One of the most severe injuries a horse can suffer is a laceration or puncture that involves a joint or tendon sheath. These wounds are common especially with wire cuts of the lower legs and for this reason, all wounds should be examined by a vet as soon as possible. Contamination of these wounds occurs at the time of the injury and infection can set up within only 6 to 8 hours. Horses treated within 24 hours have a much less chance of infection than those treated after 24 hours. However, even in the horses treated in the first 24 hours, over half developed infection. To stress the seriousness of these injuries, of the horses treated within 24 hours of a joint or tendon sheath laceration, over one-third of these horses did not survive and were euthanized. Again, one-third of the horses treated as soon as 24 hours of a wound affecting a joint still did not survive. That shows how serious these injuries can be.
Most of these horses will require anesthesia to examine the wounds and determine if a joint is involved. Treatment involves injectable antibiotics and flushing of the joint or sheath with large amounts of sterile fluids. Severe lameness is a sign of joint or tendon sheath infection. Many of these horses will require drain tubes to be inserted surgically so the wound can be flushed several days in a row. A very serious joint injury can occur with a puncture wound to the foot if the coffin joint or navicular bursa is involved. For this reason, all puncture wounds of the sole should be explored and radiographs may be required to determine depth of the puncture. Joint infections in this area should be considered deadly and aggressive diagnosis and treatment are mandatory.