Page 333 - The Veterinary Care of the Horse
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early stages if the injury is acutely painful
• with acute injuries local injection of corticosteroid may be used initially to try to reduce
VetBooks.ir • the swelling
correction of any foot imbalance
• possible use of egg bar shoes to limit extension of the fetlock
• a course of extracorporeal shock wave therapy
• a programme of controlled exercise to strengthen the ligament and help align the fibres
during the healing process
If the lameness persists, further options include:
• fasciotomy (surgical release) of the deep fascia in the region, which allows the damaged
ligament to swell and releases the pressure on the ligament and local nerves
• neurectomy (cutting) of the tibial nerve or deep branch of the lateral plantar nerves is
often combined with the above
• the ligament may be injected with stem cells or platelet-rich plasma (PRP) to help tissue
repair and healing
• medication of the distal hock joints sometimes resolves mild residual lameness following
the surgery
PROGNOSIS
The prognosis for proximal suspensory ligament injuries of the hind limb is more guarded
than similar forelimb injuries especially if there are radiographic changes or the horse has
been lame for more than 3 months. However, with early diagnosis and a combination of
surgery and a programme of controlled exercise, up to 75% of horses can successfully return
to their former level of work. Horses with an upright hind limb conformation and hyper-
extended (dropped) fetlocks are not good candidates for surgery.
Desmitis of the body of the suspensory ligament
The body of the suspensory ligament is the middle part that lies from 10–12 cm (4–5 in)
below the knee or hock to approximately halfway down the cannon bone where it divides
into medial and lateral branches. Injuries of this type are common in horses that jump fences
at speed.
Inflammation of the suspensory ligament in this region may be associated with splint
bone injuries. The new bone formed can impinge on the suspensory ligament.
