Navicular bone fracture and severe deep digital flexor tendinopathy after palmar digital neurectomy in two horses.

The study delves into potential complications in horses diagnosed with navicular syndrome, a condition that causes lameness. Specifically, it highlights two cases where horses developed fractures and severe tendinopathy after undergoing a salvage procedure named Palmar Digital Neurectomy (PDN). The research suggests using advanced imaging techniques before PDN to uncover any pathological conditions that may escalate post-procedure.

Introduction

• The study focuses on navicular syndrome, which is often responsible for lameness in a horse’s forelimb. The condition not only affects the navicular bone but also other navicular apparatus components like the DDF tendon, the impar ligament, the collateral sesamoidean ligaments, and the navicular bursa.
• For cases unresponsive to medical treatment, Palmar Digital Neurectomy (PDN) is commonly applied as a salvage procedure. However, like any surgical procedure, PDN also carries risks and can lead to debilitating complications.

The Cases

• The research outlines two specific cases where horses encountered navicular bone fractures and severe Deep Digital Flexor (DDF) tendinopathy 12 and 19 weeks after enrollment in bilateral forelimb PDN.
• In addition to these complications, distal interphalangeal joint subluxation/hyperextension was also observed.

Significance

• These case studies highlight the need for careful patient selection before performing PDN due to the high likelihood of soft tissue pathology. This can often be undiagnosed, in conjunction with visible indications of navicular syndrome.
• The authors recommend using advanced imaging techniques to identify potential soft tissue pathology associated with a horse’s navicular apparatus before conducting the PDN surgery.
• This preemptive diagnosis could prevent the escalation of the disease and avoid the potential catastrophic injury that might follow the PDN procedure.