RE: [RC] [RC] High suspensory injury - Susan E. Garlinghouse, D.V.M.
From:
ridecamp-owner@xxxxxxxxxxxxxxxxx [mailto:ridecamp-owner@xxxxxxxxxxxxxxxxx] On Behalf Of Kara Henry Sent: Tuesday, December 27, 2005
11:01 PM To: ridecamp@xxxxxxxxxxxxx Cc: Valerie Nicoson Subject: Re: [RC] [RC] High
suspensory injury
On the front leg, the suspensory
connects at the back of the knee, so a high suspensory injury is
typically very high up on the back of the cannon. One of the
vets on here can correct me if I'm wrong, but I'm pretty sure it's similar
for hind: connecting at the hock, so should be visible on
US.
Kara
No, you’re correct. The origin
of the suspensory is up behind the knee, travels downward underneath the
superficial and deep flexor tendons, and splits into two branches about 2/3 of
the way down the leg. The branches wrap around to the sides and insert
down around the top of the fetlock.
Usually, to be more precise when
ultrasounding, the leg is divided into nine regions 1A, 1B, 1C, 2A and so on,
starting at the top right at the accessory carpal bone (the bump behind the
knee) and ending where the suspensories start to branch to the sides (those are
also numbered); or some vets will make notes that a lesion is “x”
centimeters below the accessory carpal bone. So a “high”
suspensory could conceivably be anywhere up in the 1A-1C region, most likely.
A “regular” suspensory is more likely to be mid-region, although I
don’t know of any vets that wouldn’t more accurately locate the area
of lesion with measurements, etc., at least if an ultrasound scan had been
done. If one has not yet been done, then yeah---those little suckers can
fool you and the lesion can be hard to exactly pinpoint until you do the
diagnostics.
Hind leg, same thing, and any decent ultrasound
with a tendon probe will be able to visualize it. However, you have to be
careful about saying because one ligament healed well, they all will. A
suspensory injury can mean anything from straining a few fibers requiring a few
weeks off, to a complete and total rupture requiring surgery, a year or more
off, and extended physical therapy, and even then, no promises.
The UC Davis protocol is a good one for
returning a horse to work---several weeks of stall rest to let the injury set
up and let edema go down, followed by lots and lots and lots of handwalking to
let the fibers heal in correct alignment, and a very slowly increasing work
load. Returning to too much too quickly is just more likely to reinjure
the ligament and slow you down even more.
Getting a good ultrasound done by a vet
that likes working on lamenesses is a good start, just so you know exactly what
you’re working with.
