Peer-reviewed veterinary case report
Navicular bone fracture and severe deep digital flexor tendinopathy after palmar digital neurectomy in two horses.
- Journal:
- Open veterinary journal
- Year:
- 2023
- Authors:
- Larsen, Elizabeth A et al.
- Affiliation:
- Large Animal Clinical Sciences Department · United States
- Species:
- horse
Plain-English summary
This report discusses two horses that developed serious problems after a surgery called palmar digital neurectomy (PDN), which is often done to help horses with navicular syndrome, a common cause of front leg lameness. Both horses suffered fractures in the navicular bone and severe issues with a tendon called the deep digital flexor (DDF) after having the surgery, with the problems appearing 12 and 19 weeks later. The authors emphasize that it's crucial to carefully choose which horses are suitable for this surgery, as many may have other hidden issues that could worsen after the procedure. They recommend using advanced imaging techniques to check for these problems before deciding on PDN to prevent further injury. The outcome for these two horses was not favorable, as they experienced significant complications following the surgery.
Abstract
BACKGROUND: Navicular syndrome is a common cause of forelimb lameness in horses. Beyond changes to the navicular bone itself, horses with a clinical diagnosis of navicular syndrome often have pathology associated with other components of the navicular apparatus, including the navicular bursa, deep digital flexor (DDF) tendon, collateral sesamoidean ligaments, and impar ligament. Palmar digital neurectomy (PDN) is often used as a salvage procedure for horses diagnosed with navicular syndrome that become unresponsive to medical management. There are many potential complications associated with PDN, some of which are debilitating. CASE DESCRIPTION: This report describes two cases of navicular bone fracture with severe DDF tendinopathy and distal interphalangeal joint subluxation/hyperextension that occurred 12 and 19 weeks after bilateral forelimb PDN. CONCLUSION: These two cases highlight the importance of proper patient selection before PDN due to the high incidence of undiagnosed soft tissue pathology in conjunction with radiographic evidence of navicular syndrome. Advanced imaging of the digit is recommended to identify and characterize any soft tissue pathology associated with the navicular apparatus before pursuing PDN to avoid disease progression and catastrophic injury.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/38292704/