Intersesamoidean ligament injury

alsxx

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Posting on the off chance anyone has any experience of intersesamoidean ligament injuries.

4 year old found in field on 3 legs beginning of November, we think she slipped judging my skid marks. A lot of swelling in the general fetlock area. Vet out, pain relief and bandaged up, back a week later to scan and only thing of note was thickening to the intersesamoidean ligament.

Advice was to continue resting and then turn away as that had been the plan anyway, but I did get vet back out to x ray some weeks later as the swelling was persistent along with mild ish (2/10ths) lameness.

Jump forward to now, she's been going out during the day since mid December but looks no better. She's got very difficult to pick hind feet up, particularly taking the weight onto the injured leg. I was told we could wait and see, stick some steroids in or arthroscopic surgery (this was referral vet advice that my vet consulted with). I'm chasing my vet currently to put a plan in place, but as they are first opinion practice they will likely need to refer. Obviously I'm wondering about other thongs such as PRP or even stem cells.

I've been trying to do some research into these type of injuries and potential treatments. Feeling very disillusioned right now regarding future soundness but also just in terms of how we actually try and treat this. I'm open to giving her time but equally will be kicking myself if she never comes sound having tried nothing.
 
I had one.
They can be really flipping annoying niggly pita ones.
If you are insured/can afford I’d get some good imaging, MRI? Done on it.

At a bare minimum this will be a Dr. Green job, Nov is no time at all. You are prob looking more like 12 months
 
Have you had nerve blocks? Is it definitely the tendon? I only ask as our vet thought youngster had damaged tendons in foot but it turned out to be a keratoma which was only found by MRI.
 
Well, yes, just my luck it's not the most straightforward injury to have.

Managed to catch vet this afternoon and she's referring which is good. Have said I'd like to at least nerve block and make sure it IS the fetlock and nothing else funky going on higher up the leg. This ligament was the only one on ultrasound that showed up as slightly thickened. Everything else looked normal. X rays threw up a tiny bone lesion at the front of the joint, so we don't know if that's of any significance.

I'm totally open to resting but I guess I'm worried I could rest for 12 months and have missed the opportunity to improve the outcome with treatments. Tbh I'm already wondering this as its no longer acute.
 
My late gelding injured his straight sesamoidian ligament, front leg, obvious swelling and lameness, diagnosed by scan. At this point I retired him (he was 22 with plenty of historical issues), he stayed out 24/7 and I would say it took him a good 8 months to come fully sound (was on and off lame during that period). After that it didn't bother him again and the swelling almost disappeared after a year or so. At the time, vet said if I wanted to ride again, the leg would need at least 12 months field rest.
 
Thank you! I'm hoping we can get the referral eyes on, any suitable treatment and then out until the autumn, not trying any work until next spring when she'll be turning 6. I guess given her age it's not the end of the world 🤷‍♀️
 
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