Case study: Sub-solar Keratoma

 

Keratomas are usually associated as sub-mural growths within the hoof wall lamellae. Sub-solar keratoma are rare, but as this case shows, respond equally well to surgical removal with protection from a well-fitted hospital plate.

 

After a period of intermittent lameness, an area of the sole abscessed and appeared to prolapse. On investigation, an abnormal growth was found and removed.

 

The removed growth was submitted for a laboratory report, which described it as "a discrete keratoma ……there is no associated inflammatory cell infiltration and malignant change is not evident”. The picture shows the bisected keratoma.

 

A Farley Hospital Plate shoe was made and fitted. An oversized Egg Bar shoe is turned up at the heel and a 10 mm hole drilled and tapped. At the toe the aluminium plate has a tongue which fits under the shoe. One month later remarkable healing is shown. The horse was sound and resumed exercise. Two months after the operation little sign of the lesion remains and the horse continued in work.