Palmar Digital Neurectomy in Horses 57 Cases (1984–1990)

Abstract

The medical records of 57 horses that had palmar digital neurectomy performed between 1984 and 1990 were reviewed. Neurectomies were performed either by transection and electrocoagulation (47 horses) or by the guillotine technique (10 horses). Middle-aged geldings, Quarter Horses, and Thoroughbreds were significantly over-represented when compared with the hospital population. Horses used as hunter/jumpers also appeared to be over-represented. Complications occurred in 17 (34%) of the 50 horses for which follow-up information was obtained. Recurrence of heel pain was the most common complication (14 horses). Palpable painful neuromas were detected in three horses. One year after neurectomy, 74% of the horses were sound; this decreased to 63% after 2 years.

Palmar digital neurectomy in 24 horses using the guillotine technique

“…[2][3][4] This is consistent with the results of the current study, in which 21 horses radiographed at the University Veterinary Centre had changes associated with the navicular bone and lameness completely resolved in 18. Palmar digital neurectomy has also been used in horses with distal phalangeal fractures, navicular bone fractures and calcification of the collateral ligaments.…”

“…One study compared the guillotine method (10 horses) with an electrocoagulation technique (47 horses) and reported an incidence of painful neuroma of 0% and 6% respectively. 4 There were no painful neuromas in the current study, lending further support to the guillotine method of neurectomy as the preferred technique.…”

“…4,6 The period of confinement of horses in the current study was similar to, or longer than previously reported, to minimise movement at the surgical site while the inflammatory reaction subsided. 4,6 Another common complication after neurectomy is re-innervation due to regeneration of the palmar digital nerves. 2,4,17 Clinical studies have shown that removal of a 2 to 4cm section of nerve decreases the likelihood of successful re-innervation and increases the time before this occurs.…”

Diseases of the foot

“…14.19). 62 In a follow-up study of neurectomy, 74% of horses were sound one year after surgery with 63% sound two years after the procedure. However, as discussed earlier in this chapter, none of the diagnostic anesthesia procedures employed results in specific desensitization to be sound than horses that were lame longer than 18 months.…”

“…13 It is clear that the diagnosis of navicular disease and palmar heel pain is facilitated by noting the response to diagnostic analgesia. 62 Prognosis Shoeing alone is a very effective method to treat heel pain and navicular syndrome. 60 A technique for transaction of the CSL immediately proximal to the navicular bone has been reported.…”