Dorsal‐to‐palmar branch neuroanastomosis in horses undergoing palmar digital neurectomy does not reduce neuroma formation or improve outcome

Abstract

AbstractObjectiveChronic foot pain, a common cause of forelimb lameness, can be treated by palmar digital neurectomy (PDN). Complications include neuroma formation and lameness recurrence. In humans, neuroanastomoses are performed to prevent neuroma formation. The aim of the study was to evaluate the outcome of horses undergoing dorsal‐to‐palmar branch neuroanastomosis following PDN.Study designRetrospective case series.AnimalsEighty‐five horses with PDN and dorsal‐to‐palmar branch neuroanastomosis.MethodsMedical records for horses undergoing this procedure at two hospitals between 2015 and 2020 were reviewed. Palmar and dorsal nerve branches of the PDN were transected and end‐to‐end neuroanastomosis was performed by apposition of the perineurium. Follow‐up was obtained from medical records and telephone interviews. Success was defined as resolution of lameness for at least one year.ResultsLameness resolved following surgery in 81/85 (95%) horses with 57/84 (68%) sound at one year. Postoperative complications occurred in 19/85 (22%) cases. The main limitations of the study were an incomplete data set, inaccurate owner recall, and variations in procedure.ConclusionCompared to previous studies, this technique resulted in similar numbers of horses sound immediately after surgery, a comparable rate of postoperative neuroma formation but a higher recurrence of lameness rate at 1 year postoperatively.Clinical significanceEnd‐to‐end neuroanastomosis of the dorsal and palmar branches of the PDN does not reduce the rate of neuroma formation in horses. Long‐term outcome was less favorable compared to previously reported PDN techniques.