Suspensory ligaments: Their vital role and the prognosis when damage occurs *H&H Plus*

The suspensory ligaments play a vital supporting role in athletic movement, so what’s the prognosis when damage occurs? Dr Rachel Murray MRCVS discusses outcomes

Running down the back of each cannon bone is the suspensory ligament, the tough, fibrous structure that supports the fetlock when the limb is loaded. The ligament starts just below the hock or knee and splits into two branches closer to the fetlock.

With the advanced imaging modalities now available, such as magnetic resonance imaging, we are more aware that not all suspensory ligament injuries are the same. Pain can come from the ligament and the bone where the ligament attaches – the cannon bone at the top and the proximal sesamoid bones at the bottom.

Suspensory ligament injuries may be caused by a sudden-onset single incident or repetitive overload. Damage at the top, or “origin”, of the ligament (proximal suspensory desmitis) is a risk in the hindlimb of the dressage horse, but possible in any sport. Damage in the middle, or “body”, usually occurs as an extension of injury at the origin or branches. Branch injuries may be caused by a twisting hyperextension of the fetlock or by direct trauma.