Ex vivo evaluation of a percutaneous thread-transecting technique for desmotomy of normal palmar/plantar annular ligaments in horses

Authors

Diego De Gasperi, Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.
Danqing Guo, Advocate Aurora Health
Danzhu Guo, Advocate Aurora Health
Yan Lu, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, USA.
Sabrina H. Brounts, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin, Madison, Wisconsin, USA.

Recommended Citation

De Gasperi D, Guo D, Guo D, Lu Y, Brounts SH. Ex vivo evaluation of a percutaneous thread-transecting technique for desmotomy of normal palmar/plantar annular ligaments in horses. Vet Surg. 2023;52(3):388-394. doi:10.1111/vsu.13932

Affiliations

BayCare Clinic, Green Bay

Abstract

Objective: To develop and describe a minimally invasive, ultrasound-guided, percutaneous technique for the desmotomy of equine palmar/plantar annular ligaments (PALs) using a transecting thread.

Study design: Ex vivo study.

Sample population: Twenty-one normal equine distal limb specimens.

Methods: Under ultrasonographic guidance, a surgical thread was percutaneously placed around the PAL through 2 skin punctures (proximal and distal) using a 18 gauge spinal needle in equine limbs (11 forelimbs, 10 hindlimbs) with normal PALs. The ligament was transected by a back-and-forth motion of the thread until the loop emerged from the proximal skin puncture site. Each specimen was dissected and assessed for completeness of transection and iatrogenic damage under direct visualization. Descriptive statistics were reported.

Results: The PAL was completely transected in 17/21 limbs. The mean duration of the procedure was 16 minutes. Superficial needle puncture or subtle abrasion of the superficial digital flexor tendon was noticed in 4 limbs. No iatrogenic injury to other intrathecal structures was identified. After PAL division, the needle entry and exit points had a mean diameter of 1.2 and 1 mm, respectively.

Conclusion: Desmotomy of normal PALs in equine limb specimens was performed effectively using the percutaneous thread-transecting technique with minimal iatrogenic damage to adjacent structures.

Clinical significance: Information from this study will allow refinement of the technique for use in equine clinical cases either in standing or anesthetized horses.

Document Type

Article

PubMed ID

36625237