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Toe Angulation and Extensions Can Relieve Suspensory and Flexor Tendon Injuries

Case studies demonstrate orthopedic treatments do not exclude each other and can be combined

Different orthopedic concepts have been established to treat disorders of the suspensory ligament and the digital flexor tendons (see “Fetlock Support Aids Tendon and Ligament Injuries,” American Farriers Journal January/February 2021). One approach is relieving affected tendons and ligaments by changing the toe angulation

The biomechanical principle described by Denoix et al. states that a steeper hoof angle lowers the middle and proximal phalanx with more extension in the fetlock joint. According to this group, this relieves the deep digital flexor tendon (DDFT) and the navicular region, but places more strain on the suspensory ligament and the superficial flexor tendon (SDFT). The opposite occurs with a lower hoof angulation, causing more strain on the DDFT and the navicular region and relief of the suspensory ligament and the SDFT. Since practical work showed that these principles are not valid for all patients affected by tendon or suspensory ligament injuries, the author’s research on this topic has been performed (Hagen et al. 2018). In the following, the main findings are concluded:

  • A hoof angle change of at least 10 degrees – 15 degrees is necessary to cause a significant change in the fetlock angulation.
  • High individual variations occur in response of the fetlock angle to a change in hoof angulation.
  • Only  of the examined horses (n = 5) react on a 5-degree lower hoof angle with less extension in the fetlock joint. The rest of the horses showed the opposite or no reaction.
  • The longer and lower the pastern, the less likely…
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Jennifer hagen 5

Jenny Hagen

Jenny Hagen, DVM, PhD, CF, is a veterinarian, re­searcher and certified farrier. She is in private practice for equine ortho­pedics and chiropractic. She is a mem­ber of the faculty of Veterinary Medicine, Leipzig University in Ger­many.

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