INJECTION OF THE INSERTION OF THE COLLARAL LIGAMENT OF THE DISTAL INTERPHALANGEAL JOINT IN STANDING HORSES USING THE PALMAR RADIOGRAPHIC-GUIDED APPROACH.
Abstract: Injury to the collateral ligament (CL) of the distal interphalangeal joint (DIPJ) is recognized as a source of lameness in horses. Intralesional injection has been advocated to increase return to performance. This study was a proof-of-concept study in standing horses to evaluate success of a palmar radiographic-guided approach for injecting insertions of the DIPJ CLs previously described in cadaver limbs. Horses were sedated, nerve blocked, and placed on wooden blocks with the limb to be injected staggered approximately 20cm cranially to the other limb. The DIPJ CL insertion was injected, using the palmar radiographic-guided technique, with 0.5 ml of new methylene blue (NMB) dye using an 18g, 9cm spinal needle. The lateral or medial CL was randomly assigned to one forelimb for injection. Lateromedial and dorsopalmar radiographs were taken to confirm correct location of the needle. Following injection, needles were removed, and horses were euthanized. Two hours after euthanasia, the metacarpophalangeal joint was disarticulated, and the hoof wall was removed. The DIPJ, injected CL, and periligamentous structures (PLS) were assessed for presence of NMB dye. A total of 20 CLs, 10 medial and 10 lateral, were injected. Overall, 19/20 (95%) had dye in CL insertions; 4/20 (20%) had dye only in CL insertion, 6/20 (30%) had dye in CL insertion and DIPJ, and 9/20 (45%) had dye in CL insertion and PLS; 1/20 (5%) had dye only in PLS. A palmar radiographic-guided approach using a staggered stance is a reliable, repeatable way to inject DIPJ CL insertions in sedated horses.
Copyright © 2025. Published by Elsevier Inc.
Publication Date: 2025-05-07 PubMed ID: 40345405DOI: 10.1016/j.jevs.2025.105600Google Scholar: Lookup
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Summary
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The research article is about a study that examines the effectiveness of a technique, the palmar radiographic-guided approach, for injecting the region of injury in the collateral ligament of the distal interphalangeal joint in horses to alleviate lameness.
Objective and Methodology
- The study was conducted as a proof-of-concept to verify the effectiveness of a palmar radiographic-guided approach in injecting the collateral ligament (CL) of the distal interphalangeal joint (DIPJ). This technique had been previously described in cadaver limbs.
- Horses for the study were sedated, nerve-blocked, and positioned on wooden blocks with one limb staggered about 20 cm further forward than the other. This positioning facilitated the injection process.
- A new methylene blue (NMB) dye was injected into the DIPJ CL insertion using a specific needle. This dye was used to visually confirm the precise location of the injection.
- Random selection was used to decide whether the lateral or medial CL in one forelimb would be subjected to injection. Lateromedial and dorsopalmar radiographs were used to confirm the correct positioning of the needle.
- Horses were euthanized post the procedure and the DIPJ, injected CL, and periligamentous structures (PLS) were examined for the presence of NMB dye after two hours of euthanization.
Results and Conclusion
- Twenty collateral ligaments (10 medial and 10 lateral) were injected during the study.
- Of these, 19 out of 20 or 95% showed the presence of the dye in the CL insertions, validating the success of the injection. In detail, 4 out of 20 or 20% of the cases had dye only within the CL’s insertion. 6 out of 20 or 30% had dye in both the CL’s insertion and the DIPJ. Lastly, 9 out of the 20 or 45%, had dye in the CL’s insertion and PLS.
- Only one out of the 20 injections, accounting for 5%, had the dye only in the periligamentous structures which can be considered an unsuccessful injection as it was not found in the ligament’s insertion.
- From the results obtained, the study concludes that the palmar radiographic-guided approach is a reliable and repeatable method to inject DIPJ CL insertions in sedated horses. This procedure could help in reducing lameness associated with an injury to the DIPJ CL.
Cite This Article
APA
Kirkpatrick CJ, Ernst NS, Trumble TN.
(2025).
INJECTION OF THE INSERTION OF THE COLLARAL LIGAMENT OF THE DISTAL INTERPHALANGEAL JOINT IN STANDING HORSES USING THE PALMAR RADIOGRAPHIC-GUIDED APPROACH.
J Equine Vet Sci, 105600.
https://doi.org/10.1016/j.jevs.2025.105600 Publication
Researcher Affiliations
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, Minnesota, 55108, USA. Electronic address: jordan.kirkpatrick@wisc.edu.
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, Minnesota, 55108, USA.
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, 1365 Gortner Ave, Saint Paul, Minnesota, 55108, USA.
Conflict of Interest Statement
Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
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