Work

Macroscopic comparison of open Metzenbaum and ultrasound‐guided fasciotomy techniques for surgical treatment of the hindlimb proximal suspensory ligament desmopathy in horses: A cadaveric anatomical study

Year: 2026

Type: article

Abstract: OBJECTIVE: To macroscopically characterize and compare the open Metzenbaum (FOM) and ultrasound-guided (FUG) plantar fasciotomy techniques for decompression of the hindlimb proximal suspensory ligament (PSL), and to determine whether either approach induces intraligamentous splitting (ILS). STUDY DESIGN: Cadaveric experimental study. SAMPLE POPULATION: Paired hindlimbs from 10 adult horses with no history of hindlimb lameness. METHODS: Each horse contributed one limb to FOM and the contralateral to FUG. All procedures were performed by a single surgeon, and incision measurements were obtained by a blinded examiner. Skin, fascia, and ILS lengths were recorded after dissection. Integrity of the deep branch of the lateral plantar nerve (DBLPN) was evaluated macroscopically. Paired t-tests compared FOM and FUG values (p < .05). RESULTS: Both techniques induced PSL ILS. Mean ± SD incision lengths (cm) for FOM versus FUG were: skin 5.02 ± 0.41 versus 1.28 ± 0.18; fascia 5.54 ± 0.44 versus 4.39 ± 0.22; and ILS 5.33 ± 0.42 versus 4.37 ± 0.24. The FUG technique produced 74% shorter skin, 21% shorter fasciotomy, and 18% shorter ILS incisions compared to FOM (all p < .0001). No macroscopic evidence of DBLPN injury was observed. CONCLUSION: Both FOM and FUG plantar fasciotomy techniques produced ILS while achieving PSL decompression. FUG required smaller incisions, confirming comparable anatomical efficacy with reduced invasiveness. CLINICAL RELEVANCE: Intraligamentous splitting appears unavoidable during plantar fasciotomy, but the FUG technique limits its extent and associated soft-tissue disruption, supporting its use as a safer, less invasive alternative in clinical cases of chronic PSL desmopathy.

Source: Veterinary Surgery

DOI: 10.1111/vsu.70102

Authors: Grigorios Maleas, Kristyna Hargitaiova

Institution: Cornell University

Language: English

Topic: Veterinary Equine Medical Research

Subfield: Equine

Field: Veterinary

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $3,000