Horse Side Vet Guide ®

Equine Health Resource

Wounds to Heel &/or Pastern, Heel Bulb Area

Synonyms: Pastern or Heel Bulb Laceration

Wounds to the fore or hind pasterns or heel bulbs are common injuries and can be life-threatening. Wounds can result from a variety of causes; Horses often injure themselves on wire, tin, or other sharp objects, but overreaching can also be a cause.

Vital structures are near the surface here – joints, tendon sheaths, bone, tendons and ligaments. The question with any wound in this location is whether any of these structures are affected and if so, which ones and how severely.

Diagnosis requires careful veterinary examination, digital palpation and exploration of the wound. Pressurizing nearby synovial structures (joints or tendon sheaths) allows veterinarians to assess whether there is communication with the wound. Collection and analysis of fluid from synovial structures, radiography and ultrasound may provide additional information.

Treatment depends on the nature of the wound, how old it is, and it’s size and orientation, and especially whether nearby critical anatomic structures are involved.


  • Does this wound involve any critical structures?
  • What is the prognosis for this wound?
  • Will the horse be able to return to the same level of function as prior to wounding?
  • What is the best treatment approach to this wound?
  • What is the cost of the most aggressive treatment protocols versus less aggressive approaches?
  • How can I prevent similar injuries in the future?

    All of the practices that reduce the likelihood of accidents reduce the likelihood of these wounds. Minimize exposure to wire, especially barbed wire in paddocks and pastures. Remove sharp objects from pastures.

    Practice good hoof care, with consistent short shoeing intervals. Long overgrown hooves change the arcs of flight of the hooves and make overreaching more likely. For horses that have a tendency to overreach, use bell boots as necessary to protect fore pasterns and heel bulbs.

    Helpful Terms & Topics in HSVGWritten, Reviewed or Shared by Experts in Equine Health

    Author: Doug Thal DVM Dipl. ABVP


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