Proper Hoof Care: Caring for Fractured Coffin Bones

Posted by Christy Caplan
Coffin Bones

As a certified vet tech, my courses focused on both small and large animals. We had an entire course on large animal diseases and of course, spent a lot of time learning about horse hoof care and anatomy.

The coffin bone, known as P3 and the pedal bone forms the foundation of the front half of the hoof capsule. This bone is connected to the hoof capsule via the laminae.

First, these are general guidelines if you think you're dealing with a fractured coffin bone. Talk with a farrier or veterinarian about how to diagnose and treat coffin bone fractures after you've identified this is what you're dealing with. This is simply a quick article on how to identify this fracture so you can get sound medical advice from an expert. 

So how do you know you may be dealing with a fractured coffin bone? Experts say that sudden lameness after physical activity is a major indication of a coffin bone fracture. Heat and an increased digital pulse typically accompany lameness. 

Western Horseman reports,

"Coffin bone fractures are likely caused by a traumatic injury to the outside of the hoof wall. This type of fracture can result from something as simple as a horse stepping on a rock, hitting a fence or applying too much weight on a single foot."

How do you diagnose? You always need digital radiographs to determine and diagnose a coffin bone injury. Hoof care experts can put together a treatment plan.

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When looking at the coffin bone (pedal bone) on a X-ray, you want it to be as white as possible. You don’t want to see any roughness on the edge of it and you want it to be whole, minus the vein spots. None of these apply in the first picture. The first photo was taken August of ‘18 I believe. In some spots, you can barely tell that there is bone there. There is hardly any density to this coffin bone. You see how it’s kind of jagged around the edges and if you look close enough, you can see a kind of backwards “u” shape at the very tip of the toe. The roughness indicated Pedalosteitis and the “u” shape is a Crena. Not all horses have a Crena, some are sound on it and some are not. A lot of the time, toe clips on shod horses can create this Crena. * * Now, take a look at the second photo. So much more density (a lot whiter, can’t see through as much). The roughness is still there and the Crena appears to have expanded. The horse is much more sound now than the time the first X-ray was taken. Why is this? I mean, 2 out of the 3 things are worse. How is he more sound? With proper trimming, nutrition and supplementation, we have allowed that bone to “remodel” at a rate that we honestly never expected. The Crena appears worse in the second X-ray, but who is to say that it wasn’t there the whole time. The bone was so brittle to start with, those few pieces of bone were likely about to “break off” at any time. Bone turnover rate is somewhere around 10 years, I believe. If bone density has improved this much in less than a year with supplementation, who is to say that this horse won’t have a completely remodeled and overall healthier coffin bone in another year or less? * * It is always so exciting to see these positive and miraculous changes in these horses. As always, I am so excited to see what the future holds for my horses! * * #equinewellness #equinerehab #coffinbone #xray #equinerehabilitation #ottb #barefoot #barefoothorse #nutrition #equinenutrition #progressnotperfection

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The treatment plan can consist of stall rest for several months.

Kentucky Equine Research reports that treatment is designed around decreasing pain and immobilizing the bone.

"Treatment is designed around immobilizing the bone and decreasing pain and inflammation. For most small, clean fractures, the horse can have a bar shoe applied to keep the hoof wall from moving. This stabilizes the structures inside the hoof and allows the bone to heal. If there are multiple fractures, the prognosis is not as good and healing will take longer. "

The vet will likely provide anti-inflammatories too. If the broken part of the bone is small and doesn't involve the joint, many horses heal well and can return to their previous level of performance. 

Western Horseman also shares a few treatment options and one is briefly mentioned above:

  • Shoeing - Depending on the type of fracture, applying a bar shoe to a horse with a pedal bone injury can help immobilize the bone. Bar shoes, circular shoes that join the heels of a horse, stabilize and minimize outward movement of the hoof capsule. 
  • Pour-in Pads - To add extra protection and support, pour-in pads products like Equi-Pak CS from Vettec are made of urethane adhesive that bonds to the sole and produces a soft, resilient supportive pad material.  

Ask your vet about these options of course!

Other things you should know about the diagnosis? The AAEP, reports the following:

  • When the vet performs diagnostic tests on your horse, this also may include applying hoof testers and possibly nerve blocks.
  • The hoof testers are used to apply pressure to the hoof and underlying coffin bone. A reaction to the hoof testers indicates pain in the hoof or coffin bone that can be the result of a hoof abscess, navicular syndrome, or a coffin bone fracture.
  • The nerve blocks cause desensitization of a certain area on the horse's limb and determine where the lameness is localized in the leg.

X-rays are then are needed to definitively identify a coffin bone fracture. Horse owners should be aware that all three of these tests will likely be done. Definitely note any severe lameness and the clinical signs discussed as these are a good indication you need the vet out to consider the severity of the fracture.

Coffin bone fractures can occur in seven different types! Pay attention to their weight bearing when your hand walking so you can tell the vet what you're seeing before they arrive.

A quick diagnosis is really important too so don't hesitate if you think this is a coffin joint issue. Fractures of the coffin bone can be addressed but don't wait!

What do you think about this advice? Share your thoughts below.

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Proper Hoof Care: Caring for Fractured Coffin Bones