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How To Treat Club Feet And Closely Related Deep Flexor Contraction

2003 - 16th Annual Bluegrass Laminitis Symposium Notes How To Treat Club Feet And Closely Related Deep Flexor Contraction

Written and presented January 2003 by R.F. (Ric) Redden, DVM

Products for Club Feet Before we begin discussing how to treat any foot problem, we must first take a closer at the details of the respective foot. Many years ago, I found a need to develop a very simple classification system that would allow horseman, veterinarians and farriers to better communicate. Using the graded scale of 1-4 allows everyone involved to be on the same page when discussing a particular case.

Club feet are the result of mechanical imbalances that are most likely attributed to malfunctions within the deep digital flexor muscle belly. The muscle fibers normally receive an electrical stimulus that tells them to contract. This causes the fibers to shorten and subsequently move load. Apparently the imbalance is a problem at the synopsis (nerves/muscle cell unit), which results in the muscle receiving a continuous command to contract. This spastic muscle transfers the constant shortening, or pulling, to the tendon that is firmly attached to the semi-lunar crest along the posterior palmar surface of the coffin bone. Shortening the distance from the origin to the insertion point pulls the coffin bone around its articular axis.

In very soft footing, the laminae and hoof capsules move simultaneously with the flexion of the joint. Anything that changes the free flow action creates a resistance that is directly proportional to the forces at play. Basic ways to increase the counter forces placed on the muscle, tendon, bone, laminae and hoof wall network are:

1. Lower the palmar angle without decreasing the digital breakover. Lowering the heel in an effort to treat the high-heel club significantly increases the tension within the network.

2. Increase the length of digital breakover. Extend the toe using a shoe or composite also increases the forces within the network.

3. Lowering the heel and extending the toe tremendously increase the tension on all structures.

Listed above are three basic treatment plans that are often used in an effort to minimize the high heel/no toe growth syndrome. The counter-pull mechanical plan can be effective on low grade clubs, however it can create a devastating sequence of events for the higher grades. This reinforces the reasons to have a meaningful scale. It allows us to customize each treatment plan to the specific demands of each case.

The grading system for a club foot horse is quite simple, it is broken down into four categories. For individuals who have used it for several years, it can be broken down into twelve categories, grades -1, 1, +1; -2, 2, +2; etc. Note the diagrams below and basic guidelines that will help you quickly develop an eye for all four grades.

The following text corresponds with the images above: Grade 1 -- The hoof angle is 3-5 degrees greater than the opposing foot and a characteristic fullness is present at the coronary band due to the partial luxation of P2 and P3.

Grade 2 -- The hoof angle is 5-8 degrees greater than the opposing foot with growth rings wider at the toe. The heel will not touch the ground when trimmed to normal length.