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Experience w/ neurectomy for hind leg high suspensory desmitis?

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  • Experience w/ neurectomy for hind leg high suspensory desmitis?

    Anyone have this done? Results? Issues? Have seen the 2009 finding on atrophy of the muscular portion of the ligament due to this procedure but wanted to hear your own success/failure stories. Feel free to PM rather than reply on the Board. Thanks in advance.

  • #2
    no experience with this -- can you explain why this is recommended? Is it a last resort? My horse had a fasciotomy, which was a very minor surgery to relieve pressure on the enlarged suspensory, as part of his treatment for bilateral high hind susp. desmitis. He has recovered very well.
    The big man -- my lost prince

    The little brother, now my main man

    Comment

    • Original Poster

      #3
      Asterix - My apologies, fasciotomy is exactly what the vet is suggesting. I had just seen it sometimes called "neurectomy" as well, and I just pulled that term instead.

      Comment


      • #4
        OH! well, in that case, yes, I DO have experience

        As soon as my horse came up lame I took him off to the clinic and got this diagnosed -- that is, he had not been unsound or treated for this at all beforehand, although the vets told me the bilateral tears he had commonly came on in a stealth way so it's hard to know how long it took -- they think they strain one, compensate on the other, strain that one, and it goes on until it causes lameness, all of a sudden. Apparently they see a lot of that.

        So they recommended that we start with the fasciotomy to give the injuries the best chance to heal correctly. I had the surgery done at DuPont in Leesburg VA by Nat White who has tremendous expertise with this.

        It's very noninvasive -- they do have to knock the horse out, but then they just insert a scalpel along the suspensory, causing tiny incisions. There are no stitches. He could have come home the same day but it was a terribly hot and humid day and I thought he'd be more comfy in the A/C hospital over night.
        They wrap them really well and want you to keep the wrap in place several days. Unfortunately my horse had some kind of heat-induced discomfort right after I brought him home and shredded his wraps, so I had to redo them earlier than optimal. This turned out fine and it enabled me to see that 24 hours after the procedure the incisions were almost impossible to find -- they are tiny.

        He had to be on strict stall rest and wrapped for 30 days. Then we started hand walking, then walking under saddle, monitored turnout, etc etc. We also did 3 rounds of shockwave at 1 month intervals.

        It worked very, very well for my horse. He was trotting sound within 3 months and never looked back. The ultrasounds showed very good healing and I have been told he can go back to his old job (prelim eventing); we aren't there yet in terms of fitness and training but that's more about time than soundness, certainly.

        I am very glad I did the surgery. It was not hard on him (other than the anesthesia which is always tough for them) and post op care was very simple and he clearly did not seem distressed or in pain fairly quickly. He healed well and I've heard so many stories about suspensories treated less aggressively that take forever to heal or don't really heal at all.

        I would just take care to make sure you go somewhere where they have experience with this surgery and know exactly what they are doing!
        Good luck!!!
        The big man -- my lost prince

        The little brother, now my main man

        Comment

        • Original Poster

          #5
          Asterix - Thank you! Very helpful.

          Comment


          • #6
            Originally posted by kypeep View Post
            Asterix - My apologies, fasciotomy is exactly what the vet is suggesting. I had just seen it sometimes called "neurectomy" as well, and I just pulled that term instead.

            Actually fasciotomy and neurectomy are two very different procedures. Fasciotomy is tendon/ligament splitting, and neurectomy is the removal of a piece of nerve. Some horses remain lame because the scar tissue of the healing ligament impinges on the nerve. So the neurectomy removes the small piece of nerve that is causing the lameness. It's a last ditch effort, but I've heard it works really well.
            http://www.MyVirtualEventingCoach.com

            Comment


            • #7
              Mr. Studly had a neurectomy when he had surgery to remove his splint (that was irritating the suspensory - high). I don't remember much about the specifics of the neurectony since removing the splint bone turned out to be a bigger deal than expected. Everything went well for him though, and he came sound quicker than I expected.
              Y'all ain't right!

              Comment


              • #8
                good results with fasciotomy

                as part of adressing a hind suspensory lesion ( I also did PRP), after a year of rehab, horse returned to competition in great form. You can NOT hurry the reconditioning, I followed my vet's advice to the letter & was very satisfied. I would not hesitate to recommend this procedure & know of several upper-level event horses that have had it done.

                Of course now we have other issues, but that's another story....

                Comment


                • #9
                  acute suspensory desmitis of the hind limb

                  My horse was recently diagnosed and bilateral surgery is scheduled with Dr. White. Your article was very inspiring and helpful to me. Thank you! Was your horse's nerve cut? or did he get the fasiotomy without the neurectomy. It can be done with or without. I hear the muscles atrophy if the nerves are cut. Not sure what to do. My horse shows 3rd level dressage and we school 4th level. I would like to return to this work and
                  forge ahead! Any knowledge or experience is very much appreciated.


                  Originally posted by asterix View Post
                  OH! well, in that case, yes, I DO have experience

                  As soon as my horse came up lame I took him off to the clinic and got this diagnosed -- that is, he had not been unsound or treated for this at all beforehand, although the vets told me the bilateral tears he had commonly came on in a stealth way so it's hard to know how long it took -- they think they strain one, compensate on the other, strain that one, and it goes on until it causes lameness, all of a sudden. Apparently they see a lot of that.

                  So they recommended that we start with the fasciotomy to give the injuries the best chance to heal correctly. I had the surgery done at DuPont in Leesburg VA by Nat White who has tremendous expertise with this.

                  It's very noninvasive -- they do have to knock the horse out, but then they just insert a scalpel along the suspensory, causing tiny incisions. There are no stitches. He could have come home the same day but it was a terribly hot and humid day and I thought he'd be more comfy in the A/C hospital over night.
                  They wrap them really well and want you to keep the wrap in place several days. Unfortunately my horse had some kind of heat-induced discomfort right after I brought him home and shredded his wraps, so I had to redo them earlier than optimal. This turned out fine and it enabled me to see that 24 hours after the procedure the incisions were almost impossible to find -- they are tiny.

                  He had to be on strict stall rest and wrapped for 30 days. Then we started hand walking, then walking under saddle, monitored turnout, etc etc. We also did 3 rounds of shockwave at 1 month intervals.

                  It worked very, very well for my horse. He was trotting sound within 3 months and never looked back. The ultrasounds showed very good healing and I have been told he can go back to his old job (prelim eventing); we aren't there yet in terms of fitness and training but that's more about time than soundness, certainly.

                  I am very glad I did the surgery. It was not hard on him (other than the anesthesia which is always tough for them) and post op care was very simple and he clearly did not seem distressed or in pain fairly quickly. He healed well and I've heard so many stories about suspensories treated less aggressively that take forever to heal or don't really heal at all.

                  I would just take care to make sure you go somewhere where they have experience with this surgery and know exactly what they are doing!
                  Good luck!!!

                  Comment


                  • #10
                    Topfit, he just got the fasciotomy, no nuerectomy.

                    He continues to do great. He got kicked in the field and that delayed his return to work, but he just finished his first event, sound and happy!
                    The big man -- my lost prince

                    The little brother, now my main man

                    Comment


                    • #11
                      My horse injured his left hind suspensory 1 year ago. It looked really bad on ultrasound, so he had a fasciotomy, bone marrow injection and neurectomy. He was doing okay, and 5 months after the surgery it looked great on ultrasound, and the left hind looked pretty good. Although he was a little off in the right front. Long story short, I didn't continue/finish his rehab because some other issues crept up that made me decide to turn him out for a year. (He wasn't 100%, but I think there are other things going on, not just the suspensory.) Sorry this doesn't help a whole lot, I know. I can tell you though that the before and after on the ultrasound was significant.

                      Comment

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