Understanding & Treating Hindlimb Suspensory Ligament Injuries in Horses with Dr Jessica Kidd

Veterinary expert Dr. Jessica Kidd, who we were fortunate to have overseeing Hugo’s case, takes a deep dive into proximal suspensory desmitis (PSD) in this informative video. She breaks down why hindlimb PSD is more challenging to treat than forelimb cases, highlighting the anatomical constraints that make conservative treatment less effective. Dr Kidd discusses surgical options like plantar neurectomy and fasciotomy, explaining how they help relieve pain and pressure on the suspensory ligament. She also covers non-surgical approaches, post-operative care, and key factors that affect a horse’s recovery. Additionally, she emphasises the importance of varied activities to reduce injury risk and offers insights into the best time to start a horse’s training.

The discussion covers: Diagnosis: The process of diagnosing PSD, often involving nerve blocks and ultrasound, is explained. Anatomical Differences: The unique anatomy of the hindlimb, where the suspensory ligament is contained within a rigid structure, is detailed. This “box” can lead to compartmental syndrome and nerve compression when the ligament is injured.

Surgical Treatment: The common surgical approach of planter neurectomy (cutting nerves to alleviate pain) and fasciotomy (releasing pressure on the ligament) is explained. This surgery has a reasonable prognosis, with many horses returning to soundness.

Non-Surgical Treatment: Rest, controlled exercise, and other therapies are discussed, though their effectiveness can vary. Prognosis: Factors influencing the outcome, such as the presence of other orthopedic issues and the horse’s conformation, are considered.

Rehabilitation: The importance of careful post-operative care and a gradual return to exercise is emphasized.

Key Takeaways:

• Hindlimb PSD presents a greater treatment challenge than forelimb PSD due to anatomical differences leading to compartmental syndrome.
• Surgery (planter neurectomy and fasciotomy) is a common and often effective treatment option.
• The success of treatment depends on various factors, including the severity of the injury and the presence of other issues.