Dorsal-to-palmar branch neuroanastomosis in horses undergoing palmar digital neurectomy does not reduce neuroma formation or improve outcome.

Authors: Whisenant Katrijn D, Foucaud Mathieu, Mariën Tom, Levine David, Richardson Dean W, Stefanovski Darko, Scherrer Nicole M, Engiles Julie B, Ortved Kyla

Journal: Veterinary surgery : VS

DOI: 10.1111/vsu.14075 PubMed: 38361406Log in to save

Summary

# Editorial Summary: Dorsal-to-Palmar Branch Neuroanastomosis in Equine Palmar Digital Neurectomy Palmar digital neurectomy (PDN) remains a valuable surgical option for managing chronic foot pain-related forelimb lameness in horses, yet neuroma formation and subsequent lameness recurrence represent ongoing clinical challenges. Researchers compared outcomes in horses undergoing standard PDN against those receiving an additional dorsal-to-palmar branch neuroanastomosis procedure—a technique borrowed from human surgery that theoretically prevents neuroma formation by creating alternative neural pathways. Histopathological examination and clinical follow-up revealed no significant difference in neuroma formation between the two groups, nor did the anastomosis procedure improve lameness outcome or reduce complication rates. These findings suggest that whilst neuroanastomosis shows promise in human medicine, current surgical techniques have not successfully translated this benefit to equine patients, and practitioners should continue to rely on established PDN protocols rather than adopting this additional procedural step. Further investigation into alternative neuroma prevention strategies or refined anastomotic techniques may be warranted to improve long-term outcomes for horses requiring digital neurectomy.

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Practical Takeaways

•Dorsal-to-palmar neuroanastomosis should not be routinely performed as a complication-prevention measure during PDN, as it does not reduce neuroma formation or improve outcomes
•Standard palmar digital neurectomy remains the appropriate technique; surgeons should focus on surgical technique refinement rather than adding anastomosis procedures
•Clients should be counseled that neuroma formation risk persists with PDN regardless of neuroanastomosis, and long-term follow-up remains necessary

Key Findings

•Dorsal-to-palmar branch neuroanastomosis did not reduce neuroma formation following palmar digital neurectomy
•Neuroanastomosis did not improve clinical outcome compared to standard PDN
•Neuroma formation remains a significant complication despite surgical nerve reconnection techniques

Conditions Studied

chronic foot painforelimb lamenessneuroma formation post-neurectomy

Related References

Outcome of palmar/plantar digital neurectomy in horses with foot pain evaluated with magnetic resonance imaging: 50 cases (2005-2011).

Gutierrez-Nibeyro, Werpy, White, Mitchell, Edwards, Mitchell, Gold, Allen(2015)Equine veterinary journal

Farriery

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