The use of phalangeal casts for treating pastern and foot injuries had an excellent wound-stabilization success rate in a case-by-case review of 49 horses conducted by University of Illinois equine veterinarian Allison Stewart.
For her presentation at the 2009 American Association of Equine Practitioners annual meeting, Stewart reviewed the medical records of 49 horses that had been treated with phalangeal casts for wounds in the pastern and foot region. She collected existing medical data over a 12-year period from equine referral hospitals where these wounds had been treated with phalangeal casts. All had been applied in a similar fashion as shown in the accompanying photos.
Stewart found the therapy used in these cases had included wound debridement, lavage, wound closure and cast application. Antibiotics were used with 84% of the horses.
At the time of the follow-up examinations, 89.4% of the horses were sound and 89.5% had effective cosmetic healing.
Stewart’s review showed no differences regarding whether the horses were treated immediately or after a 24-hour delay.
Only eight horses had wounds with synovial structure involvement, and three of these were infected for 2 days. However, this small number of cases with synovial structure involvement did not negatively influence the outcome.
“The phalangeal casts were well tolerated by the horses and provided to be an effective treatment for wounds involving the pastern and foot region,” she says.
Photo A shows the proper placement of a elastic knitted stockinette fabric and orthopedic felt with a phalangeal cast placed on a standing horse. Photo B shows application of custom support foam and veterinary casting tape. Photo C demonstrates how the limb was elevated to incorporate the veterinary casting tape on the bottom of the foot. Photo D indicates how polymethlymethacrylate was added to the bottom of the cast.
This wound injury involved the digital flexor tendon sheath after initial debridement. Photo A shows the injury before casting, Photo B shows the leg during casting and Photo C shows the result after 6 weeks.