The fracture is anatomically reduced if necessary and stabilized with full-limb cast for an extended period of time. At regular intervals the cast is changed. Eight weeks are usually adequate to heal the fracture in a foal unless complications arise, whereas at least 3 months are required in an adult horse.
2. Nonsurgical treatment
A wooden wedge is first applied to the sole of the hoof to assure a solid footing surface while the linb is cast in an extended position. The entire limb is then covered with a double layer of stockinette.
The entire limb is then covered with a double layer of stockinette. Additional felt padding adjusted to configuration of the limb is placed at the proximal aspect of the limb between the stockinette layers. Additional padding in the shape of a doughnut is applied over the ergot and the accessory carpal bone and tuber calcaneus in the hind limb
Attention is given to assure that the hair are aligned in their normal direction. This is achieved by initially pull the first stocknieete layer further up than necessary, followed by immediately pulling it down again in the correct position.
The entire limb is covered by an even layer of cast padding. Attention is given the no folds develop and the the padding is always overlapping half of the previous turn resulting in double layer of cast padding.
This is followed by the application of the casting tape strating at the foot. Mild and even traction is applied to the casting tape, overlapping each previous turn of the tape. Every new tape is started just below where the previous tape ended. Once the tape has reached the proximal end of the limb (elbow region) some additional turns are paled there prior to advancing down the limb again. Care is taken to apply a tube of casting material that has an even thickness along the entire cast.
After a few layers the top of the stockinette is folded down and covered with casting tape to assure that the proximal most aspect of the cast is composed of stockinette and felt padding.
The proximal and distal most aspect of the cast is covered with duct tape. Also it is advisable to apply some artificial hoof resin to the sole of the cast to protect it from grinding down during activity.
Note: It is advisable to also elevate the opposite foot to assure even length of both limbs and prevent excessive loading of the sound leg.
The patient is kept in a box stall. The cast is checked daily for heat, swelling at its proximal end and odor. Additionally the extent of loading of the injured limb is checked daily. Should a sudden increase in lameness, heat, swelling or odor be detected, the cast has to be changed immediately. In young foals the cast should be changed at 2-week intervals, in older foals every 4 weeks and in adults every 4-6 weeks, dependent upon the clinical signs.
Complications include pressure necroses under the cast, which usually develop at the ergot. The accessory carpal bone and the tuber calcaneus in the hind limb. Breakage of the cast represnts another complication that necessitates an immediate cast change. Delayed and non-unions are otherccomplications that may be managed by means of internal fixation applying axial compression and solid fixation.