Puncture wounds of the equine sole - DVM
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Puncture wounds of the equine sole
How to successfully treat these complicated wounds that can easily cause infection


DVM360 MAGAZINE



Photo 6: Patten shoe bars that decrease in height by 1/4 to 1/2 inches.
Under no circumstances should you allow the horse to load the foot without the Patten shoe in place, as further tearing and disruption of the affected area will occur. (Note: If either the navicular bone or navicular bursa has been damaged, then the deep flexor tendon has as well.)


Photo 7: A puncture wound to the P3 that has been open and the necrotic bone removed. Note the shoe and hospital plate were affixed to the foot before surgery.
Objects may penetrate in front of the frog in the area directly distal to the third phalanx (P3) (blue dots in Photo 2). Infections in this area can cause full solar abscessation and bone infections with sequestrum. A 65-degree dorsopalmar view of the P3 will demonstrate fractures, sequestra that appear as darker bone than the surrounding bone of normal lucency (Photos 7 and 8, p 5E). Injecting a radiopaque liquid into the puncture site and then radiographing it will help determine the extent of the solar disruption (Photo 9, p 5E). Wounds with small penetrating tracts but with large areas of solar disruption should be injected daily with an antibiotic such as amikacin.


Photo 8: A radiograph of the foot in Photo 7 after surgery. Notice all dark bone and sequestered fragments have been removed.
Penetration of the sole as it approximates the hard hoof wall in areas other than those just described (yellow dots in Photo 2) tend to cause painful abscesses of the solar corium, but if treated correctly they will rarely cause problems to other foot structures.

In addition, keep in mind that all wounds to the solar corium of the foot will cause protrusion of the corium. This is extremely painful and requires a pressure foot packing over the opening to force the corium back inside the foot. Even minor wounds fall into this category.


Photo 9: A lateral radiograph of a probe inserted into a puncture wound that reached the depth of the P3 body. Note the arrows showing the injection of a radiopaque fluid into the clean tract demonstrating the undermined sole.
One of the complications that may arise from penetrating wounds that are sufficiently painful to produce a nonweight-bearing stance is laminitis of the unaffected feet. It's well worth your effort to protect these feet from the beginning. Losing a case to secondary complications is emotionally devastating to everyone involved.

Conclusion

Penetrating wounds, even complicated ones, can be treated successfully — just remember that some require more extensive time, work and patience than others.

Andrea E. Floyd, DVM, has specialized in equine podiatry for more than 25 years. She is the owner of Serenity Equine, Evington, Va., and the author of Equine Podiatry. Dr. Floyd is a member of the American Veterinary Medical Association, American Association of Equine Practitioners and the American Farriers Association.


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Source: DVM360 MAGAZINE,
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