Affusion Fracture

By Terry Golson

Not good news.

Back at the end of the summer, Tonka was intermittently lame. Whatever was going on was mild, but it was there, so I went the whole 9 yards. Ultrasounds, x-rays, and finally MRI. The diagnosis wasn’t awful – he had inflammation in his coffin joint, a collateral ligament was strained, and he had mild issues in the deep digital flexor tendon. Basically, the complicated components inside of his left hoof were sore and Tonka would need about three months of rest and rehab to set things right. A few weeks into that and we were on the track to soundness. To aid in the healing, Tonka would get IRAP injections. Unfortunately, he is one of those rare individuals that has a reaction to what is essentially his own blood, had a flare, and had to get the joint flushed. That set us back.

It’s hard to rest a horse and even harder to immobilize a joint, especially a hoof. Tonka needed to stay quiet, so he was kept in his stall with no turnout in the field. I was told that I could hand-graze him. Horses are designed (both mentally and physically) to move. Tonka is a calm and steady fellow and no one was worried about him straining his left hoof issues if I grazed him near the barn. But, Tonka is a horse and all horses spook. We were peacefully standing on the lawn, in the sun, on a calm day, when an unfamiliar workman suddenly appeared on a rise by the propane tank. Tonka wheeled around to get a better look, slamming into me, and then he bolted sideways. Being Tonka, though, he carefully didn’t step on me, got his wits about him, realized that the lead rope was dangling, and hence he should be ground-tied, so he stopped and resumed grazing. Another horse would have galloped off into the next county. But the damage was done. Tonka went seriously lame. (And I was sore for two weeks.)

The security cam captured that moment.


We thought that perhaps he twinged the already weak joint and after a week and some bute that we’d be back to the rehab. But that didn’t happen. Tonka continued to be limping lame.

Dr. Chope, an ultrasound specialist, came.


The images show that Tonka has an affusion fracture of the phalanx (also called the coffin bone.) What happened was that the ligament, where it attaches to the phalanx, pulled off a fragment of that bone. It is now stuck on the ligament, poking Tonka at every step. Because of where this is inside of his hoof, surgery isn’t an option. There are two collateral ligaments, one on either side of the phalanx, holding it steady. One has that chip, the other is inflamed. These ligaments are what control lateral movement. To heal, Tonka’s hoof needs to be still. But he’s a horse. You can’t bubble wrap them and suspend them from the ceiling. You can shoe the hoof to give him flat support, which we’ve done. You can limit movement by keeping them in a stall and a tiny paddock. Tonka already is in the ideal living quarters for this scenario. His stall has a Dutch door to a small runout. (I will be keeping that paddock raked and flat, and shoveled and sanded in the winter!)


You can give them time to heal. A lot of time. It will be three months before Tonka can resume hand-walking. The optimistic view is that that little piece of bone gets encapsulated by tissue and no longer bothers him, that the ligaments heal, and that in nine months we can get back to our normal activities. But, realistically, recovering from collateral ligament injury is hard enough, add an affusion fracture to that, and the prognosis is murky. Honestly, I would be happy if by next summer Tonka and I are back walking on the trails, and that’s all we do. Tonka is already wondering why we aren’t getting out and seeing new sights. I’m sure he’s as eager as I am for him to feel better. Tonka will tell me what he’s able and comfortable to do, and when, and I’ll listen.

In the meantime, I’ve ordered a slow feeder that won’t aggravate the arthritis in his neck, he’s getting a lot of grooming, and most importantly, calm companionship.

21 thoughts on “Affusion Fracture

  • Laura allemand

    Oh Terry, I’m terribly sorry for you and Tonka. That is tough news. It’s so difficult when our horse partners get hurt. So often with horses, our choices for treatment are limited, whether by expenses or their inability to cope with whatever treatment they may need. Tonka is very lucky to have you (and vice versa!), and have options. I’ve seen great outcomes in similar circumstances, and If anyone can get through this, it’s you and Tonka! Best wishes to you both. ❤️

  • Shannon

    I’m so sorry, Terry. He’s lucky to have you. I hope he can stay calm, heal well, and be back to getting out and about next year. Hugs and best wishes.

  • Gin

    I sure hate to hear about Tonka’s extended problem. Hopefully rest will take care of the problem. Rest can take care of a lot of problems, but unfortunately not all horses owners are able to do that with their horses. I had a mare with a badly bowed tendon, seven months of stall rest and then hand walking, etc. etc. and she healed with no problems. I don’t know what they do with bowed tendons now, that was a while ago, and at least I did have other horses to ride.
    Best wishes and get well Tonka!

    • Terry Golson Post author

      Bowed tendons are still treated with extended rest, but now shockwave is used to accelerate healing. It does help, but it doesn’t work without the rest.

  • Rebecca Stedman

    So sad to hear this news, but glad you are ok and Tonka
    Is getting the rest he needs. Hope this all shakes out with good results. Tonka is a lucky guy to have such a loving, caring friend. Sending good thoughts to you.

  • Daisy

    Sad news indeed, 2021 will have been a difficult year for Tonka and you. Lets hope the new year will see those problems resolved through lots of love and great companionship and of course the treatments of the great team working with you.

  • Michelle McMillen

    Oh, Terry, I’m so sorry to read this news. :’-( Horses can be so injury-prone, which makes our hearts injury-prone! I hope you get lots of catch-rides to keep your riding muscles in shape, and I pray that Tonka will be able to walk those trails with you come summer!

  • Tracy

    Oh, Terry. Oh, oh, oh. I’m so sorry. Both for Tonka and for you. My mind is racing as to what this means longer term, and I know yours’ has already been there and back. Twice. I’ll must say that he is so lucky to have you to make wise and kind decisions every step of the way. I’m thinking about you both.

  • Chris from Boise

    So sorry to hear this news. Yes, horses are horses, and despite all the precautions one may take, it just takes one spook. (I’m frankly impressed that it was “just” a spook, disastrous though it turned out to be. As you say…next county was a distinct possibility. And trampling. Good boy, Tonka!). Really glad you’re OK.

    One question – I have heard that walking is really important for horse digestion and reducing the chance of ulcers. If Tonka is on strict rest, how can one ameliorate that?

    As others have said, if anyone can cope positively with this, it will be you, Tonka and your team. Here’s to a healthier 2022!

    • Terry Golson Post author

      His gut health is a huge concern. Also, movement is tied into their cardiovascular system. And, keeping his other legs sound and healthy is a challenge without movement. But, the priority is to heal that fracture, so …
      Tonka gets no grain, just a ration balancer, so I don’t have to worry about the issues that come with those high, intense carb meals. I’ve orders a Haygain forager feeder so that he eats throughout the day with no gaps. That’s very important to reduce the risk of ulcers. I’m also making sure that his water buckets are clean and inviting. Horses need just as much water in the winter as in the summer, and yet they’re likely to drink less. Tonka gets salt in his ration to encourage him to drink. But he won’t drink from dirty buckets, and the barn is having an issue with the water quality. It’s coming out of the well silty. You have to let the water run for awhile before filling buckets. Not all of the staff do this. I’ve been scrubbing Tonka’s buckets daily.
      Ulcers also come from stress, so keeping Tonka calm yet not bored silly is currently my biggest challenge! I don’t have any perfect solutions, but observation will hopefully catch an issues before they become major.

      • Chris from Boise

        Thanks for assuaging my curiosity. I think of crate rest for dogs – we survived a TPLO surgery with lots of mental games (of course, that was “only” many weeks, not many months, and border collie, not horse). I wonder what quiet clicker-trained tricks one could teach a horse? Can horses learn modifiers (left/right, bigger/smaller)?

        Wishing you both all the best as you soldier through this.

        • Terry Golson Post author

          Yes! Horses can learn “concepts.” But I’m not doing clicker training with Tonka while on this stall rest because the priority is to keep him physically and mentally calm. He’s already too eager when I arrive at the barn. I make a point of doing other things before greeting him, and making sure that all positive interactions happen only when he is relaxed. It’s like his stall is one big cast on his hoof. Later on during the rehab I’ll be able to do interesting things with him. Hopefully!

  • Helena Harris

    Oh, poo. How stressful for you, Terry. And poor Tonka. Being stall bound is the hardest part of healing.

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