Compressive damage to the deep branch of the lateral plantar nerve associated with lameness caused by proximal suspensory desmitis.

Authors: Tóth Ferenc, Schumacher Jim, Schramme Michael, Holder Troy, Adair H Steve, Donnell Robert L

Journal: Veterinary surgery : VS

DOI: 10.1111/j.1532-950X.2008.00385.x PubMed: 18564256Log in to save

Summary

# Editorial Summary: Nerve Compression in Proximal Suspensory Desmitis Proximal suspensory desmitis (PSD) in the hind limb can be complicated by compressive damage to the deep branch of the lateral plantar nerve (DBLPN), a complication that may not be immediately obvious during routine lameness investigation. This retrospective case series examined 16 horses treated surgically for PSD-related lameness, with histological analysis of 30 excised nerve segments revealing chronic compression changes in 26 of them—including evidence of compression in apparently sound limbs of bilaterally affected horses. Following DBLPN excision, 62.5% of horses (10 of 16) returned to full soundness at follow-up of six months or longer. The practical implication is significant: horses that fail to recover from PSD despite resolution of the desmitis itself may benefit from consideration of DBLPN involvement, particularly when neurological signs are present or lameness persists beyond expected healing timescales. This finding expands the differential diagnosis for persistent hind-limb lameness and suggests that selective denervation may be a valuable option when conventional PSD management plateaus.

Read the full abstract on PubMed

Practical Takeaways

•Horses that remain lame after proximal suspensory desmitis treatment may have secondary nerve compression—consider deep branch lateral plantar nerve involvement in persistent cases
•Deep branch lateral plantar nerve compression can occur bilaterally even when clinical lameness is unilateral, suggesting screening both limbs may be warranted
•Nerve excision is a viable treatment option for horses with PSD-associated lameness, achieving soundness in approximately 63% of cases

Key Findings

•Histologic changes consistent with chronic nerve compression were found in 11 bilaterally lame horses and 5 unilaterally lame horses with proximal suspensory desmitis
•Two of three unilaterally lame horses showed bilateral nerve compression despite only one limb being clinically lame
•Excision of the deep branch of the lateral plantar nerve resolved lameness in 10 of 16 horses (62.5%) with follow-up information

Conditions Studied

proximal suspensory desmitislameness of pelvic limbsdeep branch lateral plantar nerve compression

Related References

Excision of the deep branch of the lateral palmar nerve of horses to resolve lameness caused by proximal suspensory desmitis.

Guasco Paolo Gay, Kelly Ger, Schumacher James, Henry Robert W(2013)Veterinary surgery : VS

Histological changes in the proximal suspensory ligament after neurectomy of the deep branch of the lateral palmar nerve of horses with induced proximal suspensory desmitis.

Lopez-Navarro Gabriela, Trigo-Tavera Francisco J, Rodriguez-Monterde Alejandro, Gutierrez-Ospina Gabriel, Arechavaleta-Velasco Miguel, Schumacher John, Schumacher James(2017)Veterinary journal (London, England : 1997)

Outcome following neurectomy of the deep branch lateral plantar nerve and plantar fasciotomy for hindlimb proximal suspensory desmopathy in western performance horses: 21 cases.

Tatarniuk Dane M, Hill Jacqueline A, Modesto Rolf B, Swor Tamara M, Caston Stephanie S, Kersh Kevin D(2021)Veterinary surgery : VS

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

Dyson S, Murray R(2012)Equine veterinary journal

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

Scharf Alexandra, de Solis Cristobal Navas, Sampson Sarah N, Glass Kati, Watts Ashlee E(2022)Veterinary surgery : VS