The dangers of a picked-up nail do not lie primarily in the size of the horn defect, but principally in the nature and extent of the infection of the hoof structures that is associated with the puncture, especially if synovial or osteochondral structures are involved.

For this reason, immediate resection of the puncture channel and reduction or control of the bacteria introduced by the foreign body take top priority when treating picked-up nails.

Deep punctures (>1cm) caused by picked-up nails are serious injuries which can be tedious and difficult to treat.

Patients suspected of having picked up a foreign body that has penetrated to a depth of more than 1cm, particularly in sensitive regions such as the region around the frog should be regarded as emergencies. They should be given priority treatment due to the risk of deep wound infection and the resultant life-threatening sepsis. If there is any doubt about the extent of the injury and the potential structures involved, the horse should be referred to an equine clinic without delay.The earlier the surgical procedure is performed, the greater the likelihood that the infection of the affected hoof structures can be promptly controlled.