Abstract
A mature horse was presented for investigation of severe acute hindlimb lameness with soft tissue swelling, a full thickness wound to the dorsal metatarsus and no other localising signs. Survey radiographs of the metatarsophalangeal region were unremarkable. Nuclear scintigraphy was required to reach a diagnosis of biaxial plantar process fractures of the distal phalanx, which to the authors’ knowledge is previously unreported. Flexed dorsal 45° lateral‐plantaromedial and flexed dorsal 45° medial‐plantarolateral oblique projections confirmed the diagnosis of both a type I and II fracture in the same foot. Treatment with cast immobilisation and corrective farriery was successful, and the horse became sound at six‐month follow‐up.