Nonsurgical management

These fractures are treated conservatively.

The foot is elevated and cleaned.

The sole is filled with plaster of Paris to develop an even footing surface followed by applying one role of fiber glass cast material around the hoof capsule.
Once the cast has set the horse can place weight on it again. The sole of the cast is protected by hoof acrylic to prevent rapid wear.
The cast is changed at 2 weeks and left in place for another four weeks. At that time the hoof is wrapped only with non-elastic tape for 2 weeks.

Another alternative is to apply a bar shoe with side clips. Ideally, the sole is filled as described above. These shoes are changed at 4-6 weeks intervals. At the third application the side clips can usually be removed.

The cast is changed at 2 weeks and left in place for another 4 weeks. At that time the hoof is wrapped only with non-elastic tape for 2 weeks.

Follow-up radiographs are taken at 2 months after initiation of the treatment. Dependent on the result and the findings of a brief lameness exam treatment is either continued or stopped.

Bar shoes with side clips are changed at 4-6 weeks intervals. At the third application the side clips can usually be removed. It is advisable to take radiographs at the 2nd changing of the shoes to assess healing.

Images: the 2-months follow up radiograph shows progressive bone healing and on the 6-months follow up radiographic view the fracture line is not visible any more (the former fracture line is outlined with the arrows).

Both techniques effectively prevent hoof expansion during weight-bearing, which leads to a contracted foot. The same problem occurs with the bar shoe and side clips.

Once the cast is removed a special shoe whose heels are tapered to the outside is applied to facilitate expansion of the heels. This procedure takes some time.

Prognosis

A reasonable prognosis can be given for future use of the horse. It usually takes 4-6 months for the fracture to heal at which time the horse can be ridden again. However, radiographically, the fracture may be visible much longer. Initially a fibrous union develops, which ossifies within 6-12 months. While occasionally fracture healing occurs earlier, in some cases a nonunion develops.