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Veterinary surgery : VS2021; 51(2); 259-269; doi: 10.1111/vsu.13757

Suspensory ligament size does not change after plantar fasciotomy and neurectomy of the deep branch of the lateral plantar nerve by ultrasonographic assessment.

Abstract: To determine the short-term effect of plantar fasciotomy and neurectomy (PFN) of the deep branch of the lateral plantar nerve on the proximal suspensory ligament (PSL) cross-sectional area (CSA) in horses with hindlimb proximal suspensory desmopathy (PSD). Methods: Analytical, observational, cohort study. Methods: Twenty-one horses. Methods: Records of horses with chronic PSD treated by PFN were included if a preoperative ultrasonographic examination was available and at least one postoperative ultrasonographic examination. One masked observer measured the ultrasonographic cross-sectional area (CSA) of the PSL. Intraobserver reliability was determined by repeatedly measuring a subset of ultrasonographic images (n = 127). Two masked observers measured the cross-sectional area of the proximal suspensory ligament (PSL-CSA) on preoperative proton density (PD)-weighted transverse high field magnetic resonance images (n = 19 horses) . Agreements for PSL-CSA between preoperative ultrasonographic and MRI measures and between the two magnetic resonance imaging (MRI) observers were assessed. Follow up considered the horses' ability to return to exercise and their owners' satisfaction. Results: The reliability of the ultrasonographic measurement of the PSL-CSA was excellent. Agreement between ultrasonographic assessment and MRI assessment of PSL-CSA was good. No difference was detected between preoperative (median, interquartile range; oblique-incidence, 2.07, 1.72-2.55; on-incidence, 2.23, 1.98-2.65) and postoperative (oblique-incidence, 2.08, 1.80-2.74; on-incidence, 2.28, 2.01-2.74) PSL-CSAs. At a median of 12 months (4-33 months), 16/20 (80%) owners reported the horse was "better" and 15/20 (75%) functioned at or above preoperative levels. Conclusions: Ultrasonographic measurement of the PSL-CSA was reproducible and in good agreement with MRI measurement. The PSL-CSA was not influenced by PFN. Conclusions: The PSL-CSA cannot be used to guide return to function.
© 2021 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2021-12-31 PubMed ID: 34970755PubMed Central: PMC9306907DOI: 10.1111/vsu.13757Google Scholar: Lookup
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Summary

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The research investigates the effect of plantar fasciotomy and neurectomy on the size of the suspensory ligament in horses suffering from hindlimb proximal suspensory desmopathy, finding that this procedure does not change the ligament’s size. The assessment was carried out by ultrasound and MRI, the results of which were found to be in strong agreement, but showed no influence on the ligament’s size from the surgical intervention.

Study Design and Methodology

  • The study is an analytical, observational, and cohort type, centered around 21 horses with chronic proximal suspensory desmopathy treated by plantar fasciotomy and neurectomy.
  • Horses with available preoperative ultrasound examinations and at least one postoperative exam were included in the study.
  • A single observer, masked to the condition of the horses, conducted measurements of the proximal suspensory ligament’s cross-sectional area using ultrasound. This observer’s reliability was tested by repeating measures on a set of ultrasound images.
  • In addition, two masked observers performed measurements of the ligament using preoperative proton-density-weighted transverse high field magnetic resonance imaging.
  • The study then calculated agreements of results between ultrasound and MRI measures, and also among the two MRI observers.
  • A follow-up on the recovering horses evaluated their capacity to resume exercise and gauged owners’ satisfaction levels.

Findings and Conclusion

  • Results showed that the ultrasound measurement of the proximal suspensory ligament’s cross-sectional area was highly reliable and had good conformity with MRI measures.
  • No significant changes were discovered in the ligament’s size pre and post the surgery.
  • After a median period of 12 months, 80% of horse owners reported an improvement in their horse’s condition, with 75% noting their horses performing at, or surpassing preoperative levels.
  • The study concluded that the ultrasound measurement of the suspensory ligament’s cross-sectional area can be reliably reproduced and corresponds well with MRI measurements.
  • Notwithstanding, the size of the suspensory ligament, gauged via ultrasound, was not affected by the plantar fasciotomy and neurectomy procedure, suggesting that the cross-sectional area of the ligament cannot be used as a reference for recovery or return to function.

Cite This Article

APA
Scharf A, de Solis CN, Sampson SN, Glass K, Watts AE. (2021). Suspensory ligament size does not change after plantar fasciotomy and neurectomy of the deep branch of the lateral plantar nerve by ultrasonographic assessment. Vet Surg, 51(2), 259-269. https://doi.org/10.1111/vsu.13757

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 51
Issue: 2
Pages: 259-269

Researcher Affiliations

Scharf, Alexandra
  • Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA.
de Solis, Cristobal Navas
  • Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA.
Sampson, Sarah N
  • Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA.
Glass, Kati
  • Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA.
Watts, Ashlee E
  • Department of Large Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA.

MeSH Terms

  • Animals
  • Cohort Studies
  • Denervation / veterinary
  • Fasciotomy / veterinary
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / surgery
  • Horses
  • Ligaments / diagnostic imaging
  • Ligaments / surgery
  • Reproducibility of Results

Conflict of Interest Statement

The authors declare no conflicts of interest related to this report.

References

This article includes 20 references
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Citations

This article has been cited 2 times.
  1. Guest DJ, Birch HL, Thorpe CT. A review of the equine suspensory ligament: Injury prone yet understudied. Equine Vet J 2025 Sep;57(5):1167-1182.
    doi: 10.1111/evj.14447pubmed: 39604165google scholar: lookup
  2. van Veggel ECS, Vanderperren K, Selberg KT, Bergman HJ, Hoogelander B. The Evolution of Lesions on Follow-Up Magnetic Resonance Imaging of the Proximal Metacarpal Region in Non-Racing Sport Horses That Returned to Work (2015-2023). Animals (Basel) 2024 Jun 8;14(12).
    doi: 10.3390/ani14121731pubmed: 38929351google scholar: lookup
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