x-ray and pictures of club foot

[snoopydog]

http://members.cruzio.com/~kerrin/

Here's a radiograph and a few pictures of my 10 year old TB gelding's club foot. Notice the size difference, typical of club foot companions? He had balance and soundness issues as well as difficulty in keeping shoes on his club foot (3 shoes in 3 months which totally ripped apart his hoof wall). At times I thought I would have to give up and put a boot on.

He gets a work out every day-- ridden 4-5 times per week (arena and trails) and a couple of days of ground work and turn out so he's really only lightly worked (when he's sound).

We did some research and thought that we might try a the sigafoos glue on and see what happens. After one "experiment" we figured out the process and he's been up and running ever since, completely sound! Though the shoes are expensive, the cost evens out because of the number of times I had to call my farrier out to help me with my horse between regular shoeings.

The x-ray was taken in July '05 (the cloudiness is left over apoxy and sorry about the mud!!) and the pictues were taken January 4th '06 -- actually the day my farrier came out and trimmed and reshod him (after the pictures were taken). We would like to see if we can eventually get a shoe nailed in if it makes sense to do so or we can stick to this plan since it's working for now although I am concerned about the long term effects...

The vet says that we need to take as much heel off as possible and shorten the toe and that he sees some chronic degrading on the front top of the coffin bone. My farrier sees the bone reforming and couldn't belive that the x-ray and the foot she was looking at were one in the same! Notice the bevel in the front of his club. He also develops a flare by the end of his shoeing cycle (every 6 weeks). Any suggestions?

[Forgewizard]

Snoopydog,

From the radiograph you posted, I am seeing what appears to be several other issues that foot has.

I outlined the shadowing of the radiograph so that the shape of the hoof was evident. The date on the radiograph was July of 05.

The arrows on the photo show the places that I am wondering about. It *looks* like the growth plates of the bones are still open. (yellow arrows) which is curious for a 10 year old horse. Maybe its just the tilt of the X-ray machine?

Is there a fracture on the distal(lower) end of the short pastern bone? (pale green arrow).

Any chance that you know the history of this horse? If the "club foot" developed as a result of an injury to that foot, then you stand a good chance of redeveloping a better hoof. If the club foot is congenital, then maintainence is about it.

The opposite hoof needs to be tightened up and the toe brought back and probably shod to improve hoof to pastern angle. But I haven't seen a lateral view yet. The first photos you posted showed a considerable shadow in the hair of the leg corresponding to the joint of P2 and P3 this dark shadow tells me that the hoof probably has a broken back hoof angle.

I've probably raised more questions, than answers for you.
Kim

[snoopydog]

Wow! Thanks for all the information Kim!

Unfortunately, I don't know the history of this horse. He was rescued off the track a year ago as he was headed for the slaughter house... I know he had a club but was sound at the walk trot and canter in the saddle. The vet and chiropractor say he's in good shape. I know you can't "diagnose" but how do you treat a fracture at the distal end of the short partern? I guess my vet should have picked up on that as well as the possible open growth plates... Do you recommend a full series of radiographs to gather more information? This doesn't seem to interfere with his performance. He's really sound, however I wouldn't want to aggravate any injuries which might cause chronic pain in the future.

As to the other foot... the difference really is amazing. I'll take some lateral pictures and post them.

Thanks again, Kerrin

[snoopydog]

I have added several additional views of both hooves. What do you think? They are so different it's hard to believe that he consistently picks up the correct lead although his balance is still not quite there on his left.

My main goal for this horse is to make him as sound and comfortable as possible without doing any long term damage using short term solutions. I know usually congenitally club footed horses must be managed and if that is the case then I want to know what the best course of action is for the long term. If it is a fracture with the potential for rehabilitation, then I can look into that as an option.
Thanks for your thougths, Kerrin

[Ronald Aalders]

[QUOTE=snoopydog
One day my farrier did some research and suggested that we try a the sigafoos glue on and see what happens. After one "experiment" we figured out the process and he's been up and running ever since, completely sound! Though the shoes are expensive, the cost evens out because of the number of times I had to call my farrier out to help me with my horse between regular shoeings. [/QUOTE]

Hi Kerrin,

Let me start out by saying (claiming?) in relation to your quote above that the fact a horse is sound does not imply the shoeing is correct. We also have long term consequences to reflect on.

Treating deformities in feet can be very frustrating. One important reason is that there is a lack of knowledge allround. Nobody really knows for sure what makes feet tick.

Why a club is a club is hard to answer. I think it's commonly agreed that only the deep flexor tendon (DDFT) is strong enough to cause such a deviation. But that DDFT pull may well be secondary to something else like (-my personal favourite- collateral sesamoidian ligament problems or -I like that one too- impar ligament trouble.)

Looking at the X ray, I noted the the cartilage of the navicular bone looks really thin. (The X ray is not too clear and also not hit exactly perpendicular -which is almost impossible to do without a digital machine-)

The club however would be a reason for the navicular bone to not really be well develloped. The navicular bone needs work to grow stronger.

If you would just lower heels, like the vet suggests and leave it at that, you're putting a lot of strain on a navicular bone that is not used to handling strain at all. This is not what you want. Also when the impar ligament is involved, lowering heels and leaving it at that is not a good idea either.

I do agree heels need to be lowered here, like the heels on the "slam dunk" foot need to be raised. However heels need to be lowered the smart way.

What you are looking for is to derotate the coffin bone that for whatever reason rotated. If you go to Dr. Steve O'Grady's website on these boards you will find a very clear and informative essay on realigning coffin bones. (Dr. O'Grady prefers to call derotation realignment....... ;)

After you brought the coffin bone back in a more natural position, you have in fact íncreased the pull of DDFT, the tendon that because of it's pull caused the club in the first place. So after derotation/realignment you also need to raise the heels using a special shoe (called a rail shoe or using wedges).

Raising heels after removing them by trimming may seem funny, but there is a very important difference. After derotation/realignment, the coffin bone is in a position to handle more support at the posterior part of the foot. By doing so, the muscle of DDFT is given a chance to relax and let go of the continuous contraction. When that happens, the foot is used more naturally by the horse and can also be trusted more by the horse so the other foot has a chance to regrow some heel effectively bringing the shape of the feet together allowing better use of legs, shoulders, back etc.

If you or your farrier needs more information, (maybe less theory more practice?) just let us know.


Ronald Aalders

[snoopydog]

Hi Ron,
I loooove this website!!! I have learned so much from your collective expertise. Thank you for taking the time to respond.

My primary concerns are 1) not inflict more or long term damage to an already "iffy" foot. and 2) provide comfort and natural gaiting (as much as possible). This horse is not nor ever will be an eventer of any kind (lucky sod!) so his work load is for (my) pleasure and (his) fitness.

Sooo, what does this mean? "collateral sesamoidian ligament problems or and impar ligament trouble"? Can a navicular bone grow stronger given the right program? (I've never heard of that but what do I know, I'm a teacher not a farrier!).

I have discussed with my farrier the seemingly counter intuitive process of lowering the heel and then wedging it up. The other front has an alliminum wedge shoe to attempt to even out the angles.

Another questions... How would you suggest working with the other foot? It looks healthy but like a pancake!

That's enought questions for now! Thanks again for sharing your knowledge and expertise.
Sincerely, Kerrin

[Rick Burten]

I have discussed with my farrier the seemingly counter intuitive process of lowering the heel and then wedging it up. The other front has an alliminum wedge shoe to attempt to even out the angles.
What was your farrier's response after the discussion?
Using a wedged heel shoe without also providing additional mechanical support for the structures in the rear portion of the hoof(the frog, bars, sole, sulci) often results in the back of the foot prolapsing and exacerbating the very problem(s) you are trying to remediate.

Another questions... How would you suggest working with the other foot? It looks healthy but like a pancake!
First by getting the heels back, as much as practicable, to healthy horn. Then, supporting the structures(as noted above). Also, insuring that the breakover was in the correct location(radiographs are really important here).
Conserving the sole anterior to the apex of the frog.

I also want to comment on the upright hoof. Looking at the photos, it is evident from the position/angulation of the pastern that this horse can accept and actually wants those heels lowered. Again, any work done from the bottom of the hoof should conserve all the sole anterior to the apex of the frog. If after lowering the heels, the horse seems uncomfortable, the addition of a wedge or wedges will resolve that problem(as others have already indicated). Lowering those heels will also extend the base of support. If wedges are used, or for that matter, if a rim pad is used(more on that in a minute), then the shoe will also have to be appropriately larger(longer) to accomodate the pad addition and to maintain the correct location for support of the heels. I often use a flat rim pad ammended to the shoe because that upright foot is often smaller and ends up shorter than the other foot, and thus needs the addition of the 'shim' to return its overall length to something that is correct and appropriate.

One of the biggest mistakes I see farriers make when applying pads is to think of the pad(s) as part of the shoe rather than as an extension of the hoof. When they do this, they inevitably end up 'short shoeing' the hoof which not only negates the desired outcome, but also exacerbates the main and underlying condition(s).

I often read that farriers use a size smaller shoe on the upright/club foot. Speaking only for myself here, I have never (as in not once or ever) done that. My shoe sizes have always been equal/pair of feet, and at least for me, when the one foot is smaller, it indicates that I need to add a pad.

While it may seem obvious that in the case of an upright foot, the shoe should be fit to the toe perimeter, that isn't necessarily or usually the case, especially if the dish/flare has not already been addressed.

Again, radiographs will help in determining where the breakover location should be, but absent them, there are other markers(and farrier experience) that will aid in that decision.

It is also my conviction that absent surgical intervention, we never really "cure" a front limb club/upright hoof. Especially in horses over the age of two.
What I am convinced of, is that they can be properly managed such that they often are of little to no consequence to either the horse or its people.

In my practice, most of my horses are on a six week schedule. At many of the barns where I work, I'm there every three weeks. Often, especially during the times of the year when hoof growth accelerates, I am re-trimming the upright/club foot every three weeks(and the others on the six week , regular schedule). This allows me to closely monitor and manage that foot and keeps me from having to make major trimming adjustments.

By now you have noticed how adroitly I have avoided discussing the 'collateral sesmoidian ligament problems' and the 'impar ligament trouble'. I am going to leave that discussion to my trans-Atlantic collegue. :D

[snoopydog]

Yet again... I have learned a lot that helps me illuminate some potential solutions to my issues and also reinforced my idea that yes, this is rocket science!

Quote:
Originally Posted by snoopydog
I have discussed with my farrier the seemingly counter intuitive process of lowering the heel and then wedging it up. The other front has an alliminum wedge shoe to attempt to even out the angles.


What was your farrier's response after the discussion?
Using a wedged heel shoe without also providing additional mechanical support for the structures in the rear portion of the hoof(the frog, bars, sole, sulci) often results in the back of the foot prolapsing and exacerbating the very problem(s) you are trying to remediate.

I don't know enough about shoeing to really have an intelligent conversation about it.

Thanks for the advice on managing the "pancake" foot. I will discuss this with my farrier next time. Can I ask what a rim pad is? I can't imagin how these two hooves could possibly be shod with the same sized shoes (I guess that goes with my ingorance about what a rim pad is). I know that the club (if it is a true club) will never look the same as the other hoof and that management is the goal.

I will discuss the suggestion to reduce the heel and I have already scheduled a full set of x-rays for further information gleaning.

One more question... do you have any pictures of the description of using a rim pad to shoe a club foot? I would love to see an example. Thanks!

[Rick Burten]

Can I ask what a rim pad is?
I will discuss the suggestion to reduce the heel and I have already scheduled a full set of x-rays for further information gleaning.

One more question... do you have any pictures of the description of using a rim pad to shoe a club foot? I would love to see an example. Thanks!

A rim pad is a pad that is cut to fit the width of the web of the shoe only. Basically, the center of the 'full' pad is cut out. Regardless, the fit of the shoe is done as though the horse were wearing a full pad(s), which is why you can get a larger shoe to fit that foot. One problem with fitting a keg shoe to these narrow upright feet is that often you can't get a proper fit and keep the nail holes where they need to be. This necessitates either punching new nail holes or building the shoe properly from bar stock. Alternatively, in some instances, the keg shoe nail holes can be back punched and that will allow nailing through the pre-existing holes. Generally, I'm not much on back punching because the nail holes seem to wallow out a lot more quickly. Doesn't mean I don't or won't do it, just that its not something I do routinely.

You'd think that since I bought a whiz bang high tech digital camera expressly for the purpose of taking pictures of trimming and shoeing related subjects, that I'd have a plethora of photos available, including pictures of shoes and rim pads. Unfortunately, I don't. It seems I am somewhat indifferent when it comes to taking the time to make a photo record/journal.

[Rick Burten]

Hi Rick,
One more thing... do you have any pictures of club feet using the rim pads you were talking about?
Thanks again!
No, and damnit I just did one yesterday. :mad:

[Dave Purves]

This is a pic of the foot before trimming, and after shoeing with a pad, I used a full pad with frog support on this particular horse because of the severity of the club foot. But it would be easy enough to make it a rim pad.

Dave

[Rick Burten]

Thanks Dave! Thats a nasty looking foot, and one that is more like the true definition of a Club foot/stump foot, whatever, than many of those we see with high heels and a dished toe.

A long time ago, after a clinic and while at dinner, the clinician opined that he thought that these high heeled, dished toe feet were more like a foundered foot than a club foot and he tended to treat them as such. I often think about that analogy during those long intervals of windshield time. Typically, sometimes I find myself agreeing with that assessment, and other times, not. Since all of us(Rick, Burt-N-Ernie) are offering opinions, it makes for a lively conversation :D And sure makes the long drives more palatable.

[Ronald Aalders]

A long time ago, after a clinic and while at dinner, the clinician opined that he thought that these high heeled, dished toe feet were more like a foundered foot than a club foot and he tended to treat them as such.


I still think that. By which I'm not saying I fixed all the clubs I laid my hands on. They all got better but some fell back just as fast :cool:

O I got pics too.......


Ronald Aalders

[Rick Burten]

Ron,

Photo#2 looks like you've trimmed the foot for a banana shoe. Photo#3 seems to confirm that. It also appears that you have used a wedged heel shoe. Is it an open heeled shoe or a bar shoe? And, did you add any mechanical support to /for the structures in the rear of the hoof?

[Gary Hill]

Ron do you trim the roll in the foot or hot fit it? Gary

[Double C Forge]

I don't think it would be hot fit Gary because it is an aluminum shoe.

[Gary Hill]

Yeah , but I wondered if he had a steel shoe shaped like the "nanner" because I hot fit with steel before I nail on alum. Thanks, Gary

[calshoer]

Heres another horse two very bad club feet .
On finished the other bare so you can see how the excess horn in the heels has been removed to encourage better overall foot function, then the foot wedged back up to insure no stress on the shortened muscles and deep flexor tendon. The horse has been that way 18 years. it wasn't something you could fix, but certainly could manage and make the feet better.
That is a GE aluminum wedge shoe, Castle wedge frog support pad, added little piece under the frog support to reach the ground, and dental impresion material fill.
Patty

[Ronald Aalders]

Ron,

Photo#2 looks like you've trimmed the foot for a banana shoe. Photo#3 seems to confirm that. It also appears that you have used a wedged heel shoe. Is it an open heeled shoe or a bar shoe? And, did you add any mechanical support to /for the structures in the rear of the hoof?


Close Rick. The funny thing is when you derotate the club foot what you really are doing is get P3 back into a more normal position relative to the ground. Like Dr. O'Grady explains the way to go is to draw a line parallel to the ventral border of P3 like 20 or 25 mm away from that border.

I guess you all know the drill so I don't have to go into that one.

So what you really are doing is trim the foot towards the heels, starting half an inch or so from the tip of the frog. The anterior part of the foot is not touched at all! This is vital!

Here are two pics on another club. On aal.jpg you can see the outcome viewed laterally of a derotation. See how the toe kind of sticks up in the air? aal1.jpg Is a solar view. Note that trimming here started 3/8" behind the apex of the frog.

When trimmed this way the foot kind of comes out in a banana shape like Rick noticed. That's why you don't have to do a lot of invasive trimming when getting a derotated club ready for a banana shoe. (I do bring back breakover even further, as close as I can get it to the center of articulation)

The shoe I would typically use is an aluminum wedged straight bar. As to hoofpacking I have to tell you that I do not use that routinely on cases like these. In my experience the foot needs ease of breakover to get the DDFT muscle to relax, rather then frog support. However when I do not really feel the foot is strong and solid or when derotation is massive (Grade 2's) I do use frog support. BTW I would not as a rule shoe clubs without frog support though, even advise against it. But I did one or two that turned out ok without, because money was tight.

On a laminitis case derotation is similar, so is the need for breakover. But in a laminitis case obviously always, always, use frog support.


Ronald Aalders

[calshoer]

Ronald old man, I see youre still posting in the evening (My time).... what are you doing up so late? (or so VERY early morning over in your land) ;)
Patty

[Ronald Aalders]

I know, I know, I couldn't sleep! It's a 5.15 AM here now. I woke up at 4 AM or so. Maybe I'll go back in and give it another try..............


Ronald Aalders


p.s. I'm not thát old, I sometimes just feel that old :D By the way did you ever notice how much time it takes to try and explain what you think? Hours!

[Rick Burten]

By the way did you ever notice how much time it takes to try and explain what you think? Hours!

Which perhaps explains why so many people don't think. :o

[Dave Purves]

Thanks Dave! Thats a nasty looking foot, and one that is more like the true definition of a Club foot/stump foot, whatever, than many of those we see with high heels and a dished toe.

A long time ago, after a clinic and while at dinner, the clinician opined that he thought that these high heeled, dished toe feet were more like a foundered foot than a club foot and he tended to treat them as such. I often think about that analogy during those long intervals of windshield time. Typically, sometimes I find myself agreeing with that assessment, and other times, not. Since all of us(Rick, Burt-N-Ernie) are offering opinions, it makes for a lively conversation :D And sure makes the long drives more palatable.

You are all welcome (Rick, Burt-N-Ernie) that is. Yes this foot is pretty nasty. In fact so nasty that his shoulder muscles are pretty much non-existent. I beleive it's due to range of motion, or lack there of. He's happy with the shoe though, picks up his leads, and is less choppy.

Dave

Here's a pick of his shoulder, I'm not sure you can really see the lack of muscle or the bone protruding since I downsized it, it was hard to tell before that cause the horse was pretty fuzzy getting ready for winter.

[snoopydog]

Dave!
"This is a pic of the foot before trimming, and after shoeing with a pad, I used a full pad with frog support on this particular horse because of the severity of the club foot. But it would be easy enough to make it a rim pad.

I still think that. By which I'm not saying I fixed all the clubs I laid my hands on. They all got better but some fell back just as fast"

WOW!!! How would yoou suggest I shoe my horse?

Rick
"I also want to comment on the upright hoof. Looking at the photos, it is evident from the position/angulation of the pastern that this horse can accept and actually wants those heels lowered."

Thanks for the detailed info. Now you are suggesting that the horse is just begging to have his heal lowered... then if we lower it too much we can wedge it up again. According to the the consensus, it seems that if the horse is uncomfortable with the heel lowered much then we add a wedge and that would work just fine... so in a way we can try it see if it works and recrify it if it doesn't usuing a sound procedure. Would you suggest a gradual lowering of the heel (again I plead ignorance for ****** questions).

"A rim pad is a pad that is cut to fit the width of the web of the shoe only. Basically, the center of the 'full' pad is cut out. Regardless, the fit of the shoe is done as though the horse were wearing a full pad(s), which is why you can get a larger shoe to fit that foot."


I'm still not sure I understand how a rim pad would allow you to use a bigger shoe to match (not aesthetically) but size-wise to the other foot.. Can you explain further?

Patty
"Heres another horse two very bad club feet .
On finished the other bare so you can see how the excess horn in the heels has been removed to encourage better overall foot function, then the foot wedged back up to insure no stress on the shortened muscles and deep flexor tendon. The horse has been that way 18 years. it wasn't something you could fix, but certainly could manage and make the feet better.
That is a GE aluminum wedge shoe, Castle wedge frog support pad, added little piece under the frog support to reach the ground, and dental impresion material fill."

Would you suggest a similar approach to my horses club foot though the other is not? If not what would you suggest not only for the club but for the RF?

I noticed that no one has commented on the glue on shoe... Is that an "issue" for farriers? (again I'm not up on the politics) or is it just not a good idea?

Thanks everyone, Kerrin

[Dave Purves]

These are pics of the same horse I posted earlier. From the front, you can see how much wider I can fit the shoe with the help of the pad. The club foot is two sizes smaller than the "normal" foot. He wears a size 3 kerchart on the good foot, and a size 1 would nail right on the club foot. I added a #6 heavy leather pad with hoofpak to a #3 shoe, shaped it for the club foot and nailed it on.

Dave

[Dave Purves]

This is the normal foot, for comparison.

Dave

[snoopydog]

Again I must say WOW! Now I can see the mechanics and effects of adding a rim pad to a hoof. I just couldn't picture it in my mind. It's almost like your instantly "growing" a hoof to shoe into. Before reading the posts on this thread I had never considered that it was possible to even attempt to make the hooves/ shoes the smae size (and I don't mean look the same).

Now how about the other foot... What would you do?

[Gary Hill]

Does anyone have pictures before and after that include the knees? I have a horse with a club but I have to wedge the good foot to make the knees even??? Thanks, Gary

[calshoer]

One thing I don't really consider in cases of unilateral club feet are the difference in knee height, because the knee difference is due to the difference in ANGLE of the feet not the length of leg. Change the fetlock and/or pastern angle, and the knee height changes.
If I can get both feet landing equally (in other words the same amount of heel first) I am happy.
Because the foot angle will always be different I don't worry about knees. It all seems to take care of itself in the end.
Patty

[Gary Hill]

Patty, the horse in question that I'm working with has a very obvious head bob barefoot and especially wedged or padded on the club foot. I used a flat pad not a wedge and the horse moves very smooth now? Your thoughts? Thanks, Gary

[Ronald Aalders]

Hi Dave,


It seems obvious to me that a club would push the shoulder up on that side. Lifting a shoulder will inevitably bend and rotate the thoracal back and subsequently push in a hip. The effect lumbar may show the most simply because here the back is not "braced" by the ribcage.

I agree that when adressing part of this phenomenen like by using pads may bring some result, but allow me to point out that the club foot is a foot in trouble. The mechanics described more then once on this board (derotation, reducing DDFT pull) are vital to regain a healthy balance in that foot.

If there is to be any attempt to add length like you showed us here you better be very sure you are not just adressing a symptom here. You'ld be surprised how much length a leg may seem to loose or gain simply because of a different use of muscle strength. If you are suggesting differences in length is the main culprit in causing clubs you need to focus on exact ways to measure length in bones first.

Although I can see that bones can have different lengths and may well cause problems like a club foot, I like to adress the problems in the foot first since I found more than once that if that is taken care of properly "all seems to take care of itself", like Patty said.



Ronald Aalders

[snoopydog]

Hello All,
You've given me a lot to think about and research. I have scheduled a full set of radiographs for both front feet and will set up an appointment with the farrier and vet together so we can come up with a long term plan of action. I will bring along some of the info on this post to help them (I'll leave out the friendly banter :) )to help me explain the posibilities.

The question I still have is this
What's a banana shoe and why would you use it? Would it be appropriate for this situation?

I will post the new x-rays when I get them and perhaps you can give me more thoughts with the additional information?

Thanks again and sincerely, Kerrin

[Dave Purves]

Hi Dave,

Hi Ron.


It seems obvious to me that a club would push the shoulder up on that side. Lifting a shoulder will inevitably bend and rotate the thoracal back and subsequently push in a hip. The effect lumbar may show the most simply because here the back is not "braced" by the ribcage.

This may all be true, however, the point of shoulder on the club foot, is a little over 1 inch lower, than the point of shoulder on the opposite foot. I will admit that I'm still trying to figure out the complete mechanics of this hoof conformation, however, I do believe that atrophy of the muscles surounding the shoulder is due to a lack of range of motion. We've all seen the club footed horse at a good extended trot or even as Patty likes to say "a brisk walk" and noticed how much shorter the stride is on the club foot leg. We also generally notice the unwillingness to pick up that lead, and keep it comfortably. What I do understand about the mechanics of this condition, is that when I add a flat pad (thickness depending on severity of club foot is desparity between foot and limb lengths), the strides even out between the limbs, the gait is not as choppy, and picking up and maintaining both leads seems to be easier for the horse and the rider has always commented on how much "smoother" or "easier" the horse is to ride.

I agree that when adressing part of this phenomenen like by using pads may bring some result, but allow me to point out that the club foot is a foot in trouble.

I'm not sure the foot is in as much trouble as the entire limb. But I will agree that there is trouble without a doubt.

The mechanics described more then once on this board (derotation, reducing DDFT pull) are vital to regain a healthy balance in that foot.

I'm not convinced that reducing DDFT pull can only be done with a wedge pad or banana shoe. In laminitis sure, but I don't beleive the mechanics of a club foot are the same, even though the coffin bone may be in relative positions in each instance. I know that the front legs are connected to the "sling", however there is only so much room the "sling" has to accomidate room for the differnce in limb lengths. Even the sling can throw the center of mass off to one side or the other if it's higher on one side. So in the horses way of counter-balancing this deviation, it tries to stand on it's tippy toes, to even out the length difference and place the center of mass back more centrally. Otherwise the horses center of mass would be (in the instance of LF club foot) more toward the left side in the front, and more toward the right side in the back.

If there is to be any attempt to add length like you showed us here you better be very sure you are not just adressing a symptom here.

Symptom of what?

You'ld be surprised how much length a leg may seem to loose or gain simply because of a different use of muscle strength.

You would also be surprised in the diffence in muscle use, by adding length, the horse regains a more normal range of motion, and again, like I said, stride length increases along with comfort.

If you are suggesting differences in length is the main culprit in causing clubs you need to focus on exact ways to measure length in bones first.

I'm not a doctor or a researcher, I am a mechanic and from doing this to several horses, and having the same results,
-increase in stride length
-more even gaits
-willingness to pick up and maintain both leads, when before the horse was unwilling or very un-comfortable in doing so
-a healthier appearance to the foot and leg
-a building of muscles that had been un-used before

So while I won't be coming up with a way to measure bones (I'll leave that to the Doctors) I will continue to take notes on how the mechanics of the limb are getting better. I'm not trying to debunk any theories, I'm simply using what has worked for me on several horses from barely noticable upright feet, to severe clubs like the one I posted here.

Although I can see that bones can have different lengths and may well cause problems like a club foot, I like to adress the problems in the foot first since I found more than once that if that is taken care of properly "all seems to take care of itself", like Patty said.

So when you "derotate" a club foot, and add a wedge pad, you see the limb take care of itself, does that mean the horse will "heal" and develop a normal foot? The club feet I work on do return to a little more normal looking when they start off this severe, however they never return to normal. But I don't think you can fix this foot conformation by only dealing with the foot, you have to take into account the entire limb, cause I'm pretty sure it's the entire limb that is deficient in something, what that something is I'm not sure but I have a pretty good idea and as long as I keep getting the results I'm looking for (better performance) I'll keep at it.



Thanks
Dave

[Ronald Aalders]

Hi Dave,

How can you be so sure that the short stridedness is not a result of a sore foot? Or simply a mechanical result of the akward position of the coffin bone? How can you be sure that the leather rim does not just allow "for a smoother ride"?

This soreness in the clubfoot would be one of the symptoms I was referring to. By adding a leather pad you may (hey, I don't know) well just sooth the foot allowing the horse to move more freely. You'ld be curing a symptom here not a club.

I think I agree that a club must be more than just a foot problem. But then again what about clubs that Redden classifies as grade 4 clubs? The really bad ones? If it would be a result of difference in length of bones, or other problems in a leg you'ld think that that problem you are referring to would stick out enough to be noticed.

What strikes me here Dave that I think I get similar results with stuff like derotation and ease of breakover (e.g. with a banana) as you do with your leather pad. Horses move better, lead changes improve dramatically, trainers happy and I'm the man. But like you I do not know how to turn clubs into normal feet. At best they regain a normal angle but even the most spectacular successes ended up with a narrow (former?) club and a wider foot at the other side. If lucky it would even land more or less even too.

So looking at your approach and mine here we can see common ground. Ease off soreness in the foot. Which may well be the reason why neither of us is capable of really fixing a club back to a normal foot. We can only manage the problem by tackling the symptoms and maybe even have the horse do it's thing in the meantime. Hopefully that is a help to get the horse use all of it's body in a way that helps overcome what ever causes the club. But it does leave me a little frustrated every now and then.


Ronald Aalders

[Dave Purves]

Hi Dave,

Hi Ron.

How can you be so sure that the short stridedness is not a result of a sore foot? Or simply a mechanical result of the akward position of the coffin bone? How can you be sure that the leather rim does not just allow "for a smoother ride"?

Well the horse doesn't react to hoof testers, so I'm guessing it's not a sore foot. I do agree that it is the result of the akward postition of the coffin bone, but the reason the coffin bone is in the akward postition is the question. And the rim may just allow for a smoother ride, so it's working to a degree.

This soreness in the clubfoot would be one of the symptoms I was referring to.

The soreness I see most often in club feet is due to lack of sole depth much like laminitis, so I'm sure raising the foot up off the ground offers some relief.

You'ld be curing a symptom here not a club.

Is there a cure for a club foot? Or can we simply treat the symptoms, and allow the horse to be more comfortable, and do it's job better?

I think I agree that a club must be more than just a foot problem. But then again what about clubs that Redden classifies as grade 4 clubs? The really bad ones? If it would be a result of difference in length of bones, or other problems in a leg you'ld think that that problem you are referring to would stick out enough to be noticed.

Grade 4 club feet in my experience are the direct result of contracted tendons. Why those tendons contract I don't know. But the club feet that I work on most often are the results of genetics, the horses are born with them, sometimes trimming the heels down slowly as babies you can help them out, sometimes you can't.

In the particular horse I posted, the problem in the leg does stick out, the muscles surrounding the shoulder have atrophied, this horse hasn't properly used his shoulder in 4 years. (He's 4 years old). Most times, I look at the point of shoulder in these horses and you can see a difference. In most genetic club feet, even though the coffin bone is at a steep angle, it is lined up for the most part with the rest of the boney column. This would indicate to me that it want to be there for some reason. Only at the end of a long shoeing cycle will the xrays reveal a dropped HPA. This is when the heels have out grown their welcome.

What strikes me here Dave that I think I get similar results with stuff like derotation and ease of breakover (e.g. with a banana) as you do with your leather pad. Horses move better, lead changes improve dramatically, trainers happy and I'm the man. But like you I do not know how to turn clubs into normal feet. At best they regain a normal angle but even the most spectacular successes ended up with a narrow (former?) club and a wider foot at the other side. If lucky it would even land more or less even too

Well the problem with "fixing" or "curing" a club foot lies in the reason it is a club foot to begin with. I personally feel that the limb is shorter, or acts and reacts like it's shorter than it's counterpart. I'm still not sure why you feel the foot is club, but I do understand your shoeing protocol.

So looking at your approach and mine here we can see common ground. Ease off soreness in the foot. Which may well be the reason why neither of us is capable of really fixing a club back to a normal foot. We can only manage the problem and maybe even have the horse do it's thing in the meantime. Hopefully that is a help to get the horse use all of it's body in a way that helps overcome what ever causes the club. But it does leave me a little frustrated every now and then.

I agree, although I don't get too frustrated, cause in the end we at least know that the horse is feeling better whether it's cause we helped the mechanics, or just took away the soreness, the horse is performing better and ultimately that is our job. Once we figure out why the foot is clubbed, we can better understand how to "fix" it. Although like people with odd conformations, it usually takes surgery to fix. Or making adjustments to the way the horse moves, like adding pads, or wedges or bananas.

So, one thing that I would like to know is:
what do you think is the cause of club feet? Let's just say that it was born with a club foot, uni-lateral?

thanks
Dave

[calshoer]

Would you suggest a similar approach to my horses club foot though the other is not? If not what would you suggest not only for the club but for the RF?I treat each foot as an individual, balancing it to it's own sole plane, mapping out my breakover for THAT foot, then using what appliances necessary to get each foot landing slightly heel first. I like the two feet to land equally heel first. If they are doing that, then each leg is reaching to the length of its muscle and tendon potential at that time. I do NOT try to make the pair of feet match in angle or toe length. Just in the landing.
Patty

[calshoer]

Ronald, I use a very similar trim for barefoot chronic founder. I trim the heels from a spot a little further rearward though, roll the toe way back and create that simlar "banana "foot , it works great .
I use it on those who have plenty of sole under p3 and are really old chronics.
I trim newly developing club feet on young horses (generally 12 -15 months) in a similar manner , though I only roll off the last bit of heel. Maybe from about a line halfway back on the bars, to the buttress. It has worked pretty well to stop or reverse the process, as long as I can get to them in the very early stages of the develpment. I try to maintain the trim every week for a few weeks then have the owner keep the toes rolled after that.
Patty

[Ronald Aalders]

Dave, I'm not at all sure what causes a club. Some cases may well be genetic. I have noticed more than once mares passing on their club ánd almost all the time exactly the same foot.

I noticed that when making feet more comfortable (mostly by taking steps to get to a thicker sole), horses start moving better ánd the club is easier to manage. If the origin of the club would be other than the foot itself, I can not really understand why getting a foot more comfortable has that much of an effect.

By the way I'm not sure if there is a difference between a grade 1 club and a grade 4 club other than the seriousness of the condition.

I am sure that the club causes problems elsewhere in the body but I can not deny that those problems could also be the reason for the club. It does give this question a kind of "who was first, chicken or egg" flavour to it.

In favour of a "foot problem" (what ever that problem really is) as the root cause would also plead the fact that some horses have two clubs. It's hard to see how differences somewhere in the body could cause two clubs. The differences would equal each other out. Perhaps the fact that clubs almost only happen to fronts is a pro foot argument too. Like I said on really bad clubs (in fact life threatening ones) you don't really see anything else in a horse that really sticks out as a problem responsible for that club. IMO this would add to the pro foot camp.

It does strike me that a lot of young horses that appear to have a tendency towards a club devellop one once they're in training. You know Futurity prospects that get chased around. They devellop clubs whatever you try and do. Sofar I have been reluctant to use "high end mechanical devices" to try and prevent those feet (that in my opinion are at risk) develloping full scale clubs. The problem here is that I can see a foot having a stronger heel than the other, I can see the heels slowly growing in giving them that "hawk beak" appearance Redden mentioned, but the amount of vets that are also capable of seeing that in a foot are very, very, very rare.

The reason I've been reluctant to try any preventing steps is what do I say? How do I answer a trainer or owner when they ask me why I shod their expensive promising 2 yr/o with nice aluminum bar shoes with frog support plates and hoofpack? There is nothing wrong with the horse? Even the vet said he was fine! Shoot, he was fully vet checked two months ago when we bought this prospect! There was nothing wrong! Well, you know how it goes. That's a bit of the frustration I was talking about.

Patty quoted a question on working on just the club. I never liked that approach. What I like to do is even out palmar angles as much as possible. Often the not club side is close to a zero degree palmar angle or on its way, while with enough heel I can bring back the club to that angle. By then both feet are in need of wedges, ease of breakover and hoofpack. In my work I do my best to even out the feet as much as possible, simply because the impact of the feet on body position and the way horses use their back is so big. Working on just one foot would in my humble opinion just increase the risk of getting things even more out of whack.



Ronald Aalders

[calshoer]

In my work I do my best to even out the feet as much as possible, simply because the impact of the feet on body position and the way horses use their back is so big. Working on just one foot would in my humble opinion just increase the risk of getting things even more out of whack.I do work on both feet, but it is to achieve optimal breakover and balance in both feet as individuals.
I have found that by doing this, the feet then tend to change. The low one becomes better, more upright and concave. better heels, (as one farrier said("Gathered up) , and the clubby one becomes less clubby with every shoeing. I find that the club foot will exfoliate more sole in the heel area with each shoeing and I can then lower the heels more, with less wedge or no wedge, still get my heel first landing, and eventually the two feet match better.
By evening out the foot landings rather than the angles, maybe we are both affecting the same kind of positive changes in the upper body but from a different perspective ?
Anyway it works for me :) Patty

[snoopydog]

So I have added more x rays. I met with my vet. He thinks, upon doing the exam that my horse's leg is shorter and needs a thick pad to add hight and that there should be enough hoof wall to nail into. So he think that this is not a club foot caused by a DDFT pull so much as a heel wanting to grow out to even out his shoulders. He also said that he has pedalosteitis of the coffin bone because of the repetitive concussion over the years. However he did say that the x-ray looked much better now than it did in July...(since we started with the glue on shoes)

So that's what we did. We trimmed as much heel off as possible packed it and added a thick pad and an NB. The problem with nailing the shoe was that she couldn't get anough nails in because of the boxy shape of the hoof.
However the difference to the horse was phenominal. He felt different, he seemed more comfortable and his strides were even. He even started to pick up the correct lead more easily.

So my problem? He threw the shoe in 2 weeks and ripped out the hoof wall. Oh I wish I had taken picures...

So my question... Can I use apoxy or something like that to build up the hoof wall and try again? Is there such a thing as that kind of technique? Or should I go back to glue ons? Anysuggestions?
Thanks for your help.
Original x-rays and pictures
http://members.cruzio.com/~kerrin/

New x-rays and pictures.
http://members.cruzio.com/~kerrin/right-top-2_06.jpg
http://members.cruzio.com/~kerrin/Right-coffin_pastern_canno.jpg
http://members.cruzio.com/~kerrin/Left-top-2_06.jpg
http://members.cruzio.com/~kerrin/Left-lateral-2_06.jpg
http://members.cruzio.com/~kerrin/Left-coffin_pastern_cannon.jpg

[Rick Burten]

The problem with nailing the shoe was that she couldn't get anough nails in because of the boxy shape of the hoof.
The idea is not to pull the shoe out of the box and nail it on, rather to shape/conform the shoe to fit the foot and then nail it on. Apparently, this was not done.
So my problem? He threw the shoe in 2 weeks and ripped out the hoof wall.
So my question... Can I use apoxy or something like that to build up the hoof wall and try again? Is there such a thing as that kind of technique? Or should I go back to glue ons? Anysuggestions?
There are some excellent composites for rebuilding the hoof. Your farrier should be well aware of these and should have a working knowledge of how to use them. Additionally, the shoes should probably have some side or quarter clips drawn and above all, the shoe should be shaped to the shape of the inner edge of the white line and its width and length should reflect the addition of the pad.
Glue-ons are, of course, an option, and depending on the extent of the damage, may be the best viable short term one.
Alternatively, your farrier should be able to build a shoe to fill the needs, from bar stock and then she would be able to place the nail holes in precisely the proper location to insure that they were able to properly affix the shoe to the hoof.

[kanderso]

[QUOTE=Rick Burten]....
It is also my conviction that absent surgical intervention, we never really "cure" a front limb club/upright hoof. Especially in horses over the age of two.

And it seems that even with surgical intervention we don't always cure the problem.

My colt had the check ligament desmotomy at 14 months and wore the extended toe shoe for 3 months, yet at 21 months he's still one up/one down.

I have a feeling that the club foot is better than it would have been without the surgery (although I wouldn't swear to that), but I also have a feeling that the problem that caused the club foot in the first place is still there.

At this point I can only hope that the club foot stays the way it is and doesn't get worse, because from what I've been reading it's not all that uncommon for horses to have the surgery and then go right back to developing a club foot as soon as the tendon heals.

Does anyone have any experience with this? How common is it for youngsters to have the surgery and then end up with a grade 2 or worse club foot, anyway?

Kris

[calshoer]

My colt had the check ligament desmotomy at 14 months and wore the extended toe shoe for 3 months, yet at 21 months he's still one up/one down. Sometimes the extended toe shoe is left on too long. If it is left on beyond the time the ligament is healed, the DDFT pull will again be too much because of the leverage in the long toe ,and bone rotation can start all over again. Timing is EVERYTHING when dealing with the combination of surgery and foot manipulation. They must work together, in perfect sync.
As soon as ligament is healed, the toe extension MUST be taken off to prevent undue strain in the DDFT and healed ligament, and re rotating the bone again. Patty

[THamilton]

Tony's 2 cents here:

Anoter thing to keep in mind too...

... after the shoe was removed, you cannot considered the issue "fixed" and move on like nothing happened. You must keep addressing the horse with a regular schedule of foot maintence. This doesnot mean you seee the farrier every three to four months. Regular trimming using the live sole as a guide will continue to aide in the foot developmnet. I am not saying this will cure the issue, but it is one thing to keep in mind. I am also NOT saying that you neglected or failed to have the horse trimmed in any manner.

I have seen it go both ways. I have seen horses that the surgery has helped and the owners did little after the initial shoes was pulled off. I have also seen horses on a regular schedule that have a lesser graded club foot than would have occurred if noting had happened. The flip side is always true. I have seen these casses go awry too and still remain a grade two.

Just adding to the convo here. Not degrading anyone (boy how we sish we could degrade those club feet :rolleyes: )

Thanks,
Tony

[kanderso]

[QUOTE=THamilton]Tony's 2 cents here:

>I am also NOT saying that you neglected or failed to have the horse trimmed in any manner.

Oh he got trimmed. Heck, that colt has had his feet inspected more than any other colt on earth. ;-)

At first the clubby hoof spread out quite a bit after the surgery and I thought it was going to match the other one, but now that he's almost got a new hoof I can see that the clubby one is still clubby.

>I have also seen horses on a regular schedule that have a lesser graded club foot than would have occurred if noting had happened.

Course how can we ever know what would have happened if we hadn't done any surgery? From what I'm reading some clubs correct themselves, some get worse, and some stay the same.

I wish I had a set of twins with club feet so I could have done the surgery on one and just trimmed the other. Or better yet, I wish I had a whole herd of club footed foals, a herd of genetically similar normal footed foals, and a huge grant. :-)

>The flip side is always true. I have seen these casses go awry too and still remain a grade two.

Well if this colt dies you can bet that I'm going to dissect his entire front end and see if I can figure out if there's any difference between the sides. I can't see anything different other than that one hoof is clubbier, and I watch him go all the time, but without opening him up and looking inside I'm not sure anyone could really be sure.

And even then....

Someone, somewhere must have dissected some of the really bad cases of club feet that had to be put down. Course then I suppose there's always the question of which came first, the club foot, or any changes in the legs/shoulder/back....?

(Can you tell that I'm one of the many who would really like to know what causes club feet?)

Kris