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The aim of this study was to determine how increasing stiffness of fracture site tissues distal to the pins in an equine distal limb transfixation cast influences stress at the bone-pin interface, within the bones distal to the transcortical pins, and contact pressure between the foot and the cast. A transfixation cast finite element model was used to compare the bone-pin interface stress, pin stress, bone stress distal to the pins and contact pressure between the foot and the cast, using six stiffness values for a composite tissue blo