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Penetrating injuries to the frog (cuneus ungulae) and collateral sulci of the foot in equids: 63 cases (1998–2008)

Isabelle Kilcoyne, MVB; Julie E. Dechant, DVM, MS, DACVS; Philip H. Kass, DVM, PhD, DACVPM; Sharon J. Spier, DVM, PhD, DACVIM; Journal of the American Veterinary Medical Association October 15, 2011 239 8 1104-1108
Objective—To determine the outcome of penetrating injuries to the central region of the foot in equids and identify factors that may affect treatment and outcome. Design—Retrospective case series. Animals—63 equids (61 horses, 1 pony, and 1 mule). Procedures—Records of equids incurring puncture wounds through the frog (cuneus ungulae) or collateral sulci of the foot between 1998 and 2008 were reviewed. Evaluated factors that were hypothesized to affect outcome included signalment, degree of lameness, foot affected, duration between injury and admission, and treatment. Injuries were graded from 1 (< 1 inch; involving superficial corium only) to 4 (involving a synovial structure) on the basis of severity of penetration as determined by radiographic evidence or findings on synoviocentesis at the time of admission. Results—Overall, 60% (38/63) of equids returned to soundness. Thirteen equids were euthanized on the basis of synovial structure involvement and financial constraints. Of 35 equids that were treated conservatively, which may have included undergoing a surgical procedure with the horse standing, 32 (91.4%) returned to their previous level of soundness. Fifteen equids underwent surgical treatment under general anesthesia, of which 6 (40%) became sound for intended use. Ten of 34 (29%) equids with synovial structure involvement regained soundness. Equids treated earlier after injury had a better prognosis. Equids with a hind foot injury had a more favorable outcome than those with a forefoot injury. Conclusions and Clinical Relevance—Results suggested that penetrating injuries located centrally in the foot of equids without involvement of a synovial structure have a favorable prognosis, especially if managed early. Penetration of a synovial structure provided a poor prognosis.

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