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Horseshoe fistula is one of the most. complex and potentially morbid. conditions faced in a modern anorectal. surgery. Hanley, 1965 reported his. original procedure for horseshoe fistula. which involved complete division of the. posterior 12 o'clock sphincter mechanism.
Management of anorectal horseshoe abscess and fistula. Held D, Khubchandani I, Sheets J, Stasik J, Rosen L, Riether R. Over a 10-year period 69 patients were treated consecutively for posterior and anterior horseshoe abscesses and fistulas. Fifty-nine patients had posterior and ten had anterior abscesses or fistulas. There were 52 patients with acute abscess.