## Overview Calcaneal fractures are breaks of the bone that forms the point of the hock. They usually result from external trauma such as a kick. Because the bone has little soft-tissue cover, fractures may be open and can displace the superficial digital flexor tendon or involve the sustentaculum tali and tarsal sheath. Moderate to severe lameness is typical. ## Causes Direct trauma from kicks or impact against fixed objects is the primary cause. High-energy injuries can produce comminuted or open fractures. ## Diagnosis Acute hind-limb lameness after trauma, swelling at the point of the hock, and pain on palpation are suggestive. Standard and skyline radiographs confirm the fracture configuration. Ultrasound evaluates tendon displacement and synovial involvement. ## Treatment Options include fragment removal, lag-screw fixation, or plate fixation depending on configuration. Open or comminuted fractures involving the calcaneal bursa carry a poorer prognosis. Conservative management with casting may succeed for selected incomplete, nondisplaced fractures. ## Recovery and Prognosis Prognosis for athletic function is fair to guarded and depends on fracture type, displacement, and synovial sepsis. Many horses return to pasture soundness; fewer return to high-level performance after complex repairs. ## Prevention Minimizing situations that lead to kicks or falls reduces risk.
moderate to severe hindlimb lameness; swelling at the point of the hock; pain on palpation; possible open wound; displacement of the superficial digital flexor tendon in severe cases
## Overview Calcaneal fractures are breaks of the bone that forms the point of the hock. They usually result from external trauma such as a kick. Because the bone has little soft-tissue cover, fractures may be open and can displace the superficial digital flexor tendon or involve the sustentaculum tali and tarsal sheath. Moderate to severe lameness is typical. ## Causes Direct trauma from kicks or impact against fixed objects is the primary cause. High-energy injuries can produce comminuted or open fractures. ## Diagnosis Acute hind-limb lameness after trauma, swelling at the point of the hock, and pain on palpation are suggestive. Standard and skyline radiographs confirm the fracture configuration. Ultrasound evaluates tendon displacement and synovial involvement. ## Treatment Options include fragment removal, lag-screw fixation, or plate fixation depending on configuration. Open or comminuted fractures involving the calcaneal bursa carry a poorer prognosis. Conservative management with casting may succeed for selected incomplete, nondisplaced fractures. ## Recovery and Prognosis Prognosis for athletic function is fair to guarded and depends on fracture type, displacement, and synovial sepsis. Many horses return to pasture soundness; fewer return to high-level performance after complex repairs. ## Prevention Minimizing situations that lead to kicks or falls reduces risk.
moderate to severe hindlimb lameness; swelling at the point of the hock; pain on palpation; possible open wound; displacement of the superficial digital flexor tendon in severe cases