Coffin Bone Fractures

[Jeanette James, CESMT]

As I said, I would start a new thread for coffin bone fractures. However, don't think there's much you all can offer, but here goes. This horse fractured his left hind about 2 years ago maybe 3. It was hairline. He has, however, pulled the deep digital twice since then. He tends to favor that foot in that he doesn't put full weight on it. And he rests it on the toe a lot. Some days he forgets about it and walks fairly decent. He can turn, stand, all putting weight on it and you'd never know a thing was wrong but give him few mintues and he's back to resting it. And, walking, even if he walks putting full weight on it he soon goes back to dropping his left hip and leg. He doesn't really limp on it, He just drops it as he walks. It's like the tendon is shortened and can't do full extension comfortably. He, of course, has had lots of chiropractic, massage, turn out all day long almost every single day and some other modalities. He's not sound to ride. They've tried a couple of different shoeing ideas, but nothing seems to work. Me may be barefoot behind right now. Not sure. Haven't seen the horse lately. And, after massage he will be better so something is setting him off. Lameness exams,x-rays, he's pretty clean. Nerve blocks show that if he were nerved, he would probably go sound. Owner is reluctant to do that out of concerns to any long term complications.

The horse is frustrating as about as soon as he appears to be sound enough to go back to work, he gets rode a very short bit and he pulls the tendon and there you are again.

Feel free to comment or wish him a wonderful life as a pasture ornament! :) It's really too bad. He's an absolutely gorgeous horse that has a lot of talent in dressage.

Jeanette

[Jason Maki]

Just a question: where was the fracture? Did it perhaps involve the semi-lunar crest? If the insertion of the DFT into PIII was affected, this may be the root of this problem. Assuming a balanced foot( lets define THAT :D ), a small wedge/roller motion shoe might reduce the stress placed on the compromised area. Just a thought.
Is the fracture healed, or maybe under work the greenstick fracture re-occurs?
Jason

[Dave Purves]

Jason makes an excellent point, where exactly is the fracture? I personally like to use a spider plate on coffin bone fractures, it seems to stabalize and support the coffin bone a little better, just make sure you use some type of frog support with it.
Dave Purves CF :)

[Jeanette James, CESMT]

Everyone,
I have more information from my client. A history. Here goes:

Here are Wilbur's injuries to the left hind
6/25/2002-----stepped on nail, mid frog

6/28/2002-----abscesses both bulbs of frog and under the frog

7/23/2002-----still lame - bar shoe pour in pad and squared toe

9/5,20/2002 and 10/10/2002-----shockwave therapy for possible pastern injury

as of November was sound


5/2/2003----- lame 3 out of 5, suspect P3 wing fracture - bar shoe and pour in pad

6/11/2003---all clear on xrays...still lame

7/15/2003---infection from small cut

8/21/2003---suspect DFT tear with Ultras. after coming in from pasture no weight bearing

liver failure in september........LH became secondary...........from this point on his hind leg has come on again and off again with lameness.....with blocking the area where the DFT inserts, he is 90% better..............

Because of liver, no more meds for pain relief and has learned to move with compensation .........he walks great, gallops all over the place with his toe turned down, can trot semi-sound very slow but once he has to push off with a bigger trot goes considerably unsound.

[Ronald Aalders]

Hi Jeannette,


I don't know if the pour in frog support is a good idea with a P3 wing fracture, and shockwave therapy in my experience is analgetic rather than healing. So you want to be very careful using it. Taking away or minimising the 'warning factor' pain has, may cause damage that can not be fixed.

As has been said before, what is important here is the exact site of the fracture, and I'ld be very interested in a LM X ray view of the foot and perhaps a pic or two from the shod foot, laterally and solar.



Ronald Aalders

[Jeanette James, CESMT]

Guys,

I've got another email into my client on this horse and copying to her. I asked her last night for the exact location so perhaps she can get me that or more.

Thanks,

Jeanette

[Jeanette James, CESMT]

Sorry Ron and all,

Don't know that we are going to be able to get that info. The horse belongs to someone else. My client just takes care of him. I think what we have may be all we are going to get. The reason they suspect a P3 wing fracture is that it was hairline and very hard to detect. Which was assumed because he kicked the stall wall. I think they have all given up on him. If she gets me photos I'll pass them along.

Thanks anyway!

Jeanette

[Jason Maki]

I acquired a stall kicker who had broken PIII a few years before I started doing him. The injury had heeled, but we shod him with an 1/8 inch leather and a 1 inch foam pad under the leather. He kept kicking, but never refractured the bone. I do not know if it was luck, the extra padding or what... He was a handful, and was retired to another farm, so I do not know how he is doing now. Its no fun when they hurt themselves!
Jason