Outcome of keratoma removal using different surgical techniques, including a modified partial hoof wall resection: A...

Keratomas are diseases of the equine hoof that can be associated with intermittent lameness and/or recurrent foot abscesses. Different surgical techniques for keratoma removal have been described. The aim of this retrospective study was to report the short- and long-term postoperative complications after keratoma removal using different surgical techniques: complete hoof wall resection (CR), partial hoof wall resection (PR) and a modified version of PR (MPR). The medical records of horses diagnosed with keratoma and space occupying lesion (SOL) of the hoof wall (2004-2025) at a Veterinary Teaching Hospital were reviewed. Fifty-five cases underwent surgery (18 CR, 35 MPR and 2 PR). Partial hoof wall resection cases were excluded from statistical analysis due to a very limited number. On the short term, 9/35 (25.7%) of MPR cases developed complications. Modified partial hoof wall resection showed significantly less complications (especially exuberant granulation tissue and hoof wall instability) than CR. Other short-term complications across surgical procedures included laminitis, infection, fracture, and colic. Long term follow-up (6-180 months) was available for 15 CR, 2 PR and 22 MPR cases. Modified partial hoof wall resection group showed significantly less hoof cracks than the CR group. Keratoma recurrence occurred in 3/15 cases in CR, 1/2 in PR, and only 1/22 in MPR groups. Return to activity was achieved in around 70% of CR and MPR cases. Mean time to return was significantly shorter in the MPR (6.5 months) than in the CR group and was in line with durations generally described in the literature for PR. In conclusion, MPR can be an effective alternative to traditional surgical approaches for keratoma removal.