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In Vitro Evaluation of a Single Injection Technique for Diagnostic Analgesia of the Proximal Suspensory Ligament of the Equine Pelvic Limb
Author(s) -
HUGHES THOMAS K.,
ELIASHAR EHUD,
SMITH ROGER K.
Publication year - 2007
Publication title -
veterinary surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.652
H-Index - 79
eISSN - 1532-950X
pISSN - 0161-3499
DOI - 10.1111/j.1532-950x.2007.00333.x
Subject(s) - medicine , suspensory ligament , cadaveric spasm , anatomy , cadaver , tarsometatarsal joints , metatarsal bones , surgery , radiography
Objective— To examine the anatomic relationship of the deep branch of the lateral plantar nerve (DBLPN) with structures of the proximal metatarsal region, and to define the anatomic location of a solution injected using a single injection technique for diagnostic analgesia of the proximal suspensory ligament (PSL). Study Design— Descriptive study. Animals— Cadaveric equine pelvic limbs (n=29). Methods— The proximal metatarsal region of both pelvic limbs (n=5 horses, 10 limbs) was dissected and measurements were made of anatomic structures relative to the head of the 4th metatarsal bone (HMT4). A single injection technique was used to inject dye 15 mm distal to the HMT4, axial to the MT4 at a depth of 25 mm in each limb from 10 equine cadavers (19 limbs). Hindlimbs were dissected and the position of the dye was recorded. Results— DBLPN branched from the lateral plantar nerve (LPN) at a mean distance of 30 mm proximal to the HMT4 and entered the PSL at a mean distance of 17 mm distal to the HMT4. A 2nd DBLPN was observed in 1 of 10 dissected limbs. Blue dye surrounded the DBLPN in 18 limbs (95%). Conclusions— A single injection technique was likely to have resulted in desensitization of the DBLPN in 18 of 19 limbs (95%). Clinical Relevance— This technique provides a reliable method using a single needle puncture for perineural analgesia of the DBLPN for diagnosis of proximal suspensory desmitis of the pelvic limb with a minimal risk of inadvertently desensitizing structures within the tarsal sheath and the tarsometatarsal joint.