Fractures of the os coronae result from such causes as we have just enumerated, and are nearly always seen in conjunction with fractured os suffraginis. When this latter bone is also fractured diagnosis is comparatively easy, a certain amount of crepitus, even when the suffraginis is only split, being obtainable. When the os corona alone is fractured then diagnosis is extremely difficult, the smallness of the bone and the comparative rigidity of the parts rendering manipulation almost useless, and effectually preventing the obtaining of crepitus. It is, in fact, only when the bone is broken into many pieces that crepitus may be detected, and even then it is slight.

Reported Cases. - 1. 'The subject was a four-year old hunter. While at exercise in the morning of August 10 he bolted, got rid of his rider, and ran about in a mad fashion, came into contact with a wheelbarrow in a narrow passage, and finally came into violent contact with a wall, which had the effect of throwing him down. The rider stated that the animal suddenly put down his head and managed to get off the bridle; he then bolted, and the only chance for the rider was to throw himself off.

'On examination I found the horse unable to place any weight on the off fore-leg, the pastern was swollen and painful, the hollow of the heel was also swollen, and there was marked constitutional disturbance.

'After a short time he would place the heel on the ground and elevate the toe to a slight degree. On manipulating the pastern slight crepitation could be discovered, and there was abnormal mobility in the corono-pedal articulation. On the near fore-leg there were extensive wounds in the region of the knee, and great laceration of the tissues. The animal was destroyed.

'On examining the leg I found the subcutaneous tissues infiltrated from below the knee to the foot, large masses of gelatinous blood-stained material being present along the flexor tendons and in the hollow of the heel. The inferior articular surface of the os suffraginis was denuded of cartilage anteriorly; the os coronae was fractured into eight moderate sized, irregular fragments, and ten minute pieces. The surface of the perforans tendon as it glides over the smooth surface at the back of the os coronae was lacerated, and minute portions of the bone were found embedded therein.'[A]

[Footnote A: E. Wallis Hoare, F.R.C.V.S., Veterinary Record, vol. xiv., p. 133.]

2. 'Here, again, fracture was the result of the animal bolting with his rider. Trying to avoid collision with a conveyance coming towards him, the animal slipped on a wooden pavement, sliding along until his near fore-leg came in contact with the wheel of a standing cab. There was considerable swelling from the knee downwards, great pain, and evidence of fracture in the region of the pastern.

'Post-mortem revealed the os suffraginis broken into about thirty pieces, and the os coronae with a piece broken off the inside of its proximal end.[A]

[Footnote A: A.F. Appleton, M.R.C.V.S., Veterinary Journal, vol. xiii., p. 411.]

3. 'The patient was a brown mare used for heavy van work in London. About January 10 she was lame, and as she had a cracked heel, was treated by poulticing for a day, and then by antiseptic lotions. In a week she was sent to work, but the following day lameness returned, and continued till about February 15. No special symptom was detected which indicated the exact position of any cause of lameness. Then the lameness increased in severity, and some swelling around the coronet began to show itself.

'In consultation with another veterinary surgeon, two possible causes of this intense lameness were discussed: one, that we had septic infection of the coronet, and that probably the swelling of this part would soften, and sloughs occur; the other, that a fracture of the os pedis or os coronae existed. The enlargement of the coronet was hard and firm, not particularly sensitive. It was decided to do nothing for a few days. In a week the pain abated, and the mare would put her foot on the ground, and ceased to "nurse" the limb as she had done. When moved over in the box she put a little weight on the foot, but limped very decidedly.

'Another week passed, and the pain and lameness further abated, but the swelling around the coronet continued. Perhaps it was a little less in front, but it had not decreased on the inside. It remained firm, and was not painful on pressure. It showed no soft places, and the upper part of the leg remained free from oedema.

Fig. 158.   Fracture In Situ (Os Coronae)

Fig. 158. - Fracture In Situ (Os Coronae).

'The diagnosis was now that a fracture existed, and it was proposed to send the mare to grass for a few months. The consulting veterinary surgeon suggested that before doing so a blister might be applied to the coronet. This was done. The mare was found next day again on three legs. She had apparently been down during the night. In a few days the coronet increased again in size, and within a week "broke out" in two places.

'The opinion now formed was that, with a fracture and this additional cause of inflammation around the joint, it would be most economical for the owner to have her killed. This was done, and a post-mortem examination was made by Mr. Hunting and Mr. Willis.

Fig. 159.   With Broken Portion Removed

Fig. 159. - With Broken Portion Removed.

'Post-mortem. - The foot, cut off at the fetlock-joint, showed extensive swelling all round the coronet. There were two wounds on the skin - one on the front of the coronet, the other on the inner side. From both pus and blood had escaped. They both communicated under the skin with a large abscess cavity. The abscess did not communicate with the joint. The pastern bone was sound. On separating the pastern from the coronet bone the articular surfaces were of a healthy colour, but the soft tissues immediately surrounding them were inflamed. On the centre of the articular surface of the coronary bone a thin red ring was noticed, and the portion of cartilage within it seemed raised. With the point of a scalpel this portion was lifted, and was found to be not only cartilage, but a layer of bone completely detached from the os coronae. On removing the bones from the hoof the rest of the bone was quite normal, as was the pedal bone.

'Fig. 158 shows the articular surface of the coronet with the fracture in situ; and Fig. 159 the surface from which the broken portion is removed and laid to the side of the foot.

'Some interesting questions arise. How was the fracture caused? When did it occur? Between the broken portion and the main bone there was a layer of granulation tissue, so that it is certain the injury existed before the blister was applied, and it may possibly have existed from the commencement of the lameness.'[A]

[Footnote A: R. Crawford, M.R.C.V.S., Veterinary Record, vol. viii., p. 478.]