Hello Lavinia,

I will be having Cupcake's re-trim either this Friday or next week Monday or Tuesday.  We will be doing x-rays as well prior to the trim. Were the mark ups completed and I missed them?

Thank you!

Carla Peters (Cupcake and Gunnnar)

Dec.2013/WI

https://ecir.groups.io/g/CaseHistory/files/Carla%20and%20Cupcake%20-%20Gunnar

Hi Carla,

I've added mark-ups to Cupcake's album here:

https://ecir.groups.io/g/CaseHistory/album?id=2258&p=pcreated,,,20,2,0,0

Overall, the toes still need to be brought back more although they have improved. Sole depth is barely adequate so need to be careful not to lose any while bringing the toes back to get the breakover properly realigned. There is definite distal descent (sinking) in both fronts so the amount of vertical height of the hoof capsules is deceiving. RF heels were lowered too much while the LF heels still need to come down more. Frogs are stretched forward and bars are leaning outward putting pressure on the walls to flare outward in the quarters.

LF DP xray: The foramen are not level (blue line) and the lateral joint spaces are slightly compressed (blue arrows) so the lateral hoof wall is slightly taller than the medial. Calcification of the lateral cartilages has started (side bone), a bit more on the lateral side. RF also shows sidebone beginning.

LF lateral composite: I combined the xray and the picture of the LF here so you can maybe get a better idea of how the outside view relates to the internal structures. The green lines follow the angle of the new growth coming in under the coronary band. The blue lines are where to back the toe to and then bevel under to set the breakover in the correct location for the bony column. On the xray, the pink line is where the bony column should align while the purple is where it is now. The forward bulge of the purple line denotes a broken forward hoof-pastern axis (HPA), otherwise known as bony column rotation. Need to lower the heels in order to relax that bulge back into its proper place (pink arrow). The orange line is where the bottom of the foot should be - note it is below the current sole level at the toe and passes thru the current location of the heels. Yellow line (1) is the coronary band, (2) is the extensor process. These lines should be aligned - the space between them denotes the sinking.

RF lateral composite: Green, blue and yellow lines are the same as the LF. Pink is where the bony column should be, purple where it is. In this foot, the purple line dips backward, which means the HPA is broken back. This wasn't the case in the xray before the trim was adjusted so it means the heels were lowered too much - need to NOT lower them any more as they are already too low. Pink arrow indicates the need to allow more height to develop in the heels to raise the back half of the coffin bone in relation to the front half in order to get the bony column properly aligned again. Orange line is where the bottom of the foot needs to be allowed to get to.

RF sole: Green line is an idea of where the foot should be. Arrows indicate areas that need to be brought back/inward to remove excess toe length and flaring. Red is about where the true tip of the frog. The material beyond this point is dead, stretched forward frog that has been pulled along with the soles as they stretched form the pull of the toes running forward. Bars are leaning outward and appear to have been pared away along their inner (frog side) surface. Due to the sinking, the bars are doing extra duty right now supporting the bony column. Although they need to be tamed in, this needs to be done gradually (no amputating) from the outside, leading edge working inward. Only remove small slivers of flaking material that are overlaying the sole to encourage them to start standing upright. Heels also need to be encouraged to move a bit more toward the rear as the heel buttresses should be even with the widest part of the frog. Need to be careful as there is already too little height in the heels so again, this will need to be accomplished by using a single rasp stroke to lightly extend the heel platform rearward while maintaining as much height as possible.

RH lateral composite: The lateral mark-up is the same idea as the fronts. On the sole portion, yellow is where the heel buttresses should be while the light blue is where they are now. Note how much the lateral bar has leaned outward and how the wall in that area has been pushed to flare. Need to bring those flare areas inward, rasping from the top then beveling under.

LH lateral: Same as RH.
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Lavinia, Dante and George Too

Jan 05, RI

EC Support Team