Digital Neurectomy Outcome in Horses with Chronic Foot Pain

Horses with concurrent deep digital flexor tendon lesions were four times more likely to become lame again post-surgery.
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Gutierrez-Nibeyro encouraged veterinarians to use MRI to screen horses before suggesting owners pursue a digital neurectomy. | Photo: Courtesy Dr. Santiago Gutierrez-Nibeyro

When it comes to managing horses that suffer from chronic foot pain—such as those with navicular disease or coffin bone fractures—sometimes conservative therapies just aren’t enough. In these cases veterinarians often opt to perform a palmar or plantar digital neurectomy (PDN), which involves surgically cutting the nerve in the low pastern area. However, some horses that undergo this procedure experience complications such as painful neuromas (an accumulation of fibrous scar tissue mixed with nerve tissue at the incision site) or residual lameness.

With this in mind, Santiago Gutierrez-Nibeyro, DVM, MS, Dipl. ACVS, an equine surgeon at the University of Illinois Veterinary Teaching Hospital, in Urbana, recently took a closer look at what might cause a poor outcome following a PDN. He presented his study results at the 2014 American Association of Equine Practitioners Convention, held Dec. 6-10 in Salt Lake City, Utah.

Gutierrez-Nibeyro said his goal was to evaluate PDN outcome based on lesions he identified using magnetic resonance imaging (MRI). He looked at the records of 50 horses treated at four equine clinics from 2005-2011 that had chronic foot lesions diagnosed via low-field MRI and subsequently underwent a PDN. He gathered their age, breed, sex, athletic use, lameness history and severity, response to analgesia of the digital nerves, radiograph and MRI findings, and surgical technique (of which there are three). He also noted any postoperative complications and determined whether the horse was currently sound and being used at its previously athletic level

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Alexandra Beckstett, a native of Houston, Texas, is a lifelong horse owner who has shown successfully on the national hunter/jumper circuit and dabbled in hunter breeding. After graduating from Duke University, she joined Blood-Horse Publications as assistant editor of its book division, Eclipse Press, before joining The Horse. She was the managing editor of The Horse for nearly 14 years and is now editorial director of EquiManagement and My New Horse, sister publications of The Horse.

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