"Black Hawk", a seven year old Hanoverian gelding, presented with non weight-bearing lameness of the right hind limb and a large laceration over the hock that communicated with the calcaneal bursa. Surgical exploration and intrasynovial placement of antibiotic-impregnated PMMA beads was performed. Postoperatively, daily regional limb perfusion with antibiotics was performed and an epidural catheter was placed with daily administration of analgesics. He developed osteomyelitis of the calcaneus and a second surgery to debride the lytic bone and to replace the antibiotic-impregnated PMMA beads was performed. He developed severe left pelvic limb laminitis, resulting in euthanasia. A necropsy was performed, which revealed changes consistent with wound resolution and ongoing inflammation.