Lameness in horses is not only challenging to diagnose but also to resolve. Legs are complex systems of muscle, bone, tendons, and ligaments in which injury to one structure can create a domino effect. For instance, when the proximal (upper) suspensory ligament becomes damaged and inflamed—a condition called proximal suspensory desmitis—the surrounding fascia (connective tissue) can constrict the ligament and trigger pain in what is known as compressive compartment syndrome.

In these cases equine surgeons often perform a two-in-one surgery called deep branch lateral plantar neurectomy and fasciotomy (DBLPNF). It’s a mouthful to say, but the tactical cuts release pressure from the binding fascia and derail pain signals from the plantar nerve. Until now, however, researchers hadn’t documented the surgery’s success rate in getting Western performance horses back to work.

Dane Tatarniuk, DVM, Dipl. ACVS-LA, clinical assistant professor of veterinary clinical sciences at Iowa State University, in Ames, told colleagues at the 65th Annual American Association of Equine Practitioners Convention, held Dec. 7-11 in Denver, that a recent study of 21 cases from two clinics confirms that DBLPNF surgery is a good choice for hind-limb proximal suspensory desmitis. The study included Western pleasure, reining, cutting, working cow horse, barrel racing, steer wrestling, and team roping horses. In each case, veterinarians confirmed a diagnosis of hind-limb suspensory ligament desmitis using nerve blocks and ultrasound imaging. In 12 horses, both back legs were affected.

After surgery, 86% of the horses returned to athletic use, with nine performing at their previous level or higher, while nine returned to a lower level of work. Attending veterinarians considered eight horses completely sound in follow-up exams approximately six months post-surgery. In 10 cases, owners said their horses continued to receive therapeutic joint injections to help maintain performance