Surgical treatment of a second metacarpal bone exostosis with associated desmitis of the body of the suspensory ligament in a horse
Authors: Owen K. R., Hinnigan G. J., Smith C. E., Smith M.
Journal: Equine Veterinary Education
Summary
# Editorial Summary: Surgical Management of Second Metacarpal Exostosis with Concurrent Suspensory Ligament Involvement Second metacarpal bone exostoses commonly develop in performance horses but rarely warrant surgical intervention unless they compromise neighbouring soft tissue structures or cause persistent lameness—a scenario detailed in this case report where concurrent desmitis of the suspensory ligament body necessitated operative management. Using magnetic resonance imaging to characterise both the bony lesion and the extent of ligamentous pathology, the surgical team were able to precisely plan resection of the exostosis and address the associated soft tissue involvement. The case demonstrates successful outcomes following this combined approach, with MRI proving equally valuable post-operatively to monitor healing progression and inform rehabilitation timescales before return to athletic work. For practitioners managing horses with metacarpal exostoses and lameness of unclear aetiology, this report highlights the importance of advanced imaging in identifying concurrent suspensory ligament involvement, which may otherwise remain occult on conventional radiography. The surgical technique and post-operative protocol described offer a practical framework for cases where conservative management of exostosis-related desmitis has failed.
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Practical Takeaways
- •Use MRI to fully characterize concurrent bone and soft tissue pathology before surgery in metacarpal exostosis cases with ligament involvement
- •MRI follow-up imaging helps establish realistic timelines for rehabilitation and return to work after surgical treatment
- •Surgical management of exostosis with associated desmitis can be successful when properly planned with advanced imaging
Key Findings
- •MRI enabled precise identification of suspensory ligament pathology extent and optimal surgical resection site
- •Surgical treatment of metacarpal exostosis combined with suspensory ligament desmitis resulted in successful outcome
- •MRI provided valuable post-operative assessment of healing timeline to guide return to athletic work