Equis ISSN 2398-2977

Foot: heel and hoof - avulsion injuries

Contributor(s): Gordon Baker, Olin Balch, Graham Munroe

Introduction

  • Cause: trauma.
  • Signs: minor soft tissue injuries   →    larger avulsed soft tissue lesions +/- coronary band involvement +/- small to large area hoof wall avulsion; lameness   Musculoskeletal: gait evaluation  .
  • Diagnosis: history, foot examination   Foot / shoe: examination  , sterile digital palpation, radiography   Digit: radiography  , ultrasonography   Ultrasonography: musculoskeletal  .
  • Treatment: surgical debridement and lavage of any wounds; removal of avulsed hoof wall; primary, delayed primary or secondary closure as dictated by nature of injury; dress; cast/bandage; specialist farriery. May be prolonged - several months to complete soundness.
  • Prognosis: guarded, depends on extent, location, involvement of other structures and treatment; prolonged treatment often required; injuries may severely limit function in the future or increase management responsibilities.

Pathogenesis

Etiology

  • Trauma: self-inflicted (over-reaching, kicking)   Forelimb: overreach scar  , wire injuries, entrapped foot in fence boards or division boards on boxes/trailers, stepping on sharp objects.
  • Infection: often chronic and unresolved which eventually discharges through a defect at the coronary band leading to instability of the hoof wall and possible avulsion, particularly in the heel region.
  • Long-term foot imbalance.
  • Careless shoe removal/traumatic shoe loss   →    tearing of hoof by nails.

Specific

  • The quarter and heel regions of the foot are more susceptible to traumatic lesions.

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • De Gresti A, Zani D D, D'Arpe L & Scandella M (2008) A singular case of traumatic total hoof capsule avulsion. Equine Vet Educ 20 (8), 406-410 VetMedResource.
  • Parks A H (2008) Hoof avulsions. Equine Vet Educ 20 (8), 411-413 VetMedResource.
  • Céleste C J & Szöke M O (2005) Management of equine hoof injuries. Vet Clin North Am Equine Pract 21 (1), 167-190 PubMed.
  • Janicek J, Dabareiner R M, Honnas C M & Crabill M A (2005) Heel bulb lacerations in horses:101 cases (1988-1994). JAVMA 226 (3), 418 PubMed.
  • Moyer W (2003) Hoof wall defects: chronic hoof wall separations and hoof wall cracks. Vet Clin North Am Equine Pract 19 (2), 463-477 PubMed.

Other sources of information

  • Stashak T S (2002) Avulsion Injuries of the Foot. In: Adams Lameness in Horses. 5th edn. Lippincott, Williams & Wilkins, Baltimore. pp 725-732.
  • Pollitt C C (1999) Hoof Wall Reconstruction. In: Colour Atlas of the Horses Foot. Mosby, USA. pp 75-78.
  • Wildenstein M J (1999) Horseshoeing. In: Equine Medicine and Surgery. 5th edn. Eds: Colahan P T, Merritt A M, Moore J N & Mayhew I G. Mosby, USA. pp 1420-1437.


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