It is ideal to place the foal under general anesthesia to reduce and immobilize the limb. The metaphyseal spike may be medial or lateral. When the foal is placed under anesthesia in lateral recumbency for coaptation the spike is placed uppermost. This is because the periosteal attachments on the metaphyseal side tend to be more intact and gravity will help close the fracture.
2. Nonsurgical treatment
If a splint is selected, it should be placed on the side opposite the metaphyseal spike. A palmar/plantar splint can also be added. Splints should always be attached with non-elastic tape, such as duct tape. Casts should enclose the hoof well enough to prevent motion at the metacarpo-/tarsophalangeal joint. It is important to avoid lifting the limb from below the fracture while the cast is being applied because this will displace the fracture.
The splinted bandage should be changed weekly and casts should not be left on for more than 2 weeks in young foals (less than 6 weeks old). Older foals can have casts changed at longer intervals. These fractures heal very rapidly. Most will be in simple bandages in less than a month (young foals) to two months (older foals).