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A keratoma can create pressure inside the hoof capsule and even distort the coffin bone when it grows unchecked. After removal, the priority is confirming that the hoof capsule remains stable and that the coffin bone has not shifted. Follow up radiographs allow us to evaluate the bone alignment, the quality of the healing margin, and the integrity of the remaining hoof wall. A hospital plate shoe is used during this phase because it gives controlled access to the sole for packing and medication
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