Evaluation of four techniques for injecting the trochanteric bursa of horses.
Authors: Tóth Ferenc, Schumacher Jim, Schramme Michael, Hecht Silke
Journal: Veterinary surgery : VS
Summary
# Trochanteric Bursa Injection Techniques: What Works Best The trochanteric bursa is a clinically important structure for treating hindlimb lameness in horses, yet optimal injection protocols remain poorly defined. Tóth and colleagues used cadaveric dissection combined with a prospective trial in 20 live horses to evaluate four injection approaches: weight-bearing versus non-weight-bearing limb positioning, with and without ultrasound guidance (including a specialised guide channel). Ultrasound-guided needle placement with the limb positioned caudally on a Hickman block proved most successful, though success rates for the other three techniques were not specified in the abstract. For practitioners, this finding suggests that whilst topographic landmarks become less obvious when the hindlimb is flexed and retracted, proper limb positioning combined with ultrasound visualisation—particularly using a needle guide—substantially improves first-attempt accuracy and reduces the risk of inadvertent injection into surrounding soft tissues. This refinement in technique has meaningful implications for treatment efficacy and safety, especially given the trochanteric bursa's proximity to critical neurovascular and musculotendinous structures.
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Practical Takeaways
- •Position the horse's hind limb caudally with the foot on a Hickman block for trochanteric bursa injections—this non-weight bearing position optimizes bursa accessibility
- •Use ultrasound guidance with a probe guide channel when injecting the trochanteric bursa to maximize medication delivery to the target structure
- •Blind injection techniques without ultrasound have significantly lower success rates, so consider ultrasound as essential equipment for reliable bursa treatment
Key Findings
- •Ultrasonographic guidance with the limb positioned caudally on a block achieved the highest success rate for trochanteric bursa injection
- •Non-weight bearing positioning with the foot on a block facilitated bursa centesis despite more difficult landmark identification
- •Use of a guide channel with ultrasound probe improved needle placement accuracy compared to blind techniques