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Conservative management of a transverse fracture of the distal phalanx in a Quarter Horse.

CASE DESCRIPTION
A 7-year-old Quarter Horse gelding was evaluated because of sudden onset of severe left forelimb lameness of 4 days' duration.


CLINICAL FINDINGS
Clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. Radiography revealed a transverse fracture of the distal phalanx of the left forelimb.


TREATMENT AND OUTCOME
The horse was treated conservatively with stall rest and stabilization of the hoof with fiberglass cast material and an elevated heel support. These treatments improved the lameness considerably. Over the following 4 months, the horse was exercised at an increasing level; external coaptation of the hoof was removed, and the horse was gradually shod in a flat shoe. At 6 months after injury, the horse had no signs of lameness when working at its previous performance level, but it was euthanized for reasons unrelated to orthopedic disease. Radiographically, the fracture was unapparent; however, results of magnetic resonance imaging and histologic examination of the cadaveric limb confirmed the presence of tissue changes consistent with a healing fracture.


CLINICAL RELEVANCE
Conservative management of transverse fractures of the distal phalanx of a forelimb may be effective and enable affected horses to be returned to their intended use.