Treatment of solar prolapse using the heart bar shoe and dorsal hoof wall resection technique.
Authors: Eustace, Caldwell
Journal: Equine veterinary journal
Summary
# Editorial Summary: Solar Prolapse Treatment with Heart Bar Shoe and Dorsal Resection Solar prolapse—where the tip of the pedal bone (covered by solar corium) penetrates through the sole itself—represents one of the most severe manifestations of acute laminitis, yet treatment options remain limited. Eustace and Caldwell's 1989 study examined ten horses with this catastrophic complication, nine of which had concurrent distal phalangeal rotation and one with sinking, using a combined approach of heart bar shoeing and surgical resection of the dorsal hoof wall. Although two horses required euthanasia due to severity of lameness, seven of the remaining eight cases returned to their previous level of performance, with only one showing persistent trotting lameness—a notably encouraging outcome given the gravity of the condition. The heart bar's mechanism of redistributing loading away from the apex of the frog whilst the dorsal wall resection allows drainage and surgical access to non-viable tissue appears to address both the biomechanical and septic complications simultaneously. For practitioners managing end-stage laminitis cases where solar prolapse has occurred, this combined technique warrants consideration as a salvage option before euthanasia is contemplated, though case selection and prognosis assessment remain critical to identifying suitable candidates.
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Practical Takeaways
- •The heart bar shoe with dorsal hoof wall resection is a viable salvage treatment for severe laminitis cases with solar prolapse where the pedal bone tip penetrates the sole
- •This technique achieved return to work in 70% of cases, making it worth attempting before euthanasia in advanced laminitis
- •Expect variable outcomes: some horses resume full function while others may retain mild lameness or require euthanasia despite treatment
Key Findings
- •Heart bar shoe combined with dorsal hoof wall resection successfully treated 10 cases of acute laminitis with solar prolapse
- •Nine cases had distal phalangeal rotation and one had distal displacement of the distal phalanx
- •Seven of 10 horses (70%) returned to previous use at comparable performance levels
- •Two horses were euthanized due to severity of lameness; one remained slightly lame at trot