Tierarztliche Praxis. Ausgabe G, Grosstiere/Nutztiere2026; 54(4); 244-252; doi: 10.1055/a-2794-3232

[Puncture wounds of the equine hoof – a retrospective study of 96 cases – Part 2: Management and prognosis].

Herschel, TL
·
Winter, K
·
Scharner, D

Abstract: Puncture wounds are a common and potentially life-threatening injury in equine veterinary practice. The aim of this study was to systematically analyze data from horses presenting to the clinic with a puncture wound. Unassigned: A retrospective study was conducted on patient data from horses with a puncture wound in the period from September 2008 to August 2024. Analyzed data included medical management and surgical treatment, complications, duration and costs of hospitalization, short-term survival rate and treatment success. Unassigned: A total of 96 horses met the inclusion criteria. Seven of the 96 horses (7.3%) were euthanized after examination and diagnosis, and three others (3.1%) were euthanized during surgery. Treatment was carried out in 86/96 (89.6%) of cases and was performed under general anesthesia in 62/86 (72.1%) of the animals. The surgical procedure consisted of the funnel-shaped enlargement of the solar defect and the debridement of the complete penetrating tract. If the navicular bursa was affected, endoscopic bursal lavage was performed via the puncture tract. Systemic antibiotic treatment was preferably administered in the form of penicillin and gentamicin. Intravenous regional perfusion was undertaken in 39.5% of horses. During hospitalization, 5/96 (5.2%) horses were euthanized due to economic and prognostic considerations. 81/96 (84.4%) horses were discharged from hospital treatment. Of the 81 horses discharged from hospital treatment, 70 (86.4%) were available for follow-up. 64/70 (91.4%) animals were returned to their intended purpose. Horses with injuries to the corium, or digital cushion were reused in 96.3% (26/27), with involvement of the distal phalanx and/or deep flexor tendon in 91.2% (31/34). In the case of synovial involvement, 77.8% (7/9) of the horses were returned to their intended purpose. Unassigned: Depending on the structures involved and prompt initiation of therapy, the prognosis for puncture wounds is good to excellent. If the navicular bursa is affected, endoscopic lavage via the puncture tract after gentle debridement is an effective treatment method leading to good results. Der Nageltritt stellt eine in der tierärztlichen Praxis regelmäßig auftretende und potenziell lebensgefährliche Verletzung dar. Das Ziel der hier vorgestellten Studie war die systematische Datenanalyse von Pferden, die mit einem Nageltritt in der Klinik vorgestellt wurden.In einer retrospektiven Studie wurden Patientendaten von Pferden mit einem Nageltritt im Zeitraum von September 2008 bis August 2024 geprüft. In die Analyse wurden Daten zur medikamentösen und chirurgischen Therapie, den Komplikationen, Dauer und Kosten des Klinikaufenthalts sowie Kurzzeitüberlebensrate und Therapieerfolg einbezogen.96 Pferde erfüllten die Einschlusskriterien. Von den 96 Pferden wurden 7 (7,3%) nach Untersuchung und Diagnosestellung sowie 3 (3,1%) weitere Pferde intra operationem euthanasiert. Bei 86/96 (89,6%) Pferden wurde eine Therapie durchgeführt. Diese erfolgte bei 62 (72,1%) Tieren unter Allgemeinanästhesie. Das operative Vorgehen bestand aus trichterförmigem Umschneiden des Stichkanals bis zu dessen Ende. Bei Beteiligung der Bursa podotrochlearis wurde diese endoskopisch über den Stichkanal gespült. Die antibiotische Versorgung fand vorzugsweise durch die Gabe von Penicillin und Gentamicin statt. Stauungsantibiosen wurden bei 39,5% der Pferde angewendet. Während des Klinikaufenthalts wurden 5/96 (5,2%) Pferde euthanasiert. 81/96 (84,4%) Pferde konnten aus der Klinikbehandlung entlassen werden. Von den 81 entlassenen Pferden konnten 70 (86,4%) nachverfolgt werden. 64/70 (91,4%) Tiere wurden für den vorgesehenen Verwendungszweck wieder genutzt. Pferde mit Verletzungen von Lederhaut, Ballen- oder Strahlpolster konnten zu 96,3% (26/27), mit Beteiligung von Hufbein und/oder tiefer Beugesehne zu 91,2% (31/34) wieder verwendet werden. Bei synovialer Beteiligung wurden 77,8% (7/9) der Tiere wieder für ihren vorgesehenen Zweck genutzt.Die Prognose der Nageltrittverletzung ist je nach beteiligten Strukturen und zeitnaher Therapie gut bis sehr gut. Bei Beteiligung der Bursa podotrochlearis stellt die endoskopische Spülung über den Stichkanal nach gewebsschonender Wundumschneidung eine effektive Therapiemethode dar, die zu guten Ergebnissen führt.

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Publication Date: 2026-08-20 PubMed ID: 42624121DOI: 10.1055/a-2794-3232Google Scholar: Lookup

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English Abstract
Journal Article

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Overview

This study retrospectively analyzed 96 cases of puncture wounds in horse hooves, focusing on treatment methods, complications, hospitalization outcomes, and prognosis.
It found that with timely and appropriate surgical and antibiotic management, most horses recovered and returned to their intended use, even in cases involving serious structures like the navicular bursa.

Background and Objectives

Puncture wounds to the equine hoof are common and can be life-threatening due to the complex anatomy and risk of infection.
The study aimed to systematically review cases of horses presented with hoof puncture wounds to identify effective treatment approaches and evaluate prognosis.
Data spanned a timeframe from September 2008 to August 2024, providing a long-term perspective on management and outcomes.

Methodology

Retrospective study design analyzing medical records of 96 horses meeting inclusion criteria with puncture wounds in the hoof.
Data analyzed included:

Medical and surgical interventions
Complications during treatment
Duration and costs of hospital stay
Short-term survival and treatment success

About 90% (86/96) of horses received treatment, with a majority undergoing surgery under general anesthesia.

Surgical Treatment

Surgery involved funnel-shaped enlargement of the solar wound and debridement of the entire penetrating tract to ensure thorough cleaning.
If the navicular bursa was involved, endoscopic bursal lavage was performed through the puncture tract, a less invasive and effective flushing technique.

Medical Management

Systemic antibiotic therapy primarily used penicillin and gentamicin to combat infection.
Intravenous regional perfusion, a targeted antibiotic delivery method, was applied in approximately 39.5% of cases to enhance local antibiotic concentration.

Outcomes and Prognosis

Mortality rate: 7 horses euthanized after diagnosis (7.3%) and 3 intraoperatively (3.1%). An additional 5 horses (5.2%) were euthanized during hospitalization, often due to economic or prognosis concerns.
Follow-up was possible for 70 of the 81 discharged horses (86.4%).
Return to intended use was high: 91.4% (64/70) of followed-up horses were successfully reused.

In horses with injuries limited to corium, digital cushion, or heel bulbs, 96.3% returned to use.
Involvement of the distal phalanx and deep digital flexor tendon saw a 91.2% return rate.
Synovial structure involvement (including navicular bursa) had a somewhat lower return rate of 77.8%, but still favorable.

Conclusions

Prognosis for equine hoof puncture wounds is generally good to excellent, depending on structures affected and how quickly treatment is initiated.
The study highlights the effectiveness of conservative surgical enlargement and debridement combined with endoscopic lavage of the navicular bursa when involved.
Systemic antibiotics paired with regional perfusion contribute substantially to positive outcomes.
Overall, the combination of appropriate surgical intervention and antibiotic therapy enables most horses to recover and return to their intended activities.

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APA

Herschel TL, Winter K, Scharner D. (2026). [Puncture wounds of the equine hoof – a retrospective study of 96 cases – Part 2: Management and prognosis]. Tierarztl Prax Ausg G Grosstiere Nutztiere, 54(4), 244-252. https://doi.org/10.1055/a-2794-3232