Ligamentum accessorium m. flexoris digitorum profundi
The inferior check ligament (accessory ligament of the deep digital flexor tendon, ALDDFT) continues the common palmar ligament of the carpus. It originates principally from the palmar aspect of the carpus (including the third carpal bone region) and blends with the deep digital flexor tendon in the middle third of the metacarpus. In the forelimb it is a substantial structure, similar in size to the DDFT itself. Its main function is to act as a passive check on DDFT tension during weight-bearing, reducing the muscular effort needed to stabilize the digit and helping prevent over-extension of the coffin and fetlock joints. It also contributes to the stay apparatus. In the hind limb the ligament is smaller, more variable, and occasionally absent. Fibrous connections can exist between the ALDDFT and the superficial digital flexor tendon, which may predispose to adhesions after injury. Desmitis is recognized in performance horses (especially jumpers and older athletic horses) and can affect load sharing with the DDFT. Surgical transection (desmotomy) is sometimes used to relieve DDFT contracture in foals or to manage certain chronic cases.
Desmitis produces variable lameness and swelling in the proximal to mid palmar cannon region. Ultrasound is the primary diagnostic tool; careful evaluation of the junction with the DDFT (deep digital flexor tendon) is important. Prognosis with rest and controlled rehabilitation is fair to good for many cases. Desmotomy is a selective surgical option for contracture.
Swelling or heat on the back of the upper cannon, especially after jumping or hard work, should be evaluated with ultrasound. Do not assume all swelling in this area is a classic bowed tendon.
Desmitis produces variable lameness and swelling in the proximal to mid palmar cannon region. Ultrasound is the primary diagnostic tool; careful evaluation of the junction with the DDFT (deep digital flexor tendon) is important. Prognosis with rest and controlled rehabilitation is fair to good for many cases. Desmotomy is a selective surgical option for contracture.
Swelling or heat on the back of the upper cannon, especially after jumping or hard work, should be evaluated with ultrasound. Do not assume all swelling in this area is a classic bowed tendon.
See the Inferior Check Ligament on our interactive 3D horse model. Open 3D Model