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Fracture of the Pedal Bone

Pedal bone fractures (fracture of the third phalanx, os pedis, or distal phalanx) generally follow a jarring injury, producing a sudden onset of lameness during exercise or racing. Most fractures are through the wing (flat side) of the pedal bone and often extend up into the adjacent joint.

A horse that fractures its pedal bone immediately becomes lame. Compressing the foot with hoof testers causes pain. Lightly tapping the hoof with a hammer also may cause pain, and turning the horse or making it pivot on the affected leg worsens the lameness. Lameness may improve considerably after 48 hours of stall rest, unless the fracture extends into the joint.

Diagnosis is confirmed by regional analgesia and x-rays. X-ray confirmation may be difficult immediately after the injury because the fracture may be only a hairline at this stage. Repeating the x-ray 2 or 3 days later may be necessary for confirmation and to determine the extent of the fracture.

Conservative treatment of 6 to 9 months' rest is usually all that is required for fractures that do not involve the joint. The horse should return to soundness, although the fracture will remain visible on x-rays. It is usual to fit a plain bar shoe with a clip well back on each quarter to limit expansion and contraction of the heels. In young horses (less than 3 years old), fractures into the joint usually heal satisfactorily, provided a 12-month rest period is given. Horses older than 3 years have a much less favorable outlook for recovery, and insertion of a bone screw is recommended. However, infection is a frequent complication. Many fractures heal in the presence of infection, but the screw must be removed at a second surgery to restore the horse to complete working soundness.