Outcome following neurectomy of the deep branch lateral plantar nerve and plantar fasciotomy for hindlimb proximal suspensory desmopathy in western performance horses: 21 cases.
Authors: Tatarniuk Dane M, Hill Jacqueline A, Modesto Rolf B, Swor Tamara M, Caston Stephanie S, Kersh Kevin D
Journal: Veterinary surgery : VS
Summary
Proximal suspensory desmopathy (PSD) affecting the hindlimb's proximal suspensory ligament presents a significant clinical challenge in western performance horses, yet surgical options remain poorly documented in this population. This retrospective analysis examined 21 western performance horses (predominantly Quarter Horses) treated with deep branch lateral plantar neurectomy combined with plantar fasciotomy between 2009 and 2019, with follow-up conducted more than two years post-operatively through re-examination and owner interviews. Forty-three per cent of horses returned to similar or higher levels of performance, whilst 43 per cent resumed work at a reduced level; importantly, recovery to athletic function typically required a median of eight months, and owner satisfaction was high in 76 per cent of cases despite the lengthy rehabilitation period. Although three horses (14 per cent) failed to return to intended function, the procedure demonstrates sufficient success in restoring some degree of athletic capacity to warrant consideration as a surgical option when conservative management proves inadequate. Farriers and practitioners managing western performance horses with hindlimb PSD should counsel owners on realistic timelines and variable outcomes, whilst recognising that neurectomy/fasciotomy represents a viable alternative when prolonged rest and rehabilitation have not resolved lameness.
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Practical Takeaways
- •Deep branch lateral plantar neurectomy with fasciotomy is a viable surgical option for hind limb PSD in western performance horses, with most returning to some level of work
- •Plan for approximately 8 months recovery time before resuming athletic training post-operatively
- •Set realistic expectations with owners: while most horses improve, only about 43% return to their previous level of performance
Key Findings
- •21 western performance horses treated with deep branch lateral plantar neurectomy and plantar fasciotomy for hind limb PSD had median 8 months recovery before returning to training
- •43% of horses (9/21) returned to similar or higher athletic level, while 43% (9/21) returned to lower level of performance
- •14% of horses (3/21) could not return to intended function
- •High owner satisfaction achieved in 76% of cases (16/21)