Management of hindlimb proximal suspensory desmopathy by neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy: 155 horses (2003-2008).

This research investigates the long-term outcomes of treating proximal suspensory desmopathy (PSD), a horse lameness condition, with two surgical procedures: neurectomy and fasciotomy. The study found mixed success rates depending on the horse’s specific condition, and highlights importance of recognising risk factors for treatment failure.

Background of the Study

• The study addressed a condition called proximal suspensory desmopathy (PSD), a common cause of lameness in horses. The research aimed to study the long-term efficacy of two surgical interventions for PSD: neurectomy of the deep branch of the lateral plantar nerve and plantar fasciotomy.
• While these are accepted treatments for PSD, there have been limited studies analysing the long-term outcomes of such procedures.

Methodology

• The researchers assessed the condition of 155 horses that had undergone the treatments between 2003 and 2008.
• Success was determined by the horse being able to work fully for at least a year after surgery.
• The horses were placed into three groups based on the results of the clinical assessment and diagnostic analgesia.
• Group 1 had primary PSD with no other musculoskeletal problems. Group 2 included horses with primary PSD along with straight hock conformation and/or hyperextension of the metatarsophalangeal joint. Horses in Group 3 had PSD along with other defects causing lameness or poor performance.

Results

• In Group 1, 77.8% (70 out of 90) of treated horses had successful outcomes. The success rate was significantly lower in Group 3, where only 44.2% (23 out of 52) of the animals returned to full function for more than a year.
• All the horses in Group 2 remained lame despite the intervention. This indicated that co-existing issues such as straight hock conformation or hyperextension of the metatarsophalangeal joint contributed to poor results.
• The study also documented complications from the surgeries including damage to the suspensory ligament, seroma formation (collections of serous fluid), residual swellings that resembled “curbs”, and the growth of white hairs at the surgery site.

Conclusion

• The study results suggested that these surgical procedures do have a role in the long-term management of hindlimb PSD.
• It is vital to recognise risk factors like conformation features of straight hock or fetlock hyperextension, as these can lead to poor treatment outcomes.
• The researchers emphasise the need for further research and careful patient selection to improve the long-term success of these surgical interventions for PSD.