Executive Editor: Jörg Auer

Authors: Jeffrey Watkins

Phalanges Middle phalanx, Biaxial eminence, Double-plate fixation

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Surgical preparation for P2
Preparation of the surgical site enlarge

Preparation of the surgical site

In preparation for surgery, the hair is removed from the distal limb starting from the hoof wall and extending proximally to the mid-metatarsal/metacarpal region. The periopal and superficial hoof wall are removed with a rasp or another suitable instrument (the author routinely uses a electric sanding tool.)
A waterproof barrier is established to isolate the solar region from the surgically prepared area.


Nerve block

To allow the horse to be anesthetized in a lighter plane without sensing any surgical pain during the procedure, a medial and lateral palmar/plantar nerve block is applied just proximal to the proximal sesamoid bone. This avoids potential complications secondary to swelling of the soft tissues between the bone and the cast, which could occur if the nerve blocks were applied at the abaxial sesamoid level, as it is typically described.

Draping enlarge


The distal leg is prepared for aseptic surgery including meticulous draping of the foot and the application of an impervious “see through” “sticky” drape over the distal limb.

v1.3 2013-11-20