Effect of three shoe types on the duration of breakover in sound trotting horses

In a controlled experimental study, eight sound horses were shod with a plain steel shoe on one forelimb (control limb) and with four different shoe types on the other forelimb (treated limb). The four shoe types used on the treated limb were a plain steel shoe, a rocker-toe shoe, a rolled-toe shoe, and a square-toe shoe. The selection of the treatment limb (left or right) was randomized between the horses and a replicated Latin square design was used to determine the order of application of the shoes to the treatment limb. High speed cinematography (200 frames/s) was used to film the horses trotting in hand on a concrete surface. Eight strides were analyzed for each shoeing treatment. The breakover times of both forelimbs were measured, and the breakover ratio was computed as the ratio between the breakover time of the treated limb to the breakover time of the control limb. The results of an analysis of variance, using a probability of 0.05 alpha, showed that the breakover ratio did not differ significantly between the four types of shoes (p=0.10). It is concluded that, in sound horses trotting at a slow speed on a hard surface, the application of a rocker-toe shoe, a rolled-toe shoe or a square- toe shoe did not shorten forelimb breakover duration significantly compared with a plain steel shoe.     

Compensation for changes in hoof conformation between shoeing sessions through the adaptation of angular kinematics of the distal segments of the limbs of horses

OBJECTIVE: To determine the mechanism that enables horses to partially counteract the shift of the center of pressure under the hoof induced by changes in hoof morphology attributable to growth and wear during a shoeing interval. ANIMALS: 18 clinically sound Warmblood horses. PROCEDURES: Horses were evaluated 2 days and 8 weeks after shoeing during trotting on a track containing pressure-force measuring plates and by use of a synchronous infrared gait analysis system set at a frequency of 240 Hz. All feet were trimmed toward straight alignment of the proximal, middle, and distal phalanges and shod with standard flat shoes. Results-Temporal characteristics such as stance time and the time between heel lift and toe off (ie, breakover duration) did not change significantly as a result of shoeing interval. Protraction and retraction angles of the limbs did not change. Compensation was achieved through an increase in the dorsal angle of the metacarpohalangeal or metarsophalangeal (fetlock) joint and a concomitant decrease of the dorsal angle of the hoof wall and fetlock. There was an additional compensatory mechanism in the hind limbs during the landing phase. CONCLUSIONS AND CLINICAL RELEVANCE: Horses compensate for changes in hoof morphology that develop during an 8-week shoeing interval such that they are able to maintain their neuromuscular pattern of movement. The compensation consists of slight alterations in the angles between the distal segments of the limb. Insight into natural compensation mechanisms for hoof imbalance will aid in the understanding and treatment of pathologic conditions in horses.     

Use of a pressure plate to analyse the toe-heel load redistribution underneath a normal shoe and a shoe with a wide toe in sound warmblood horses at the walk and trot

The objective of this study was to use a pressure plate to quantify the toe-heel load redistribution in the forelimbs of sound warmblood horses with normal shoes and shoes with a wide toe and narrow branches, used empirically in the treatment of superficial digital flexor tendon or suspensory ligament injuries. In a crossover-design study, six horses, randomly shod with normal shoes and shoes with a wide toe, were led over a dynamically calibrated pressure plate to record data from both forelimbs. There were no significant differences between both shoes in the toe-heel index of stance time, peak vertical force and vertical impulse. For the adapted shoe, the peak vertical pressure was slightly lower and was exerted slightly earlier in the stance phase, albeit not significantly. However, the significantly larger toe contact area of the adapted shoe resulted in a significantly lower total vertical pressure in the toe region. Hence, the pressure plate adequately visualised the individual loading of the toe and heel region, and clearly demonstrated the altered pressure distribution underneath the shoe with a wide toe. Although further research on a deformable surface is needed to confirm this hypothesis, the pressure redistribution from the toe to the heels could promote sinking of the heels in arena footing, thereby mimicking the biomechanical effects of a toe wedge and providing a rationale for its application in the treatment of SDFT or SL injuries. The pressure measuring equipment used in this study can offer to the clinician a diagnostic tool for the evaluation of the load distribution underneath the equine hoof and for the fine-tuning of corrective shoeing.     

Changes in location of centre of pressure and hoof-unrollment pattern in relation to an 8-week shoeing interval in the horse

REASONS FOR PERFORNING STUDY: In order to optimise shoeing and shoeing conditions, it is essential to know how the horse adapts to a common shoeing interval. OBJECTIVES: To measure changes in location of the centre of pressure (CoP) and hoof-unrollment pattern during a shoeing interval and to assess whether these changes in CoP result directly from changes in hoof conformation or are also influenced by compensatory mechanisms. METHODS: Eighteen horses were trotted over a pressure-force measurement system shortly after shoeing and 8 weeks later. The position of the CoP was measured and also predicted using calculations based on changes in hoof conformation. RESULTS: The measured shift in CoP was less than calculated. This difference was largest in the hind feet. The hoof-unrollment pattern stayed basically the same in the front feet, but in the hind feet there was a substantial lateral shift of the trajectory of the CoP. CONCLUSIONS: Horses can compensate, to a certain extent, for changes in hoof conformation that develop during 8 weeks on shoes. As the capacity to compensate is less in the forelimbs, the relative increase in loading of these limbs during a shoeing interval is larger than in the hindlimbs. Potential relevance: This study provides essential basic data for the development of science-based shoeing techniques.     

The effect of plain, eggbar and 6 degrees-wedge shoes on the distribution of pressure under the hoof of horses at the walk

AIM: To quantify the effect of plain, wedged and eggbar shoes on the distribution of pressure under the hoof of horses at the walk, at selected areas of interest (AOI), to find scientific evidence for the perceived efficacy of these shoes in the treatment of palmar heel pain. METHODS: Six clinically sound adult Warmblood mares weighing 551 (SD 25) kg were shod (forelegs) with either plain, eggbar or 6 degrees-wedge shoes using a latin-square experimental design. All horses were shod by the same farrier, and each balanced and aligned for its individual conformation. Data were collected on three walking strides for each foreleg using a 550 x 405-mm pressure plate to quantify the distribution of pressure under each type of shoe at five AOI. RESULTS: Landing of the hoof with all three shoes was predominantly from lateral to medial (range 7-15 msec). Irrespective of the type of shoe, the greatest pressure was found in the lateral and medial toe (lateral 39.7 (SE 0.6) N/cm2 and medial 35.0 (SE 0.5) N/cm2) and the point of the toe (33.3 (SE 0.5) N/cm2). The lowest peak pressure was in the heel (lateral 25.9 (SE 0.5) N/cm2 and medial 21.1 (SE 0.4) N/cm2; p<0.05). Eggbar and wedge shoes increased total stance time (938 (SE 8) msec and 952 (SE 6) msec, respectively) compared with plain shoes (898 (SE 14) msec) (p<0.05). The wedge shoe reduced breakover compared with the plain and eggbar shoes (13.8% vs 15.8% and 14.5%, respectively; p<0.05). The eggbar shoe had lower total shoe peak pressure (29.5 (SE 0.7) N/cm2) than plain (31.8 (SE 0.5) N/cm2) and wedge (30.9 (SE 0.6) N/cm2) shoes. CONCLUSIONS AND CLINICAL RELEVANCE: Both the eggbar and 6 degrees-wedge shoe offer advantages for palmar heel pain. In comparison to the plain shoe, the eggbar shoe had less peak pressure at the heel AOI, and across the entire shoe, due to the greater bearing surface and the effect of the longer heel. The 6 degrees-wedge shoe had greater loading on the lateral heel AOI, but promoted earlier breakover at the toe. Both shoes offer advantages for the horse with palmar heel pain, though choice of shoe will depend on clear identification of the causative factors, to provide therapeutic shoeing that maximises the individual horse's response.     

A comparison of three horseshoeing styles on the kinetics of breakover in sound horses

A variety of horseshoe designs are believed to 'ease' breakover, or the unloading of the foot once the heels leave the ground. In this study, conventional toe-clip shoes, quarter-clip shoes, fitted to the white line at the toe, and Natural Balance horseshoes were fitted to the front feet of 9 sound Irish Draught-cross type horses. Forceplate and video motion analyses were undertaken during trot locomotion to determine the moment arm of the ground reaction force on the distal interphalangeal (DIP) joint, the peak DIP joint moment and the peak compressive force on the navicular bone. DIP joint moment arm during breakover was reduced with both Natural Balance (mean +/- s.d. 77 +/- 7 mm) and quarter-clip shoes (78 +/- 9 mm) compared to the toe-clip shoes (86 +/- 6 mm) (P<0.01). Peak DIP joint moment was not significantly different (175 +/- 37,171 +/- 38 and 175 +/- 31 Nmm/kg, in Natural Balance, quarter-clip and toe-clip shoes, respectively) and neither was peak force on the navicular bone (5.52 +/- 1.52, 5.79 +/- 1.53 and 6.14 +/- 1.47 N/kg, respectively). Breakover duration (heel off to toe off) was not significantly reduced by the Natural Balance shoes (39 +/- 6 ms) or the quarter-clip shoes (40 +/- 6 ms) compared to toe-clip shoes (42 +/- 9 ms). This study has demonstrated that the use of Natural Balance shoes reduces the moment arm of the ground reaction force (GRF) during breakover but does not reduce the peak DIP joint moment or the force on the navicular bone.     

The art of horseshoeing--between empiricism and science

To correctly shoe a horse requires the farriers to have a good working knowledge of postural anomalies and movement patterns, as well as of the different concepts of horseshoeing and to be able to apply the appropriate technique to every individual horse they shoe. The correct technique for specific problem cases is frequently a subject of debate amongst specialists and many theories would benefit from objective gait analyses. The case study presented examines the influence of different shoeing conditions on selected gait analysis parameters. The measurements were conducted on a Warmblood mare: (A) shod with long toes, (B) properly trimmed without shoes, (C) conventionally shod with rolled toes and finally (D) shod using the 4-point technique. Data on force-, time- and distance parameters were recorded using an instrumented treadmill. First contact and breakover of the hooves were documented using high-speed videography. A long toe resulted in a prolongation of the breakover time and, therefore, in a prolongation of the second half of the stance phase. Additionally, the prolonged stance duration associated with an unaltered force impulse, led to decreased force peaks. It was possible to objectively record differences between the trimmed, unshod foot, the shod long-toe and the shod rolled toe configurations. The differences between the rolled toe and the 4 point shoe however, were minimal. Gait analysis is a technique well suited for objective evaluation of different shoeing techniques under standardised conditions.     

Hoof growth between two shoeing sessions leads to a substantial increase of the moment about the distal, but not the proximal, interphalangeal joint

REASONS FOR PERFORMING STUDY: There is little insight into the effects of routine farriery on the internal structures of the distal limb in sound horses. OBJECTIVES: To measure the effect of change in hoof conformation during a shoeing interval on the moments about the proximal and distal interphalangeal joints (PIPJ, DIPJ) and to determine whether and how the horse compensates for this change in hoof conformation. METHODS: Both front feet of 9 sound Warmblood horses were measured while standing on a pressure-force measuring system and radiographed in a lateromedial direction shortly after shoeing and 8 weeks later. From these data, ground reaction forces (GRF) and lever arms were measured in order to calculate joint moments. RESULTS: After 8 weeks, the moment about the PIPJ did not increase significantly, but the moment about the DIPJ did so, indicating a compensatory mechanism for a change in hoof conformation in the DIPJ. CONCLUSIONS: Standing horses compensate for hoof conformation change during an 8-week shoeing interval, which leads to increased DIPJ extension and consequently an increased loading of the deep digital flexor tendon. POTENTIAL RELEVANCE: This study quantifies the effect of a shoeing interval on the internal structures of the foot and helps to determine an appropriate shoeing interval for individual horses in which the hoof with the lowest hoof angle is the best indicator. The exact determination of an optimal individual shoeing interval requires further study.     

Long Toes in the Hind Feet and Pain in the Gluteal Region: An Observational Study of 77 Horses

This study deals with the relationship between long toes in the hind feet and pain in the gluteal region in horses, and the remedial value of trimming/shoeing that moves the breakover point back at the toe. Seventy seven client-owned horses were studied, 67 shod riding horses retrospectively and 10 barefoot broodmares prospectively. The 10 mares were evaluated twice, and 24 of the 67 riding horses were re-evaluated at the next shoeing, for a total of 111 observations. Each horse underwent gluteal palpation and lateral radiographs of both hind feet. Toe length was quantified as breakover distance (BD), the horizontal distance between the tip of the third phalanx and the dorsalmost point at which the wall/shoe was in contact with the ground. The BD was then shortened with trimming +/− shoeing to a length of ≤15mm (shod horses) or ≤20 mm (barefoot horses). The 24 riding horses were re-evaluated 4-6 weeks later and the 10 broodmares 1 week after trimming.     

Shoeing principles for the management of navicular disease in horses

Navicular disease was diagnosed in 36 horses. Each horse was treated, using shoeing as the only major means of treatment. Phenylbutazone was used initially for 10 days after shoeing. Shoeing was designed to correct preexisting problems, enhance physiologic function of the foot, and ease breakover of the foot. The horses were evaluated over a period ranging from 12 to 54 months. The lameness improved in all horses. Thirty-one of the 36 horses treated were not lame when last evaluated. Shoeing was most effective when performed within 8 months of the first signs of lameness. Also, horses used for show ring performance classes had a better response to treatment than did horses used for gaming or jumping.     

Use of gyroscopic sensors for objective evaluation of trimming and shoeing to alter time between heel and toe lift-off at end of the stance phase in horses walking and trotting on a treadmill

OBJECTIVE: To determine whether a shoe with an axialcontoured lateral branch would induce greater lateral roll of the forelimb hoof during the time between heel and toe lift-off at end of the stance phase (breakover). Animals-10 adult horses. PROCEDURE: A gyroscopic transducer was placed on the hoof of the right forelimb and connected to a transmitter. Data on hoof angular velocity were collected as each horse walked and trotted on a treadmill before (treatment 1, no trim-no shoe) and after 2 treatments by a farrier (treatment 2, trim-standard shoe; and treatment 3, trim-contoured shoe). Data were converted to hoof angles by mathematical integration. Breakover duration was divided into 4 segments, and hoof angles in 3 planes (pitch, roll, and yaw) were calculated at the end of each segment. Multivariable ANOVA was performed to detect differences among treatments and gaits. RESULTS: Trimming and shoeing with a shoe with contoured lateral branches induced greater mean lateral roll to the hoof of 3.2 degrees and 2.5 degrees during the first half of breakover when trotting, compared with values for no trim-no shoe and trim-standard shoe, respectively. This effect dissipated during the second half of breakover. When horses walked, lateral roll during breakover was not significantly enhanced by use of this shoe. CONCLUSIONS AND CLINICAL RELEVANCE: A shoe with an axial-contoured lateral branch induced greater lateral roll during breakover in trotting horses, but change in orientation of the hoof was small and limited to the first half of breakover.     

The horse-racetrack interface: a preliminary study on the effect of shoeing on impact trauma using a novel wireless data acquisition system

REASONS FOR PERFORMING STUDY: There is a need to determine accelerations acting on the equine hoof under field conditions in order to better assess the risks for orthopaedic health associated with shoeing practices and/or surface conditions. OBJECTIVES: To measure the acceleration profiles generated in Thoroughbred racehorses exercising at high speeds over dirt racetracks and specifically to evaluate the effect of a toe grab shoe compared to a flat racing plate, using a newly developed wireless data acquisition system (WDAS). METHODS: Four Thoroughbred racehorses in training and racing were used. Based on previous trials, each horse served as its own control for speed trials, with shoe type as variable. Horses were evaluated at speeds ranging from 12.0-17.3 m/sec. Impact accelerations, acceleration on break over and take-off, and temporal stride parameters were calculated. Impact injury scores were also determined, using peak accelerations and the time over which they occurred. RESULTS: Recorded accelerations for the resultant vector (all horses all speeds) calculated from triaxial accelerometers ranged 96.3-251.1 g, depending on the phase of the impact event. An association was observed between shoe type and change in acceleration in individual horses, with 2 horses having increased g on initial impact with toe grab shoes in place. In the final impact phase, one horse had an increase of 110 g while wearing toe grab shoes. Increased accelerations were also observed on break over in 2 horses while wearing toe grab shoes. CONCLUSIONS: Shoe type may change impact accelerations significantly in an individual horse and could represent increased risk for injury. Further work is needed to determine if trends exist across a population. POTENTIAL RELEVANCE: The WDAS could be used for performance evaluation in individual horses to evaluate any component of the horse-performance surface interface, with the goal of minimising risk and optimising performance.     

The hindlimb in walking horses: 1. Kinematics and ground reaction forces

The objective was to study associations between kinematics and ground reaction forces in the hindlimb of walking horses. Video (60 Hz) and force (2000 Hz) data were gathered for 8 strides from each of 5 sound horses during the walk. Sagittal plane kinematics were measured concurrently with the vertical and longitudinal ground reaction forces. The hindlimb showed rapid loading and braking in the initial 10% stride. The stifle, tarsal and coffin joints flexed and the fetlock joint extended during this period of rapid loading. The vertical ground reaction force showed 2 peaks separated by a dip; this pattern was similar to the fetlock joint angle-time graph. Peaks in the longitudinal ground reaction force did not appear to correspond with kinematic events. Total braking impulse was equal to total propulsive impulse over the entire stride. Flexion and extension of the hip were responsible for protraction and retraction of the entire limb. Maximal protraction occurred shortly before the end of swing and maximal retraction occurred during breakover. During the middle part of stance the tarsal joint extended slowly, while the stifle began to flex when the limb was retracted beyond the midstance position at 28% stride. Flexion cycles of the stifle and tarsal joints were well coordinated during the swing phase to raise the distal limb as it was protracted. The results demonstrate a relationship between limb kinematics and vertical limb loading in the hindlimbs of sound horses. Future studies will elucidate the alterations in response to lameness.     

Injection of corticosteroids, hyaluronate, and amikacin into the navicular bursa in horses with signs of navicular area pain unresponsive to other treatments: 25 cases (1999-2002)

OBJECTIVE: To determine history, clinical and radiographic abnormalities, and outcome in horses with signs of navicular area pain unresponsive to corrective shoeing and systemic nonsteroidal anti-inflammatory drug administration that were treated with an injection of corticosteroids, sodium hyaluronate, and amikacin into the navicular bursa. DESIGN: Retrospective study. ANIMALS: 25 horses. PROCEDURE: Data collected from the medical records included signalment, history, horse use, severity and duration of lameness, shoeing regimen, results of diagnostic anesthesia, radiographic abnormalities, and outcome. RESULTS: 17 horses had bilateral forelimb lameness, 7 had unilateral forelimb lameness, and 1 had unilateral hind limb lameness. Mean duration of lameness was 9.2 months. All horses had been treated with corrective shoeing and nonsteroidal anti-inflammatory drugs for at least 6 months; 18 had previously been treated by injection of corticosteroids and sodium hyaluronate into the distal interphalangeal joint. Fourteen horses had mismatched front feet, and 21 horses had signs of pain in response to application of pressure over the central aspect of the frog. Palmar digital nerve anesthesia resulted in substantial improvement in or resolution of the lameness in all horses. Twenty horses (80%) were sound and returned to intended activities 2 weeks after navicular bursa treatment; mean duration of soundness was 4.6 months. Two horses that received numerous navicular bursa injections had a rupture of the deep digital flexor tendon at the level of the pastern region. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that navicular bursa treatment may provide temporary improvement in horses with signs of chronic navicular area pain that fail to respond to other treatments.     

Three-dimensional kinematics of the equine distal forelimb: effects of a sharp turn at the walk

REASONS FOR PERFORMING STUDY: Sharp turns are suspected to increase expression of several distal forelimb lamenesses even at the walk but the biomechanical consequences of such a movement remain unknown. OBJECTIVE: To quantify the effects of a sharp turn at the walk on the 3-dimensional movements of the distal segments of the forelimb. METHODS: Kinematics of the distal segments were measured in 4 healthy horses invasively with an ultrasonic system. Three-dimensional rotations of the digital joints were calculated by use of a joint coordinate system. Data obtained for a turn at the walk were compared to those obtained in a straight line. RESULTS: During the stance phase in a turn, the inside forelimb underwent an adduction that induced lateromotion and medial rotation in the distal interphalangeal joint and medial rotation in the proximal interphalangeal joint. These movements were maximal at heel-off and decreased during breakover as the hoof underwent a sudden lateral rotation. CONCLUSIONS: Walking in a sharp turn affects the kinematics of the digital joints outside the sagittal plane. POTENTIAL RELEVANCE: This knowledge offers the opportunity to derive hypotheses on biomechanical factors that could contribute to the pathogenesis of digital injuries and on consequences for rational shoeing.     

Effects of Shortening Breakover at the Toe on Gait Kinematics at the Walk and Trot

Point of breakover, defined as the portion of the hoof last in contact with the ground during the terminal stance phase of a limb, can be influenced by many factors including craniocaudal placement of the shoe. Shortening the point of breakover has been suggested to decrease strain on the deep digital flexor tendon and navicular bone as well as to improve the alignment of the second and third phalanx. The current experiment involved eight sound horses fitted with aluminum plates adhered to their front hooves, which were drilled and tapped to allow additional aluminum plates of various lengths to be attached (the longest plate was placed flush with the toe, while the shortest plate was moved 3.81 cm caudal to the toe). Horses were recorded on video while at the walk and trot over a distance of 70 meters for six repetitions to determine differences in gait kinematics. Results of this study show significant changes in stride kinematics caused by shortening the point of breakover. Retraction of the forelimbs was greatest when breakover was moved 1.27 cm back from the toe (P < .05), and minimum height of the fetlock at the trot was higher on all treatments where the breakover point was moved caudally (P < .05). Some improvements in gait quality were observed when breakover was shortened, although extreme caudal placement of the shoe (negative placement in relation to P3) resulted in a decrease in gait quality as seen by decreased retraction of the forelimb (P < .05) coupled with hoof height occurring earlier in the stride (P < .05).     

Diagnosis and treatment of the navicular syndrome in horses

Navicular syndrome can be treated in a variety of ways. This is related to the fact that it has a variety of causes. Prognostically, most horses will improve with treatment. One can expect about 50 per cent of the horses to become useably sound for 1 year, no matter what treatment is used. The disease is progressive, and affected horses eventually will need to be retired because of lameness. The author's therapeutic approach is to utilize shoeing as the primary therapy. Shoeing is performed to correct structural problems and to ensure that shoeing is physiologically sound. Nonsteroidal anti-inflammatory drugs are not used unless radical changes have been made in the shoeing. In cases of confirmed distal interphalangeal joint synovitis, either sodium hyaluronate or polysulfated glycosaminoglycans will be used in conjunction with shoeing. In cases where decreased circulation is documented, isoxsuprine hydrochloride will be administered if shoeing alone has not improved the horse within 6 weeks. If therapy does not improve the horse within 6 to 12 weeks, palmar digital neurectomy is recommended.     

Wedge and Eggbar Shoes Change the Pressure Distribution Under the Hoof of the Forelimb in the Square Standing Horse

The shoe types most commonly applied to horses with navicular disease or other forms of palmar heel pain are shoes with heel wedges and eggbar shoes, although their efficacy has been a matter of debate among veterinarians and farriers for centuries. To quantify the effect of these different types of “navicular” shoeing on static hoof pressure distribution, 6 warmblood horses were shod with 6° wedge, eggbar, and plain shoes. While standing square with weight evenly distributed across both forelimbs, the center of pressure and pressures at selected areas of interest (AOI: toe, medial and lateral toe, medial and lateral heel) were measured using a Footscan (RsScan International, Belgium) pressure plate in a Latin square design using the plain shoe as a reference.Wedge shoes did not provide a significant shift in the center of pressure. The application of eggbar shoes did not alter the relative position of the center of pressure under the hoof. However, the absolute distance from the toe to the center of pressure was significantly larger with eggbar shoes (77 + 12 mm) compared with plain and wedged shoes (70 ± 8 mm, P < .05) resulting in an absolute, caudal shift of the center of pressure. When pressure (N/cm²) values at the five AOIs were averaged for each shoe type, the wedge and eggbar shoe recordings showed a significantly lower mean pressure than plain shoes (P < .05).In conclusion, mean AOI pressures decreased with wedge and eggbar shoes, and eggbar shoes provided a caudal shift in the center of pressure. These effects are believed to decrease the moment of the coffin joint and reduce the pressure on the navicular bone. Thus, the findings of this study might contribute to the scientific evidence of efficacy of the use of wedge and eggbar shoes in “navicular” lame horses.     

Three-dimensional kinematics of the distal forelimb in horses trotting on a treadmill and effects of elevation of heel and toe

REASONS FOR PERFORMING STUDY: Comprehensive understanding of the 3-dimensional (3D) kinematics of the distal forelimb and precise knowledge of alterations induced by dorsopalmar foot imbalance remains incomplete because in vivo studies performed with skin markers do not measure the actual movements of the 3 digital joints. OBJECTIVE: To quantify the effects of 6 degree heel or toe wedges on the 3D movements of the 4 distal segments of the forelimb in horses trotting on a treadmill. METHODS: Three healthy horses were equipped with ultrasonic markers fixed surgically to the 4 distal segments of the left forelimb. The 3D movements of these segments were recorded while horses were trotting on a treadmill. Rotations of the digital joints were calculated by use of a joint coordinate system. Data obtained with 6 degree heel or toe wedges were compared to those obtained with flat standard shoes. RESULTS: Use of heel wedges significantly increased maximal flexion and decreased maximal extension of the proximal (PIPJ) and distal (DIPJ) interphalangeal joints. Inverse effects (except for PIPJ maximal extension) were observed with the toe wedges. In both cases, neither flexion-extension of the metacarpophalangeal joint nor extrasagittal motions of the digital joints were statistically different between conditions. CONCLUSIONS: At a slow trot on a treadmill, heel and toe wedges affect the sagittal plane kinematics of the interphalangeal joints. POTENTIAL RELEVANCE: Better understanding of the actual effects of toe and heel wedges on the 3D kinematics of the 3 digital joints may help to improve clinical use of sagittal alteration of hoof balance in the treatment of distal forelimb injuries.     

Quantitative comparison of three commonly used treatments for navicular syndrome in horses

OBJECTIVE: To quantitatively compare 3 commonly used treatments for navicular syndrome (NS) in horses: heel-elevation shoeing alone, heel-elevation shoeing and phenylbutazone administration, heel-elevation shoeing and injection of the distal interphalangeal joint (DIPJ) with triamcinolone acetonide (TA), and all 3 treatments in combination. ANIMALS: 12 horses with NS. PROCEDURE: A force plate was used to measure baseline peak vertical ground reaction force (PVGRF) of the forelimbs. Each horse's forelimbs were shod with 3 degrees heel-elevation horseshoes; PVGRF was measured 24 hours and 14 days after shoeing. Fourteen days after shoeing (following data collection), phenylbutazone (4.4 mg/kg, i.v., q 12 h) was administered (5 treatments). Two hours after the fifth treatment, PVGRF was measured; TA (6 mg) was injected into the DIPJ of the forelimb that generated the lower baseline PVGRF Fourteen days later, PVGRF was measured. Phenylbutazone was administered as before, and PVGRF was measured. Percentage body weight of force (%BWF) was calculated from PVGRF measurements and used for comparisons. RESULTS: 14 days after shoeing, mean %BWF in both forelimbs significantly increased from baseline; additional administration of phenylbutazone significantly increased %BWF applied from the more lame forelimb. Compared with shoeing alone, there was no significant change in %BWF after injection of the DIPJ with TA in shod horses. CONCLUSIONS AND CLINICAL RELEVANCE: Heel-elevation shoeing alone and in combination with phenylbutazone administration quantitatively decreased lameness in horses with NS. Although not significant, additional DIPJ injection with TA resulted in further quantitative decrease in lameness, compared with that achieved via shoeing alone.