Harrisburg, South Dakota

Excellence in Large Animal Medicine and Surgery since 1981!

 

 

Club Feet

    A four-year-old pony mare was presented to the clinic for treatment of a conformational defect of her front feet known as club feet or flexor tendon contraction.  Lateral radiographs of the feet confirmed the physical appearance noted.  A club foot is one that has a foot axis of 60 degrees or more.  Severe cases have the appearance of the hoof wall having a very vertical "up and down" angle with a long high heel and shot toe.

    Several types of club foot exists.  Some milder grades can be corrected with proper trimming or shoes.  This was the initial treatment used for this mare's condition along with anti-inflammatory medications.  Then she was shod three months later with a four point shoe.  Improvements were noted on radiographs at this time.  Our concern however was that her right front heel did not contact the ground and the slight lameness associated with that did not resolve completely.  We recommended performing an inferior check ligament desmotomy.  This would relieve the tension in the tendon to allow the heel to contact the ground.

    A serious form of club foot is caused by a relative shortening of the deep digital flexor tendon that attaches to the coffin bone which results in a flexural deformity at the coffin joint.  As this tendon continues to contract; it pulls the heels off the ground and they tend to grow long.  The horse's weight is then shifted onto the toe, which causes excessive wear and dishing of the toe.(1)

    Club feet have been classified into four grades.

  1. The feet are mismatched and the hoof angle of the affected foot is three to five degrees greater than that of the opposite foot.

  2. The angle of the affected foot is five to eight degrees greater than the other foot.  Growth rings are present and the sole touches the ground.  The heel will not have contact to the ground when trimmed normal length.

  3. A dish is prominent on the dorsal hoof wall and growth rings are twice as wide at the heels than the toe.  The coronary band protrudes over the dorsal surface of the hoof wall.  Radiographic changes of the coffin bone may start to be present.

  4. The affected hoof wall angle is eighty degrees or greater and a dish is very prominent to the dorsal hoof wall.  The sole of the hoof bears the majority of the weight and on radiographs the coffin bone may appear to be rotated. (2)

    Treatment of a club foot is aimed at re-aligning the hoof pastern axis by lowering the heels and preventing further wear of the toe.  This can usually be achieved in grades 1 and 2.

    In grades 3 and 4 the preferred approach is to elevate the heels with an elevated shoe or wedge pad.  This procedure allows the heel to bear weight, takes pressure off of the toe and lessens the constant strain of the deep flexor tendon.  When the horse still can not be comfortable due to the tendon contracture the surgery is preformed to help correct this deformity with great success.

    This surgery was preformed under general anesthesia and the aftercare instructions included bandages, daily exercise and anti-inflammatory medications (Bute) given as needed for pain and continual farrier visits.  On her follow up exam two weeks after surgery the mare was moving sound and the heel had normal contact with the ground surface.

(1) Reference - Adams Lameness Horse

(2) Reference - Adams Lameness Horse

 

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Last modified: 02/13/08