Suspensory Ligament (Interosseous Medius) - Horse Anatomy
Muscular System

Suspensory Ligament (Interosseous Medius)

Musculus interosseous medius

Overview

Origin: Proximocaudal on Mc3 and palmar carpal ligament. Insertion: Proximal sesamoid bones, with extensor branches passing around proximal phalanx to join the common digital extensor tendon. Innervation: Deep branch of ulnar nerve. Function: Counteracts overextension of the fetlock joint. Contains little muscular tissue in the adult (fairly muscular in the foal). The principal component of the suspensory apparatus.

Anatomical Details

Origin: Proximal palmar/plantar MC3/MT3 (cannon bone) and distal row of carpal/tarsal bones

Insertion: Abaxial surfaces of the proximal sesamoid bones; extensor branches join the common digital extensor tendon

Action: Supports the fetlock joint; prevents hyperextension of the fetlock during weight bearing

Innervation: Deep branch of the lateral palmar/plantar nerve (vestigial innervation)

Clinical Significance

The suspensory ligament (m. interosseus medius) is a key component of the suspensory apparatus of the fetlock joint. Desmitis (inflammation) of the suspensory ligament is one of the most common causes of lameness in athletic horses. Proximal suspensory desmitis and branch desmitis are distinguished. In the foal, the interosseous is fairly muscular; in the adult it is entirely tendinous.

Common Conditions & Injuries

Proximal suspensory desmitis (PSD)

Inflammation at the origin of the suspensory ligament, a very common cause of both forelimb and hindlimb lameness in sport horses. Often insidious onset.

Suspensory branch injuries

Tears of the medial or lateral branches where they insert on the sesamoid bones. Very common in racehorses and eventers.

Suspensory body lesion

Damage to the mid-body of the suspensory in the cannon bone region.

Degenerative suspensory ligament desmitis (DSLD)

A progressive, systemic connective tissue disorder causing bilateral breakdown of the suspensory apparatus. No effective treatment. Common in certain breeds (Peruvian Paso, Saddlebreds, some Warmblood

Sesamoiditis

Chronic inflammation and remodeling of the proximal sesamoid bones from repetitive loading and suspensory ligament traction.

Frequently Asked Questions

What is Proximal suspensory desmitis (PSD) in horses?

Inflammation at the origin of the suspensory ligament, a very common cause of both forelimb and hindlimb lameness in sport horses. Often insidious onset. Signs include: Gradual onset lameness; worse on soft/deep footing; may be bilateral (appears as stiffness rather than obvious lameness); pain on palpation of the proximal cannon; worse on circles; responds to diagnostic nerve blocks.

What is Suspensory branch injuries in horses?

Tears of the medial or lateral branches where they insert on the sesamoid bones. Very common in racehorses and eventers. Signs include: Acute lameness; swelling over the affected branch (medial or lateral, just above the fetlock); heat; pain on palpation; visible on ultrasound as fiber disruption.

What is Suspensory body lesion in horses?

Damage to the mid-body of the suspensory in the cannon bone region. Signs include: Swelling in the mid-cannon region (may be subtle in the hind limb where it's deeper); lameness worse at trot; pain on palpation; confirmed on ultrasound.

What is Degenerative suspensory ligament desmitis (DSLD) in horses?

A progressive, systemic connective tissue disorder causing bilateral breakdown of the suspensory apparatus. No effective treatment. Common in certain breeds (Peruvian Paso, Saddlebreds, some Warmbloods). Signs include: Bilateral fetlock dropping (may start unilateral); progressive over months to years; fetlocks sink closer to the ground; pasterns become increasingly horizontal; pain and reluctance to move; eventually unable to support weight; no response to rest or treatment.

What is Sesamoiditis in horses?

Chronic inflammation and remodeling of the proximal sesamoid bones from repetitive loading and suspensory ligament traction. Signs include: Chronic low-grade forelimb lameness; pain on palpation of the sesamoid bones; positive flexion test; enlarged, remodeled sesamoids on radiographs; seen in young racehorses and sport horses.; Consult veterinarian for specific symptoms.

What are the clinical concerns for the Suspensory Ligament (Interosseous Medius)?

The suspensory ligament (m. interosseus medius) is a key component of the suspensory apparatus of the fetlock joint. Desmitis (inflammation) of the suspensory ligament is one of the most common causes of lameness in athletic horses. Proximal suspensory desmitis and branch desmitis are distinguished. In the foal, the interosseous is fairly muscular; in the adult it is entirely tendinous.

Explore This Structure in 3D

See the Suspensory Ligament (Interosseous Medius) on our interactive 3D horse model. Open 3D Model