Wounds of the pastern and foot region managed with phalangeal casts: 50 cases in 49 horses (1995-2006).
Authors: Ketzner, Stewart, Byron, Stewart, Gaughan, Vanharreveld, Lillich
Journal: Australian veterinary journal
Summary
# Phalangeal Casts for Pastern and Foot Wounds: A 12-Year Clinical Review Managing contaminated or complex wounds in the distal limb presents significant challenges due to the region's limited soft-tissue coverage, high infection risk, and proximity to vital synovial structures. This retrospective analysis examined 50 wounds across 49 horses treated with phalangeal casts at equine referral hospitals between 1995 and 2006, evaluating both healing outcomes and functional recovery. Standard treatment protocols included thorough debridement and lavage, primary closure where feasible (56% of cases), cast application, and systemic antibiotics in 84% of cases. At follow-up, 42 of 47 horses (89.4%) achieved soundness, with cosmetic healing achieved in 89.5% of wounds; only three horses remained lame and one required euthanasia due to persistent lameness. Notably, neither acute presentation (within 24 hours) nor delayed treatment, nor involvement of synovial structures (joints, tendon sheaths, bursae), significantly affected outcomes. For equine practitioners, these findings suggest that phalangeal casting offers a reliable, well-tolerated approach to distal limb wound management with strong prognostic indicators, potentially reducing the need for more invasive interventions or extended box rest in cases where cast tolerance can be established.
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Practical Takeaways
- •Phalangeal casts are an effective and well-tolerated treatment option for pastern and foot wounds, with high success rates for both soundness and cosmetic healing in equine practice
- •Delaying treatment beyond 24 hours does not significantly worsen outcomes, which may provide clinical flexibility when immediate treatment is not possible
- •Synovial involvement should not necessarily preclude phalangeal cast treatment, as it did not negatively impact prognosis in this study
Key Findings
- •89.4% of horses (42 of 47) were sound at follow-up after phalangeal cast treatment for pastern and foot wounds
- •89.5% achieved cosmetic healing with phalangeal cast management
- •Timing of treatment (acute <24 hours vs delayed >24 hours) did not significantly affect outcomes
- •Involvement of synovial structures in wounds did not significantly influence healing outcomes