Patient Presentation
A gelding presented with a puncture wound over the poll after sustaining trauma to the head and neck region.

Initial Evaluation and Findings
Radiographs revealed a small avulsion fragment from the occipital bone. The wound’s location and depth raised concern for partial disruption of the nuchal ligament and involvement of the poll bursa, making this a complex soft tissue and orthopedic injury.

Medical or Surgical Management
Dr. Fairfield Bain and the veterinary team initiated a comprehensive treatment plan including anti-inflammatory medication, oral antimicrobials, and intensive wound care with daily lavage and bandaging. Advanced wound management techniques were utilized, including antibacterial foam followed by placement of a sterile amnion-derived membrane to support healing and reduce infection risk.

Outcome

The gelding is recovering well with ongoing monitoring and continued wound management. The multidisciplinary approach and advanced therapies contributed to a positive clinical response. In a great outcome, veterinarians at the track reported that the wound healed so well it is no longer detectable, and the horse has successfully returned to racing.

Educational Takeaway
Puncture wounds in the poll region can be complicated by underlying bone and ligament involvement. Early imaging, aggressive antimicrobial therapy, and advanced wound care strategies are critical to promoting healing and preventing long-term complications in these challenging cases.

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