Suspensory Ligament Branch Injuries
By Jonathan McLellan, BVMS (hons), MRCVS, Dipl. ACVSMR and Sarah Plevin, BVMS, MRCVS, CVA, Dipl. ABVP, ACVSMR

The suspensory ligament is a fibrous structure that runs from behind the knee or hock down the limb to insert on the sesamoid bones just above the fetlock joint. It consists of an origin at the top, a body in the middle, and, a little farther down, a bifurcation, where it splits into two structures: a medial (inner) and lateral (outer) suspensory branch. Each branch attaches to the related medial or lateral sesamoid bone. The ligament and its branches form an integral component of the suspensory apparatus, suspending the fetlock during maximum weightbearing when, without these structures, the joint would collapse to the ground.

Injury Significance & Prevalence

Thankfully, a suspensory branch injury itself is not typically catastrophic. However, inflammation in the area can cause pain that can result in potentially performance-limiting lameness. In some cases branch injury can also result in effusion (fluid accumulation) and arthritis in the fetlock joint. Even in horses that show no clinical signs of branch injury, veterinarians might detect one following flexion tests or ultrasound during a prepurchase examination, which can result in failure to sell or a reduced selling

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