Nonsurgical management

Cast application is not recommended in the management of incomplete fractures of the proximal phalanx, except for first aid and transport.

With persistent or severe lameness, internal fixation is the much better option for long term soundness than external coaptation.

Bandaging is recommended for the first 7-10 days. In horses to be managed nonsurgically, they should be walking comfortably within a few days after the injury, without the use of analgesics. Soft-tissue swelling and persistent lameness is an indication for re-evaluation and probable internal fixation.

Fracture healing is followed radiographically at 8 weeks post injury.

If the fracture is healing satisfactorily small paddock exercise for four weeks followed by field exercise for 4 weeks is recommended before additional radiographs 16 weeks post injury are taken.

Return to training is typically 4-6 months post injury.