Complete and partial hoof wall resection for keratoma removal: post operative complications and final outcome in 26 horses (1994-2004).
Authors: Boys Smith, Clegg, Hughes, Singer
Journal: Equine veterinary journal
Summary
# Keratoma Removal: Weighing Surgical Approaches Keratomas—benign ossifying fibromas of the hoof—require surgical removal to restore soundness, yet the relative merits of complete versus partial hoof wall resection remain poorly characterised. This retrospective analysis of 26 horses treated at a single equine hospital between 1994 and 2004 compared post-operative outcomes following complete resection (CR, n=14) and partial resection (PR, n=12), examining complication rates, time to return to work, and long-term soundness. Counter-intuitively, the more extensive CR approach yielded a significantly higher complication rate (71% versus 25%, P<0.01), with horses experiencing excessive granulation tissue proliferation, hoof wall cracks and keratoma recurrence; however, horses undergoing PR demonstrated substantially faster return to athletic work (P<0.01). Despite this apparent advantage, both surgical approaches proved remarkably successful overall, with 25 of 26 horses (96%) ultimately returning to their previous exercise level. For practitioners advising on keratoma management, PR emerges as the preferred initial strategy where anatomically feasible, offering reduced post-operative morbidity and accelerated rehabilitation, though the excellent long-term prognosis associated with either approach should provide confidence in surgical outcomes.
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Practical Takeaways
- •Partial hoof wall resection should be preferred over complete resection when anatomically feasible, as it reduces post-operative complications and accelerates return to work
- •Expect a lengthy recovery period with complete resection, but recognize that long-term prognosis for soundness remains excellent with either approach
- •Monitor for excess granulation tissue, hoof cracks, and recurrence during post-operative healing, particularly in horses undergoing complete resection
Key Findings
- •Complete hoof wall resection (CR) had a 71% complication rate compared to 25% for partial resection (PR) (P<0.01)
- •Partial resection resulted in significantly faster return to full work than complete resection (P<0.01)
- •Common complications included excessive granulation tissue formation, hoof crack formation, and keratoma recurrence
- •25 of 26 horses (96%) returned to their previous exercise level regardless of surgical method