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Diagnosis of palmar foot lameness (Proceedings)

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Aug 01, 2008

Anatomy of the Palmar Foot

• Those structures that can be associated with lameness:

o Hoof

• Digital cushion

• Collateral cartilages

• Frog

• Heels

• Sole

o Synovial structures

• Coffin joint

• Navicular bursa

• Digital sheath

o Bone

• P2

• P3

• Navicular

o Tendons

• Deep digital flexor

o Ligaments

• Impar

• Suspensory ligament of the navicular

• Distal digital annular ligament

• Collateral ligaments of the distal interphalangeal joint

The Foot

• Diagnostics - localization

o Peri-neural anesthesia

• Palmar digital nerve block

• Dorsal branches

• Abaxial sesamoid nerve block

o Intra-synovial

• Coffin joint

• Navicular bursa

• Digital sheath

• Palmar digital nerve block

o 1.5 – 2 ml of anesthetic

o Placed over neurovascular bundle

o Just axial to collateral cartilages

o Desensitizes ⅓ to ½ of the foot

o Structures blocked: (Stashak TS Adams Lameness in Horses pp 162)

• Navicular bone

• Navicular bursa

• Navicular apparatus

• Distal sesamoidean ligaments

• DDFT, SDFT

• Digital sheath

• Digital cushion

• Frog

• Sole

• Palmar coffin joint

• Palmar ⅓ and distal aspect of P3

• Dorsal branches – pastern ring block

o 3 to 5 ml anesthetic

o Just proximal to collateral cartilages

o Directed dorsally

o Structures blocked

• Coffin joint

• Pastern joint

• Remainder of P3

• Remainder of sole

• P2

• Abaxial-sesamoid nerve block

o 2 – 3 ml anesthetic

o Placed over neurovascular bundle at base of the proximal sesamoids

o Structures blocked (in addition to those with PD)