Epidemiological Investigation of the Aid of Magnetic Resonance Imaging in Determining Long-Term Prognosis for Soundness Following Palmar/Plantar Digital Neurectomy for Chronic Foot Pain

• Published in: Equine veterinary journal Vol. 47; pp. 15 - 16
• Format: Journal Article
• Language: English
• Published: British Equine Veterinary Association 01.09.2015
• ISSN: 0425-1644; 2042-3306
• DOI: 10.1111/evj.12486_35

REASONS FOR PERFORMING STUDY: Accurate diagnosis of chronic foot pain by magnetic resonance imaging (MRI) allows appropriate case selection for palmar/plantar digital neurectomy (PDN). OBJECTIVES: To report follow‐up for chronic foot pain treated by PDN, with and without MRI diagnosis. STUDY DESIGN: Retrospective cohort study. METHODS: The electronic patient records of all animals that underwent PDN were reviewed. Follow‐up was obtained from owners using a structured postal/telephone questionnaire. Chi squared/Fisher's exact tests or 2‐sample t tests were used, with statistical significance set as P<0.05. RESULTS: One hundred and nine PDN cases were undertaken. Follow‐up response rate was 72.5%. From these 79 cases, 52 had MRI (MRI+) and 27 did not (MRI−). There was no significant difference in case distribution between the 2 groups: predominantly horses, Warmbloods, geldings, used for full competitions, except MRI+ were younger than MRI− (median 9.99 and 11.71 years respectively, P = 0.004). Median follow‐up time for MRI+ was 31.4 months, and for MRI− was 36.8 months. There was no significant difference in outcome. In total, 78.9% MRI+ achieved their intended use, compared with 73.1% MRI−. For those intended for exercise, 83.7% MRI+ reached a level of exercise, compared with 87.5% MRI−. Median length of exercise maintenance was 25.2 months for MRI+ and 24.0 months for MRI−. For MRI+ there was one suspected and one confirmed neuroma and 4 neuritis cases. Two MRI− animals developed neuritis. Complications requiring euthanasia occurred in 2 MRI− cases: complete rupture of the deep digital flexor tendon in a bilateral forelimb lameness and one previous chronic laminitic with solar prolapse. CONCLUSIONS: These results are comparable with previous reports of 80% of MRI+ returning to previous athletic use for 20 months. Achievement of intended use, length of exercise maintenance and complication rate was similar with and without MRI diagnosis, although both catastrophic complications occurred in animals which did not undergo MRI. Ethical animal research: Ethical approval obtained: AHT47‐2013. Explicit owner informed consent for inclusion of animals in this study was not stated. Source of funding: C.E. Wylie is funded by The Margaret Giffen Charitable Trust. Competing interests: None declared.