Posted by Patty Stiller on February 04, 2003 at 23:20:13:
In Reply to: Re: Cracked Navicular Bone posted by Chris Newman on January 23, 2003 at 03:25:11:
: : : : Just took over a 16 yrs old fox trotter with a cracked navicular bone on right front hoof. Any suggestions on shoeing for this problem and will this ever heel.
: : : Mike,
: : : I've never worked on a broken navicular bone; but have had success with somewhat severe cases. I do my own bastardization of "Natural Ballance" and would recomond that site,
: : : I lower the heels, to get the frog suported, roll the toe, hold the toe of the shoe back, use a frog suport pad with impresion putty or Equthane sole pack. Like a charm it works.
: : : My $0.02
: : : Bill
: : Mike,
: : I would certainly NOT fly solo on this one. A good equine vet will have more resources and experience with fractures(radiographs, previous fracture experience etc). Also, if it all goes south, you have a co-conspiritor to share the greif with...
: : All fractures will heal, the question is will it heel properly. That is a medical question best ansewered by a D.V.M. However, after he/she supplies the needed info, I would utilize these thoughts:
: : I would trim the foot to balance, remove all flares( using my knee, not a hoof stand on this foot). I would then purchase/ build a three degree eggbar to break the axis forward. Fit your shoe with considerable base under the load. Raising the angle TEMPORARILY would remove stress from the DFT,loading the suspensory ligament, thus removing stress on the fulcrum, or navicular bone. I would also rocker the toe web halfway, deep seating behind the rocker and fit to the foot. I would then use a hospital plate fit just behind the rocker to protect the damaged basil surface of the foot. This plate could also be removed for exams, palpation, etc. A vertical bar across the fracture would notoffer total protection. In this case, i would avoid any frog support or pressure, as this could place stress on the fractured navicular bone which is located just behind duckett's dot. Nailing may not be practicable without a nerve block or Dormo. Unless you can make a light weight package, glueing may not work.( I have never glued on a shoe, so i am guessing?!)
: : The horse will be less willing to load a foot with a fracture, so he will over load the other foot. You might consider a heart bar with light, or "one dime" frog pressure. That is to say, when the shoe is rested on the foot , with the frog plate stopping at Ducketts dot, you could place one dime between the buttress and the shoe. I would also rocker the toe of this shoe.
: : Another option might be a Patton bar. This may be overkill, and would be difficult on keep on a front foot. I would discuss that option with the attending D.V.M.as well.
: : After the fracture has healed, you could lower the angle back to proper, being sure to go slow as you transfer stress back to the DFT. I would ALWAYS rocker the toes on this horse, to keep the stresses down on the navicular bone. After he is willing to load the opposite foot, the heart bar would become unneccasary as well.
: : I hope some of that might help. Use your best judgement, work with the vet and good luck.
: : Jason Maki
: ////////
: Yikes ! My first thought would be to advise the owner to
: change the horse's address!
: Failing that, short toes (on both fronts and both rears
: to ensure easy breaking and minimize overreach threat which
: could refracture the front nav bone if the horse decides
: he feels good or gets a scare)
: Extra high heels...and two toe clips on fronts to keep the
: hoof from splitting while you are placing that extra
: pressure on the toes. "Natural Balance" works for
: a working foot...but this foot is seriously injured.
: Feed changes must also be made. No grass, no oats.
: Reduce the laminitis risk so he's not resting on his
: heels and causing all that junk to slow healing.
: That horse will be sore on the second or third day
: due the abrupt change in angle. Bute should be enough
: to get him over it.
: This advise was passed on to me by one of Canada's top
: race farrier's , who has been successful in repairing
: such an injury. (Then again, he'd also raced and won
: with a horse after 6 months who had foundered so bad
: the coffin bone protruded through the sole).
I have successfully treated the only true navicular fracture I have ever seen in my practice(including at the university ,using a variation on EDSS (which is based on NB but has added components for treating pathologies).
If treating navicular fractures the tension in DDFT needs to be temporarily relieved so wedging is certainly part of it.
I trim the foot to NB standards,except leaving a little bit more wall to help *unload* the frog (Bill take note...added frog support is not appropriate in Navicular fractures)
I used the EDSS shoe, the tallest wedge rails, and a hard plate ( EDSS aluminum P3 fracture plate) in place of the normal frog support pad. In fractures, I only use support material in the rear inch of frog, or less,just to keep debris out from under the plate.
I have not had problems nailing navicular or coffin bone fractures.
Also the wedge rails on EDSS allow eased breakover medial laterally as well as just forward, which a huge thing for the comfort and healing of the horse as it relieves tension on the ends of the navicular suspensory ligament and the impar ligament. A wedge shoe or wedge pads can not do that unlesss the shoe has a well rolled edge all around.
Patty