The theory in the following procedure is to rebuild the hoof capsule using an acrylic compound and a composite shoe.  In addition, drilling is done to create expansion holes which relax the hoof capsule and the distorted tubulars.  This procedure allows the hoof capsule to return back to its mechanical harmony.  I have found that this procedure also allows for the quickest healing times.  In my experience I have found that if a stapling or stitching technique is used on the hoof it is often too stressful to the hoof capsule resulting in longer healing times.  I have also found that using a patch puts the hoof out of balance, adding stress to the hoof capsule, and lengthening the healing process. 

After I have diagnosed that I am dealing with a quarter crack I take the time to explain to the horse owner the process that I will be using.  I also go over my recommendations for the best possible recovery of the horse.  In addition, I request that a veterinarian be called in to assist with pain management and to prescribe antibiotics if necessary.  It is always best to work in conjunction with a veterinarian in complex cases. 

The first thing that I do when repairing a quarter crack is to dremmel tool the toe crack out.  All drilling should be done under load because the hoof will be under maximum expansion.  This gives you a realistic view of what the hoof will look like under loaded conditions.  Drilling rejuvenates hoof growth in every case.  I half moon the bottom of the cracked hoof wall to relieve pressure; taking care to not hit any live tissue.  At the top of the crack I drill a single hole to keep the crack from advancing into the coronary band and to relieve pressure on the crack.  If this is not done there is a very good chance that the crack will advance into the coronary band causing more problems down the road.  I then drill four holes on each side of the quarter crack.  These holes will act as stabilizing holes for the acrylic that I will treat the hoof with.  I then drill up to twenty holes to act as expansion holes for the entire hoof.  These holes will relax the hoof capsule and the bent tubulars giving relief to the horse. 

Now that the hoof is prepped, it is time to apply the acrylic.  In this case I am using HOOF-it Acrylic.  I fill in the quarter crack, expansion, and stabilizing holes with the acrylic.  This stabilizes the entire hoof capsule and helps to equalize the hoof from concussion and impact related to the normal movement of the horse.  The application of the acrylic also assists in bringing the hoof back into mechanical harmony and helps in restoring normal growth to the hoof capsule. 

Now it is time to put on the shoe.  I recommend a composite shoe for this process.  The composite shoe provides almost no torque to the hoof wall.  In addition, the composite shoe aids in circulation and has tremendous shock absorbing qualities.  A steel or aluminum shoe may be used, but I have found that the composite shoe leads to quicker healing.  I cut out the composite shoe at the point of the quarter crack.  This removes pressure at the toe of the crack.  I typically take out half the thickness of the shoe.  I never take this out of the foot itself, the tissue of the foot is excellent support and there is no reason to remove it for this procedure.  I roll the shoe 45 degrees from the first nail hole on each side to assist in supporting the hoof capsule.  I glue or use two nails to nail on the shoe to finish the job. 

Recovery will depend on the level of infection that you are dealing with.  It can be anywhere from seven days to six months.  I like to apply betadine where the quarter crack is closest to the coronary band to help prevent infection.  I recommend keeping the horse in hospital conditions until obvious signs of healing takes place.  This is a good time to work in conjunction with your veterinarian.