Superior Check Desmotomy May be Linked to Suspensory Ligament Desmitis

Superficial digital flexor (SDF) tendinitis is common in performance horses and is associated with prolonged loss of training time as well as early retirement from competition. 

Many treatments have been used to speed tendon healing and to reduce the chance of recurring injury once training resumes. Surgical transection of the accessory ligament of the SDF muscle (superior check desmotomy) has been advocated to help reduce the high recurrence rate of SDF tendinitis.

The goal of this procedure is to enhance the elasticity of the SDF muscle-tendon unit, thereby reducing stress on the healing tendon.

However, evidence exists that this procedure actually increases strain on the SDF, and may predispose horses to suspensory ligament injuries.

Researchers in Australia therefore evaluated SDF and suspensory ligament strain following superior check desmotomy in 10 equine cadaver forelimbs.

The procedure resulted in increased strain on both structures. Increased extension of the fetlock and carpal joints also occurred. 

The researchers reached the conclusion that the superior check ligament has an important role in maintaining normal joint angles and load distribution in the forelimb, and that superior check desmotomy might predispose horses to suspensory ligament desmitis.

— Alexander GR, Gibson KT, Day RE, Robertson ID.  Effects Of Superior Check Desmotomy On Flexor Tendon And Suspensory Ligament Strain In Equine Cadaver Limbs. Veterinary Surgery 2001; 30: 522-527.

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