Revision Surgery for Neurectomy of the Deep Branch of the Lateral Plantar Nerve: A Case Report of Four Horses

Case Reports: Cases 1 and 2 had recurrence of lameness after previous deep branch of the lateral plantar nerve (DBLPN) neurectomy (2 and 6 years), which blocked to the DBLPN. There were no localising clinical signs of pain on palpation. Revision surgery found neuroma-like swellings at the neurectomy sites, with no visual or histological evidence of re-growth of the nerve. The nerve endings were resected, and lameness resolved in both horses. Case 3 had been recently purchased, developed lameness and was diagnosed with hindlimb proximal suspensory desmitis (PSD). At surgery there were previous surgical scars already present, but the DBLPN was intact on both limbs. There was swelling of the lateral plantar nerve distal to the bifurcation, consistent with neurectomy of this structure. DBLPN neurectomy and removal of the neuroma-like swellings was performed, and the lameness resolved post-operatively. Case 4 had been diagnosed with right hindlimb PSD and surgery undertaken at a different clinic 1 year previously. There was persistence of lameness, which still blocked to the DBLPN. Revision surgery showed the previous incision to be positioned too distally, and the deep branch was identified as normal, and was removed in standard fashion. The horse made good progress, with a resolution of the hindlimb lameness. These are the two different ways of failure of neurectomy of the DBLPN; one with axonal swelling or possible re-innervation; one with a technical failure to remove the correct nerve branch. Although these complications are rare, they appear to respond well to revision surgery.

Proprietary/Conflict of Interest: There was no proprietary interest or funding provided for this project.

Publication History

Article published online:
26 October 2022