HI Sarah,

I've added mark-ups to Bullitt's album:

https://ecir.groups.io/g/CaseHistory/album?id=253052

Generally, there is too much horizontal toe length on all four feet, along with the heels being underrun. It appears as if you may have more overall depth to work with on the hinds than there is on the fronts. The RF and RH are worse than the LF, LH.  Need to take the toes back on all four feet, as well as lower the walls so they aren't longer than the soles. Then bevel the walls all around so that Bullitt's weight is distributed over a larger area that includes his frogs, bars, and soles rather than being left with only his walls providing the majority of the support. The following links provide some more in-depth information regarding the needed changes:

https://www.hoofrehab.com/Breakover.html

https://www.hoofrehab.com/HorsesSole.html

https://www.hoofrehab.com/FrogTrim.html

https://www.hoofrehab.com/DistalDescent.htm

https://www.hoofrehab.com/Coronet.html

RF lateral: The blue area is the excess toe length that needs to be removed so that the breakover is brought back into alignment with where the bony column needs it to be. This will This may look like it is invading the "white line" but it is only removing laminar wedge material that has developed. The apparent location of the white line at ground level has been distorted by the stretching of the sole along with the excess toe as this wedge has built up over time. The orange line shows where the heels should be located - as you can see, they are quite a bit further forward than this. Whether they can be brought back entirely at this time or not will depend on the amount of sole depth that is present.

RF sole: The solid blue line indicates where the outer perimeter of weight bearing should be. The hashed areas should all be removed/beveled out of ground contact beyond this point. At the toe - from about 10-2 o'clock, all of the hashed area needs to be removed completely as that is the excessive horizontal toe length that is interfering with the breakover location. This corresponds with the blue area at the toe on the lateral view.

LF lateral: Same discussion as the RF. The green line follows the angle of the new, healthier, better attached growth coming in under the coronary band . Where this line would hit the ground is where the toe should end. There shouldn't be anything beyond this point at ground level. This isn't a trim line, just a visual marker. The blue area is the material that needs to be removed.

LF sole: Solid blue is again the outside perimeter while the hashed areas are what needs to be relieved/removed. The yellow hashed ares on the frog are overgrown flaps that are covering the collateral grooves and the actual backs of the heels and they should be trimmed away.

RH lateral: Blue area is the excess toe length that needs to be removed so the breakover is set further back.

RH sole: More excess toe length on the RH than the LH. More overgrown frog material that is covering the collateral grooves and the backs of the heels and needs to be removed.

LH lateral: Same as the fronts. Orange line again indicates where the heels should be located so that they are supporting the entire leg properly.

LH sole: Same discussion as the LF sole but the overgrown frog is more prolific. It appears as if it may already be shedding on its own to some degree.

Getting the toes backed up will prevent the lever forces that are now tearing at his lamina with every step that he takes, which will allow him to grow in healthier, more stable feet.

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Lavinia, George Too, Calvin (PPID) and Dinky (PPID/IR)
Nappi, George and Dante Over the Bridge
Jan 05, RI
Moderator ECIR