Retrospectieve evaluatie van de chirurgische versus de conservatieve behandeling van hoornzuilen bij 41 kreupele paarden (1995-2001)

A keratoma is a rather uncommon disorder of the equine hoof that can lead to lameness. Few quantitative data exist about the prognosis of different treatment regimens. The outcome of 41 cases that were presented to the Department of Equine Sciences in the period 1995-2001 and that were treated according to different regimens was retrospectively evaluated. All horses showed lameness that could be attributed to the keratoma: 23 (56%) were treated surgically using a standardized procedure, while the other 18 (44%) were treated conservatively. Results were based upon 35 horses; 6 were lost to follow-up. Range of recovery time for the surgically treated patients, was 2-12 months and for the conservatively treated group 2 weeks to 6 months. Of the surgically treated patients 83% (n =23) returned to the same or higher performance level as before the onset of the lameness, as opposed to 42% (n = 12) of the conservatively treated horses (p<0.05). The average hospitalization period was significanty longer for the surgically treated patients (35 vs. 5 days, p<0.05). It is concluded that surgical excision of the keratoma is the preferred treatment for horses suffering from lameness caused by a keratoma, because the better outcome outweighs the longer hospitalization and the longer overall recovery time.