. Centrocentral anastomosis of the proximal nerve stump in the treatment of painful amputation neuromas of major nerves. J Neurosurg 1993;79(3):331‐334.
    doi: 10.3171/jns.1993.79.3.0331google scholar: lookup
  19. Kester WO. Guide for Veterinary Service and Judging of Equestrian Events. 4th ed. American Association of Equine Practitioners; 1984.
  20. Lee SK, Wolfe SW. Peripheral nerve injury and repair. J Am Acad Orthop Surg 2000;8(4):243‐252.
    doi: 10.5435/00124635-200007000-00005google scholar: lookup
  21. Belcher HJCR, Pandya AN. Centro‐central union for the prevention of neuroma formation after finger amputation. J Hand Surg Am 2000;25 B(2):154‐159.
    doi: 10.1054/jhsb.2000.0372google scholar: lookup
  22. Wu R, Zhang C, Wang H. Clinical observation of end‐to‐end neuroanastomosis in the treatment of complete injury of the unilateral recurrent laryngeal nerve. Gland Surg 2020;9(6):2017‐2025.
    doi: 10.21037/gs-20-633google scholar: lookup
  23. Ducharme NG, Viel L, Partlow GD, Hulland TJ, Horney FD. Attempts to restore abduction of the paralyzed equine arytenoid cartilage III. Nerve anastomosis. Can J Vet Res 1989;53(2):216‐223.
  24. Lundborg G, Rosen B, Dahlin L, Danielsen N, Holmberg J. Tubular versus conventional repair of median and ulnar nerves in the human forearm: early results from a prospective, randomized, clinical study. J Hand Surg 1997;22(1):99‐106.
  25. Lidor G, Hall RL, Nunley JA. Centrocentral anastomosis with autologous nerve graft treatment of foot and ankle neuromas. Foot Ankle Int 1996;17(2):85‐88.
  26. Oliveira KM, Pindur L, Han Z, Bhavsar MB, Barker JH, Leppik L. Time course of traumatic neuroma development. PloS One 2018;13(7):e0200548.
  27. Mathis S, Magy L, Le Masson G. Value of nerve biopsy in the management of peripheral neuropathies. Expert Rev Neurother 2018;18(7):589‐602.
  28. Mueller M, Leonhard C, Wacker K. Macrophage response to peripheral nerve injury: the quantitative contribution of resident and hematogenous macrophages. Lab Invest 2003;83(2):175‐185.
  29. Chiu IM, Phatnani H, Kuligowski M. Activation of innate and humoral immunity in the peripheral nervous system of ALS transgenic mice. P Natl Acad Sci USA 2009;106(49):20960‐20965.
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