Unusual penetrating foot injury with complete perforation of the distal phalanx by a metal object

Summary A 12‐year‐old Warmblood gelding was presented with acute, nonweightbearing left hindlimb lameness. A foreign object was detected in the toe area of the solar surface. Radiographic examination confirmed foot penetration by a metal object, perforating the distal phalanx and dorsally reaching the lamellar dermis. Standing surgical exploration was performed. After manual removal of the object, a small circular opening in the dorsal hoof wall was created to facilitate debridement and flushing of the complete tract. Radiographically, the distal phalanx presented an irregular circular defect (35 × 33 mm) at the dorsal half of the sole just medial to the sagittal plane, without other lesions. The horse received broad‐spectrum antimicrobial and nonsteroidal anti‐inflammatory treatment. Lameness decreased gradually and the lesion presented progressive granulation and epithelisation. After 4 weeks, the horse was discharged from the hospital. A final cast change was performed during an ambulatory check‐up at the hospital 2 weeks later. At that stage, epithelisation was complete, and first signs of keratinisation were observed. Further follow‐up was performed by the referring veterinarian. The horse resumed its previous level of exercise in a riding school. Six‐month follow‐up did not reveal lameness; radiographically, the circular defect in the distal phalanx remained visible yet without other abnormalities.