Phalanx distalis (P3)
The coffin bone of the right hindlimb.
The pastern region is assessed with radiography and MRI. Fractures can be sagittal or comminuted and often involve the joint.
Laminitis/founder
A coffin bone fracture is a break in the distal phalanx inside the hoof capsule. These fractures can be articular (involving the coffin joint) or non-articular (such as wing fractures) and are usually
Pedal osteitis refers to inflammation and degenerative changes in the [coffin bone](/anatomy/coffin-bone-distal-phalanx-p3) (distal phalanx) inside the hoof. It is most often caused by chronic concuss
Laminitis/founder Signs include: Consult veterinarian for specific symptoms.
A coffin bone fracture is a break in the distal phalanx inside the hoof capsule. These fractures can be articular (involving the coffin joint) or non-articular (such as wing fractures) and are usually caused by trauma or severe concussion. They often result in acute, severe lameness and require prompt veterinary evaluation. ## What it is The [coffin bone](/anatomy/coffin-bone-distal-phalanx-p3) is a critical weight-bearing structure enclosed within the rigid hoof capsule. Fractures most commonly occur as wing fractures (non-articular) or through the solar margin. Articular fractures that enter the coffin joint carry a more guarded prognosis because they can lead to osteoarthritis. The enclosed nature of the hoof makes these injuries particularly painful due to pressure and limited ability for swelling to occur. Coffin bone fractures are often traumatic, resulting from missteps, kicks, or high-impact landings, but they can also occur in horses with pre-existing bone weakening from chronic [laminitis](/conditions/laminitis) or [pedal osteitis](/conditions/pedal-osteitis). ## Signs and symptoms - Sudden onset of severe lameness, often non-weight-bearing - Strong bounding digital pulse - Increased heat in the hoof - Marked pain response to hoof testers over the affected area - Shifting weight or holding the limb off the ground - In some cases, swelling at the coronary band if the fracture is articular or complicated ## Causes and risk factors Most coffin bone fractures result from acute trauma or severe concussive forces. Risk factors include working on hard or uneven ground, conformational issues that increase stress on the foot, and pre-existing conditions that weaken the bone such as chronic laminitis. Horses in high-speed or jumping disciplines have a higher incidence of traumatic fractures. ## How it is diagnosed Diagnosis is confirmed with radiographs. Multiple views are usually required because the hoof capsule can obscure fracture lines. In some cases, especially with non-displaced or hairline fractures, repeat radiographs after several days or advanced imaging (CT) may be needed. Nerve blocks help localize the pain to the foot. ## Treatment and management Treatment depends on the type and location of the fracture. Non-articular wing fractures are often managed conservatively with stall rest, supportive shoeing (often with a bar shoe and heel elevation), and pain management. Articular fractures may require more aggressive treatment and carry a higher risk of long-term joint problems. Healing typically takes several months, and prognosis is better for non-articular fractures. ## When to call the vet Call your veterinarian immediately for any sudden, severe lameness. Coffin bone fractures are serious injuries that require prompt diagnosis and appropriate management to optimize healing and minimize complications such as infection or osteoarthritis. ## Prevention Prevention focuses on minimizing trauma through good footing, appropriate conditioning, and careful farriery. Prompt treatment of any underlying foot conditions that weaken the coffin bone (such as laminitis) can also reduce risk. ## Frequently asked questions **How long does it take for a coffin bone fracture to heal?** Most fractures take 3 to 6 months or longer to heal, depending on the type and the horse's age and overall health. **Can a horse return to work after a coffin bone fracture?** Many horses return to some level of work, especially with non-articular fractures. Articular fractures have a more guarded prognosis for high-level performance due to the risk of osteoarthritis. **Is surgery needed for coffin bone fractures?** Most are managed conservatively. Surgery is occasionally considered for certain articular or displaced fractures. This information is for educational purposes only. Always consult with a licensed veterinarian for diagnosis and treatment of your horse. Signs include: Sudden onset of severe lameness, often non-weight-bearing; strong bounding digital pulse; increased heat in the hoof; marked pain response to hoof testers over the affected area; shifting weight or holding the limb off the ground; in some cases, swelling at the coronary band if the fracture is articular or complicated
Pedal osteitis refers to inflammation and degenerative changes in the [coffin bone](/anatomy/coffin-bone-distal-phalanx-p3) (distal phalanx) inside the hoof. It is most often caused by chronic concussive forces or secondary to [laminitis](/conditions/laminitis) and appears on radiographs as demineralization or roughening along the solar margin of the bone. While it can contribute to ongoing lameness, it is frequently part of a broader foot pathology rather than a standalone disease. ## What it is The coffin bone is subject to significant concussion during locomotion, especially in horses worked on hard surfaces or those with poor hoof conformation. Over time, this repetitive stress can cause inflammation of the bone (osteitis), leading to bone resorption, roughening of the solar margin, and sometimes the formation of enthesophytes or new bone growth. Pedal osteitis is commonly seen in conjunction with [laminitis](/conditions/laminitis), thin soles, or long-term [navicular syndrome](/conditions/navicular-syndrome). The condition reflects the bone's response to chronic overload or inflammation rather than an acute injury. It is more frequently diagnosed in performance horses and those with conformational issues that increase concussive forces on the front feet. ## Signs and symptoms - Chronic, low-grade forelimb lameness that worsens on hard ground - Increased sensitivity to hoof testers across the sole - Shortened stride and reluctance to land heel-first - Heat in the hoof in active cases - Radiographic changes including solar margin demineralization or roughening - May occur alongside other foot problems such as laminitis or navicular syndrome ## Causes and risk factors Pedal osteitis develops from repetitive trauma and concussion to the coffin bone. Major risk factors include working on hard surfaces, poor hoof conformation (especially thin soles or long toes), previous or chronic laminitis, and inadequate hoof care. Horses with high body weight relative to foot size or those in high-impact disciplines are more commonly affected. ## How it is diagnosed Diagnosis is made through a combination of clinical signs and radiographs. Veterinarians look for solar margin changes on X-rays, including demineralization, roughening, or new bone formation. Because pedal osteitis often occurs with other foot pathology, a full lameness workup including nerve blocks and possibly MRI is recommended to identify all contributing factors. ## Treatment and management Treatment focuses on reducing concussive forces and managing any underlying conditions. This typically includes corrective farriery with supportive shoes or pads, rest or controlled exercise on softer surfaces, and anti-inflammatory medication during flare-ups. Addressing concurrent issues such as laminitis or poor hoof balance is essential. In many cases, long-term management rather than a cure is the goal. ## When to call the vet Contact your veterinarian if your horse develops persistent forelimb lameness, especially if it worsens on hard ground or is accompanied by increased hoof heat or sensitivity. Radiographs are needed to confirm pedal osteitis and rule out more serious problems such as fractures or advanced laminitis. ## Prevention Prevention centers on minimizing chronic concussion and maintaining good hoof health. Regular professional farriery to keep the foot balanced, avoiding excessive work on very hard surfaces, and prompt treatment of laminitis or other foot problems help reduce the risk of developing pedal osteitis. ## Frequently asked questions **Is pedal osteitis the same as laminitis?** No. Laminitis involves failure of the laminae, while pedal osteitis is inflammation and demineralization of the coffin bone itself. The two conditions often occur together. **Can pedal osteitis be cured?** In many cases it can be managed effectively, but complete resolution of radiographic changes is uncommon. The focus is usually on reducing pain and slowing progression. **Does every horse with radiographic changes have pain?** No. Some horses show radiographic signs of pedal osteitis without obvious lameness. Clinical signs and response to nerve blocks are more important than radiographs alone. This information is for educational purposes only. Always consult with a licensed veterinarian for diagnosis and treatment of your horse. Signs include: Chronic, low-grade forelimb lameness that worsens on hard ground; increased sensitivity to hoof testers across the sole; shortened stride and reluctance to land heel-first; heat in the hoof in active cases; radiographic changes including solar margin demineralization or roughening; may occur alongside other foot problems such as laminitis or navicular syndrome
The pastern region is assessed with radiography and MRI. Fractures can be sagittal or comminuted and often involve the joint.
See the Distal Phalanx / Coffin Bone (Right Hindlimb) on our interactive 3D horse model. Open 3D Model