Heel Bulb Laceration Recovery

Surgeons at Kansas State University conducted a retrospective case review of 62 horses with heel bulb lacerations seen at a veterinary teaching hospital over a 14-year period. Data were collected by reviewing medical records and interviewing owners for follow-up information by phone.

Geldings and mares were evenly represented among the horses presenting with heel bulb lacerations. The average age was 9 years, and most were Quarter Horses. About half the horses were lame on presentation with 45% of these having a 4/5 (obvious) or 5/5 (severe) lameness. Most (60%) of the wounds were categorized as deep, with 40% considered superficial. About a third (34%) of the wounds communicated with a synovial structure, with the coffin joint most affected followed by the deep digital flexor tendon sheath, the navicular bursa and the pastern joint. Three horses had severe complications including osteomyelitis of the pastern bones, subluxation of the coffin joint and a fracture of the coffin bone.

Most (79%) of the injuries were initially managed with bandaging followed by casting of the foot for about half the horses. At the time of cast removal, half of the wounds had healed with the other half requiring continued bandaging. Most (95%) of the horses survived to the time of discharge. Long-term follow-up information was available for only 18 horses, but among these 78% returned to their previous level of activity. Horses with a wound duration of fewer than 2 days were more likely to have a good outcome. Surprisingly…