Clubfoot


Club Foot

Club Foot

Not Club Foot

Not Club Foot

These are X-Rays of the front feet of a yearling filly.  The first figure is the right foot, the bottom is the left. The top photo depicts a classic clubfoot, the bottom is a normal foot.  The external evidence indicating it is a clubfoot is the curved, dished wall of the foot. The coffin joint angle is the radiographic evidence showing it’s a clubfoot. The angle between the coffin bone (P3) and the short pastern (P2) is ‘broken’, whereas in the non-clubfoot, the angle is smoother, more of a straight line. The clubfoot even shows a ski tip already from high heels and rotation putting pressure on the coffin bone tip.

Below is an Xray of a Right Front hoof.  The right side is the medial side, the left is the lateral one. (The view is from the front).

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The two views are the same, one shown un-marked up for clarity.

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 The tops of the collateral grooves are indicated with red marks.  The depth of the collateral groove is determined by the height (or length) of the bar, which is not visible on xray. The collateral groove on the medial side is very deep, much more so than the lateral side. It appears to be projecting up into the bottom of the coffin bone which is probably very painful, since this area is full of sensitive tissue.  The bar and collateral groove has pushed up the inside side of the foot, displacing the balance of the foot.   The inside wall is much higher and longer than the outside. The hairline and top of the wall/coronary band are indicated with the red arrows. The two points should be straight across, parallel with the ground. Another detrimental effect of this deep collateral groove is the displacement of the P3/P2 joint. The joint space is narrower on the outside, wider on the inside.  This can lead to ossifications and arthritic problems such as sidebone and ringbone.

Lowering the bar on the inside to the same length as the outside will correct these balance problems.

From the November EVJ.  This study concludes that close to half of foals can develop club-footed tendencies early in life due to their conformation.  The full text of the study is available online at the journal’s website with a subscription:

http://www.evj.co.uk/index.htm

Uneven feet in a foal may develop as a consequence of
lateral grazing behaviour induced by conformational traits

M. C. V. VAN HEEL*, A. M. KROEKENSTOEL, M. C. VAN DIERENDONCK, P. R. VAN WEEREN and W. BACK
Derona Equine Performance Laboratory, Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12,
NL-3584 CM Utrecht, The Netherlands.

Abstract:
Reasons for performing study: Conformational traits are important in breeding, since they may be indicative for performance ability and susceptibility to injuries.
Objectives: To study whether certain desired conformational traits of foals are related to lateralised behaviour while foraging and to the development of uneven feet.
Methods:
Twenty-four Warmblood foals, born and raised at the same location, were studied for a year. Foraging behaviour was observed by means of weekly 10 min scan-sampling for 8 h. A preference test (PT) was developed to serve as a standardised tool to determine laterality. The foals were evaluated at age 3, 15, 27 and 55 weeks. The PT and distal limb conformation were used to study the relation between overall body conformation, laterality and the development of uneven feet. Pressure measurements were used to determine the loading patterns under the feet.
Results:
About 50% of the foals developed a significant preference to protract the same limb systematically while grazing, which resulted in uneven feet and subsequently uneven loading patterns. Foals with relatively long limbs and small heads were predisposed to develop laterality and, consequently unevenness.
Conclusions:
Conformational traits may stimulate the development of laterality and therefore indirectly cause uneven feet.

For an illustration, please see this case of a club-footed 9-month old filly, posted earlier here.

rfsm.jpgThis is a 9 month old filly whose right front foot is clubby. It has been shod on the recommendation of several vets and farriers who believe the tendon is ‘tight’ (despite no evidence to indicate this), and shoeing it and gradually lowering the heel is expected to correct this situation.

The toe wall has begun to bulge out,  possibly  as a result of the shoe ‘holding’ the bottom of the foot while the rest of the foot tries to grow outward.

 

lfsm.jpg The left front leg is shown for comparison. Note the differences in the angle of the long pastern bone (P1)  in relation to the  short pastern bone (P2)

 

 

 

 

 

 

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side2.JPG               sole-2.JPG

This is a 5 yo Morgan mare. The trim was started at age 3, and the second row of pictures shows the progress after about one year.

With frequent trimming, the heel has been kept low and the coffin bone placed in a near-ground parallel orientation.  This has enabled the dish in the toe wall to grow out, and the hoof rings to become somewhat more concentric (more equal distance between them at the heel and at the toe.  When the heel grows faster than the toe, the rings are wider at the heel.   A healthy foot’s growth should be even all around with equidistant rings).  However by the age of three there was already considerable joint adaptation in the coffin joint, creating the broken forward hoof-pastern axis. 

dressage-test-corner.jpg © James Matteson

The mare recently competed in her debut dressage show, winning her Intro test amongst a class of six, as well as getting an award for second highest score of the day.  She has a bright future ahead of her as an all-around fun horse.