Re: FAO Lavinia - Please can I have some trim advice? 2ND TRY

Lavinia Fiscaletti

Hi Jenny,

I've added a couple of mark-ups to Dewie's album:

The last trim did address a bit of the excess toe length, but mostly it just thinned the laminar wedge on the dorsal wall.  There is sinking and ski tips on both, along with some arthritic changes but the bony column alignment is pretty good. The good news is that there's some excess foot to work with to bring the toe back so that the breakover is set where the bony column needs it to be. Sole depth is also more than needed so there's a bit of excess across the bottom that can be removed. Both fronts appear to be somewhat laterally high, which the older DP rads (10-2020) confirmed. Heels are underrun and the frogs were trimmed too much, which likely is contributing to his discomfort. The heels will move back a bit when the trim gets done but not by too much, as moving them back right now would make the palmer angle too low. Need to get them to stand up straighter, rather than just cutting them down. No pictures of the hinds but usually, similar problems are found, just maybe to a lesser degree.

LF lateral composite: On the radiograph, the pink line shows how the bony column should align and ends where the breakover point needs to be at ground level. Any horizontal toe length beyond this point needs to be out of ground contact so it doesn't interfere with the stride and doesn't apply tearing forces to the laminar connections. The purple line follows the actual bone alignment and should line up with the pink line - which is what it does. Green line is only a visual marker of where the dorsal wall should be located. It's NOT a trim line. Anything outside of this is laminar wedge material that will eventually need to be removed as it grows down, but not at this time. This area was already thinned quite a bit during the last trim. Blue solid lines are the trim lines, with the blue Xs in the areas of excess foot that should be removed. Yellow line #1 runs thru the coronary band, #2 points to the extensor process. These two lines should overlap in a healthy foot. The distance between them denotes the amount of distal descent (sinking) that is present.
On the photo of the foot, the green line is the same as the one on the rad and shows where the dorsal wall should eventually be. The blue areas correspond to the blue Xs on the rad.

LF dorsal: Green line follows the angle of the new growth down to the ground. Blue area is the lateral wall flare that can be removed. Also need to check the medio-lateral balance, as it appears that the lateral wall is taller. Need to check the collateral groove depths to see whether that is still an issue or whether the flaring is only leftover damage. See here for more info:

LF sole: Blue solid line is where the perimeter of the hoof a ground level actually should be. The blue hashed areas are all the excess toe length and flaring lateral wall that need to be taken out of ground contact/removed. Orange squares are where the new heel buttresses should end - at the wall-bar junctures, with the outside wall beveled away so it is completely out of weight bearing to allow it to start to relax and stand up straighter. Leave the frogs alone, except for any rag-tag pieces that may exist. Add rockers to the backs of the heels to both ease the landings and to help get them standing more upright. Here's more info on each of the goals:

RF lateral composite: Same discussion as the LF.

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

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