Excision of the Deep Branch of the Lateral Palmar Nerve of Horses to Resolve Lameness Caused by Proximal Suspensory Desmitis

Objective To assess outcome after neurectomy of the deep branch of the lateral palmar nerve (DBLPaN) as a treatment for horses with persistent lameness associated with chronic proximal suspensory desmitis (PSD) of the thoracic limb. Study Design Case series. Animals Adult, mixed-breed horses (n = 4), weighing 510–585 kg, used for amateur show-jumping. Methods Records of 4 horses chronically lame because of PSD of one or both thoracic limbs that were treated by neurectomy of the DBLPaN were reviewed. The site of pain causing lameness was localized using regional anesthesia. The proximal aspect of the suspensory ligament of the affected limb(s) of all horses were enlarged on ultrasonographic examination, but fiber disruption was not observed. All horses remained lame after conservative therapy. Neurectomy was performed with the horses anesthetized and positioned in dorsal recumbency. Results All 4 horses were sound at 6 weeks and remained sound for at least 12 months after neurectomy. Conclusion Lameness in horses caused by chronic PSD can be resolved by neurectomy of the DBLPaN in horses that are refractory to conservative management.