Surviving a Coffin Bone Fracture

Researchers in the Netherlands studied the outcomes of coffin bone fractures in 223 horses. Success was defined as becoming sound and at least returning to the previous level of work. Front feet were most commonly affected (70%). Wing fractures of the palmar/plantar process that did not involve the joint (36%) and fractures that extended through the joint to the lateral or medial side of the bone (29%) were most common. Only 5% of the fractures were solar margin fractures around the periphery of the coffin bone.

Most of the horses (77%) had a successful outcome. Horses with palmar/plantar process and nonarticular solar margin fractures had significantly higher success rates (92% and 80%, respectively) than horses with articular fractures (70%) or fractures with multiple fragments (57%). Hindlimb fractures had a significantly better prognosis than forelimb fractures.

Despite initially being more lame, most horses treated with stall rest alone (97%) had a successful outcome compared with 81% treated with hoof immobilization (special shoe or cast). The authors concluded that hoof immobilization did not contribute to a successful outcome. About one-third of the horses treated with hoof immobilization developed contracted heels, but the authors felt this didn’t significantly affect the outcome.

The radiographic appearance or disappearance of the fracture line did not correlate well with soundness. The authors recommend that most fractures be treated with stall rest for at least 2 months, followed by resuming work when the horse becomes sound. Hoof immobilization by casts or special shoes…