Neurectomy of the deep branch of the lateral plantar nerve can cause neurogenic atrophy of the muscle fibres in the proximal part of the suspensory ligament (M. interosseous III).
Authors: Pauwels F E, Schumacher J, Mayhew I G, Van Sickle D C
Journal: Equine veterinary journal
Summary
# Editorial Summary Neurectomy procedures targeting the deep branch of the lateral plantar nerve are sometimes used to manage chronic heel pain in horses, but their effects on the suspensory ligament's structural integrity remain poorly understood. Pauwels and colleagues performed unilateral neurectomy on a mature horse and examined both hind suspensory ligaments histologically six weeks post-operatively, measuring cross-sectional areas of the muscular (interosseous) component in a blinded comparison. The treated ligament demonstrated profound neurogenic atrophy of muscle fibres with significantly reduced cross-sectional area compared to the contralateral control, indicating that denervation of the deep plantar branch directly compromises the structural composition of the proximal suspensory ligament's muscular portion. This finding has important implications for farriers and veterinarians considering neurectomy in cases of chronic palmar foot pain: whilst the procedure may provide short-term analgesia, it appears to cause progressive degeneration of musculature critical to suspensory ligament function, potentially predisposing to long-term deterioration in limb stability and load-bearing capacity. Practitioners should weigh these documented structural consequences carefully against pain relief benefits when counselling clients on neurectomy as a management strategy for intractable heel conditions.
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Practical Takeaways
- •Lateral plantar nerve damage or neurectomy procedures may compromise suspensory ligament function through denervation-induced muscle atrophy, potentially affecting ligament support and load-bearing capacity
- •Clinicians should be aware that nerve injuries in the distal hindlimb can have consequences for proximal suspensory ligament integrity and function beyond the primary site of injury
- •Consider the anatomical relationship between plantar nerves and suspensory ligament muscles when evaluating or treating hindlimb lameness involving nerve pathology
Key Findings
- •Neurectomy of the deep branch of the lateral plantar nerve resulted in profound neurogenic atrophy of muscle fibres in the proximal suspensory ligament within 6 weeks
- •Clear difference in cross-sectional area of the muscular part of the suspensory ligament was measurable between the treated and control limbs
- •The interosseous III muscle (muscular portion of the proximal suspensory ligament) is innervated by the deep branch of the lateral plantar nerve