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Discuss Tell me about Upright Pasterns/Club Foot ***New Pics Post 32*** at the Horse Health forum - Horse Forums.

Well I had a new farrier out that actually showed up yay! lol (i'll get ...
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    Tell me about Upright Pasterns/Club Foot ***New Pics Post 32***

    Well I had a new farrier out that actually showed up yay! lol (i'll get pics of their hooves tomorrow for you all to critique). Anyway in short, my farrier told me my 2 yr old was pretty worthless and to not put much money in him .. He said he is nice from the knees up!! haha He did not say this in a mean way though of course just educating me.

    So basically he said his shoulder is very steep and his pastern angle matches his shoulder angle, so is steep aswell. So he is landing almost toe first, less heel. He said he will never have a flowing gait with heel first landing because of this . He said he could make them 'look pretty' for a show but functionally they will be the same. Also he said the 'white line disease' is NOT WLD and whoever told me that was WRONG. He showed me the white line is perfect and nothing wrong with that. Just the outside of the hoof integrity is poor. He suggested Biotin, which I agree with.

    We moved the trimming to 6 weeks instead of 8. He also said he has lots of flaring on the outside of his hooves. Something about there is pressure on the inside, so it's pushing the outside capsule out?? or something, I forget. But he said he could trim at it some and work on it but chances are it will probably always be an issue. When he first looked at him, he said 'wow he's almost got like club feet, a level 2' or something ... (i forget a lot!!).

    Anyway PLEASE tell me about upright pasterns and club feet, mainly the upright pastern thing. Anyway have a nice horse with bad pasterns? I was hoping to do some lower level eventing with him but now I'm not so sure . I really don't want to harm him at all and I know time will tell. I see him run and play in the pasture and he has a very short stride but like LOTS of suspension. Almost like he is piaffing at times when he is excited. So I will get pictures and conformation shots for you all tomorrow but anyone have experience????
    Last edited by KristinJ; 01-13-2010 at 02:16 PM. Reason: gram
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    Don't let your farrier discourage you! I'd love to see hoof pictures when you get them. But as far as the pasterns go, many horses have steep pasterns and get along fine. Do they match the hoof angle? I ride a horse with very uproght pasterns in my lessons and he hasn't been lame as far as I know. He really loves jumping as well. If your horse is properly conditioned, you get the hoof flaring under control and get the mfunctioning as well as they naturally can be, your horse will probably be fine doing some eventing as long as he enjoys it.
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    Quote Originally Posted by crayon View Post
    Don't let your farrier discourage you! I'd love to see hoof pictures when you get them. But as far as the pasterns go, many horses have steep pasterns and get along fine. Do they match the hoof angle? I ride a horse with very uproght pasterns in my lessons and he hasn't been lame as far as I know. He really loves jumping as well. If your horse is properly conditioned, you get the hoof flaring under control and get the mfunctioning as well as they naturally can be, your horse will probably be fine doing some eventing as long as he enjoys it.
    Ohh yea he wasn't mean about it or anything, we joked about it. He said he is a very nice horse but may not withstand the rigors of hard training. The pasterns do NOT match the hoof angle (going on memory here). I'll try to find some old pictures until I can get new ones tomorrow.
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    I'm interested to see new pictures. I've only seen those few photos at bad angles from your other thread. I couldn't tell much about them other than that the hoof form was lacking.

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    It could either be conformational or due to hoof conformation that could be improved with good trimming. Low level eventing doesn't require nearly as much work as higher levels, but still a bunch to get the horse conditioned to run a whole cross country course. Some horses hold up better than others, even the ones with "perfect" conformation. But we love them no matter what they can and can't do.
    Quote Originally Posted by Heavenly Jumper View Post
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    Thank you guys, I looked through ALL of my old pictures and NONE are suitable to show you accurately. I will be sure to take about 329545 photos tomorrow =P of conformation of leg/hoof, and new hoof shots. I really like this farrier and really SEEMS to know what he is talking about and took the time to explain everything to me, so hopefully the pictures will show he did a good job at the trim aswell!! I would have taken them today but we just finished up at 5pm, and well i have no lighting in my barn!! hehe. Tomorrow for sure =)
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    They really didn't look like "Grade 2 Club feet" to me.... LOL. Although WLD not being the cause of that weird hoofwall, I do agree with. The integrity loss is in the waterline, not the laminae connection. Maybe I didn't mention it before, but I've seen that kind of chipping caused by long-term flaring. Tightening up his trim schedule will probably encourage it to grow out properly.

    Love to see the confo pics tomorrow. Let me tell ya, my coming-2-yr-olds all look pretty upright in their pasterns (not done growing yet), and they don't have club feet. However, if he does have a steep shoulder, not much you can do about that.
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    Quote Originally Posted by IIIBarsV View Post
    They really didn't look like "Grade 2 Club feet" to me.... LOL. Although WLD not being the cause of that weird hoofwall, I do agree with. The integrity loss is in the waterline, not the laminae connection. Maybe I didn't mention it before, but I've seen that kind of chipping caused by long-term flaring. Tightening up his trim schedule will probably encourage it to grow out properly.

    Love to see the confo pics tomorrow. Let me tell ya, my coming-2-yr-olds all look pretty upright in their pasterns (not done growing yet), and they don't have club feet. However, if he does have a steep shoulder, not much you can do about that.
    Thank you! You are giving me some hope =) I really hope he is just not done growing !! That is basically what my farrier said with the whole 'WLD' thing. I'm not really sure what he meant by the grade 2 club foot. He looked at it, and goes to his son 'it almost looks like a grade 2 club...' and then never really mentioned it again....
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    Club Foot Concerns

    by: Marcia King
    April 01 2001, Article # 21

    Club feet might be one of the most common growth problems in young horses. Affecting youngsters primarily between birth and 6 months of age, the club foot actually is a flexural deformity of the distal interphalangeal joint (coffin joint) caused by a shortening of the musculotendinous unit of the deep digital flexor tendon. As a result, the hoof capsule becomes distorted, the hoof angle approaches 60 or greater, and the horse begins walking on its toe. It is most commonly presented in the front legs, usually affecting one limb but occasionally occurring in both. It usually is an acquired condition, but can be congenital (present at birth).
    In congenital forms of club feet, the newborn is unable to extend the joint of the distal limb, is unable to place its heel on the ground, and thus walks on its toe. Usually both forelimbs are affected. Stephen O'Grady, DVM, MRCVS, of Northern Virginia Equine, says, "This could be due to uterine malpositioning of the fetus, nutritional management of the mare during gestation, exposure to influenza virus, or possibly a genetic link."
    With acquired forms, O'Grady says, initial clinical signs might be subtle -- abnormal hoof wear at the toe, a normal or slightly increased hoof angle, and possibly a prominent coronary band. Heels might not contact the ground after trimming.
    "As the condition progresses, severe changes will occur," reports O'Grady. "You get a prominent bulge around the coronary band, a higher heel, a broken-forward pastern angle, and a boxy, tubular-shaped foot that's dished out along the dorsal surface of the hoof wall."
    Acquired forms usually involve one leg, and are considered to be from developmental orthopedic disease. Tracy Turner, DVM, MS, Dipl. ACVS, Professor of Large Animal Surgery at the University of Minnesota, explains, "This disease is associated with the growing horse. As the young horse's bones are lengthening out from the growth plates, anything that causes the animal pain can cause the problem. Epiphysitis (inflammation of the growth plates) is a primary cause. If that occurs, the pain causes the animal to have a withdrawal reflex, such as if you would put your hand on a hot stove, then immediately pull your hand away. It's the same sort of reflex. It results in the horse trying to lift its heels up off the ground because the withdrawal reflex is carried in the flexor tendon."
    Other factors associated with acquired club feet include:
    • Genetics -- "Often you find mares which had a club foot will produce offspring with a club foot in the same limb," O'Grady notes.
    • Rapid growth -- "This is more common in Quarter Horses and warmbloods, although we see it in Thoroughbreds, too," says Turner.
    • Overweight -- "Overfeeding of carbohydrates (grain) or mare's milk can make the baby too bulky," Turner says. "Warmblood mares, especially, can produce milk like a dairy cow, so the baby simply gets too much."
    • Nutrition -- "Nutrition has always been incriminated, especially calcium/phosphorus deficiencies and/or imbalances," states O'Grady. "Copper was recently thought to be a problem, but that's unproven."
    • Over-exercising -- "Sometimes young show horses are longed and conditioned, especially for halter shows," Turner notes. "This can cause trauma leading to leg problems."
    • Environment -- "Exercising on very, very hard ground, combined with excessive, improper, or insufficient trimming can contribute," says O'Grady.
    Getting Grounded
    Diagnosis is via clinical observation and radiography. O'Grady strongly recommends grading the severity of the disorder. "Grading the club foot is a good idea," he states. "This ensures that veterinarians and farriers are on the same wavelength." He uses a grading system developed by Ric Redden, DVM, as follows:
    • Grade I indicates a hoof angle three to five degrees greater than the opposing foot and fullness at the coronary band.
    • Grade II signifies a hoof angle five to eight degrees greater than the opposing foot, growth rings wider at the heel than at the toe, and a heel that doesn't touch the ground when trimmed to normal length.
    • Grade III denotes a dished anterior hoof wall and growth rings at the heel twice as wide as at the toe.
    • Grade IV has an anterior hoof wall heavily dished with an angle of 80 or more, a coronary band as high at the heel as at the toe, and a sole that is below the ground surface of the hoof wall.
    Conservative Treatment
    Treatment depends on severity. "In newborns, repeated intervals of brief exercise in a small paddock the first few days of life may be all that is necessary," says O'Grady.
    Sometimes veterinarians will administer oxytetracycline, an antibiotic with muscle relaxant properties, to allow the affected musculotendinous unit to stretch out and the newborn to load the leg normally, Turner adds.
    Other cases might require more intensive therapy. "Physical therapy in the early stages, which involves manually straightening the limb two or three times daily, may also be helpful," O'Grady says. "If the condition has not improved by the third day post-foaling, every-other-day administration of oxytetracycline under veterinary supervision is frequently beneficial along with the application of a toe extension. The toe extension is cut from a thin piece of aluminum upon which the foal's foot has been traced along with the amount of extension needed. The toe extension is then taped on the foot with Elastikon (an elastic bandage). In severe cases, splints can be combined with the toe extension."
    In acquired cases affecting the older youngster, O'Grady says grade I or grade II deformities usually only need therapeutic shoeing, anti-inflammatory agents to relieve pain, oxytetracycline to cause muscle relaxation, and exercise restriction.
    Turner prefers to relieve the tension on the tendon by raising the heel with either glue-on shoes or shoes and pads, which he says, "makes the condition look worse, but it gets the horse to bear weight very comfortably throughout its foot." Rest allows the muscle spasms from the reflex to relax. Once the tendon appears relaxed, usually after one to two weeks, then the foot is restored to its normal position, and exercise is gradually increased.
    Another method involves the use of exercise restriction, anti-inflammatories, oxytetracycline, and lowering the heel. Says O'Grady, "The heels are lowered and Equilox (which can be used to form an artificial hoof wall) can be applied to the dorsal hoof wall to form a toe extension. The Equilox-impregnated fiberglass is continued over the solar surface to protect that area from further bruising. The toe extension will serve as a lever arm for the toe."
    Often when the heels are rasped off excessively, the heels will not contact the ground. In that case, O'Grady cautions that a toe extension will create severe tension in the deep digital flexor tendon, which can damage the laminae of the immature foot and make the condition worse.
    "Another approach is to take the heels down as much as possible, then put a wedge underneath these animals and raise them back up," O'Grady says. "This will make the animal load the heel area and not the toe of the foot. Over time, as we continue to trim these animals, we'll slowly let them back down where they should be. This procedure is not always effective in the cases I see."
    With medical therapy and therapeutic shoeing, the horse with a grade I or grade II condition should improve within two weeks, says Turner. "Once they are normal looking, they can go back to work anytime. Introduce the work gradually." Prognosis for full recovery is good.
    Surgical Correction
    In more severe grade III and grade IV cases, surgery and therapeutic shoeing is necessary to achieve correction. The distal check ligament provides the upper attachment for the deep digital flexor tendon that attaches to the horse's foot. "We cut that ligament and that releases stress on the tendon, allowing us to go ahead and make hoof capsule corrections," Turner explains.
    Immediately after surgery, a toe extension should be applied, suggests O'Grady. This increases the surface area of the foot, promotes weight-bearing on the heels, and protects the toe portion of the hoof. The heels are lowered in a tapered fashion from the point or apex of the frog to the end of the heel until the sole adjoining the hoof wall becomes soft. To create a toe extension, the dorsal hoof wall and ground surface of the foot in front of the frog is prepared for Equilox using a rasp or Dremel tool. Deep separations are exposed and filled with Keratex putty, if necessary. The foot is washed with solvent and dried with a heat gun. The composite is applied to the prepared surface and piece of one-eighth-inch aluminum is incorporated into the Equilox to provide strength and reinforcement to the toe extension.
    "Foals undergoing this procedure are usually between two and five months of age. The size and weight of the foal makes reinforcing the toe extension necessary. This reinforcement allows the older foals to be walked daily without the toe extension breaking or wearing out," adds O'Grady.
    Turner reports that there are no side effects. "Surgical correction is immediate, and the ligament will eventually heal back together. Full recovery takes about six to eight weeks.
    Post-surgically, horses should receive two weeks of stall rest with two weeks of hand-walking, followed by turn-out, recommends Turner. "I try to keep the bandages on their legs for an extended period of time so the cosmetics of the surgery turn out better."

    With regards to farrier care, O'Grady recommends trimming the heels at two- to four-week intervals, depending on the amount of hoof growth. "The object is to normalize the hoof capsule," he says. "The toe extension is maintained for two months following the surgery. The heels are lowered as necessary from the point of the frog back, and the toe is rasped back from the front of the hoof wall until the desired hoof conformation is attained. We remove no sole anterior to the frog. When the desired effect is reached, we trim the foot normally."
    Once the problem is successfully resolved either surgically or therapeutically, horses should be able to continue in their careers. "We've found that these horses meet or better their expected potential," Turner states.
    Reduce The Risk
    While it might not be possible to prevent club feet in every affected horse, Turner states that risks can be minimized. "Watch the foals' nutrition, try to make sure they don't grow too rapidly, and try to keep their weight down," he says. "Don't overdo forced exercise."
    Should signs of a club foot begin to appear, seek early treatment. Doing so can mean the difference between conservative treatment and surgery, and can help ensure a successful outcome.
    Want To Know More?
    For more information on club feet and flexure deformities, check out the website of Stephen O'Grady, DVM, MRCVS at www.equipodiatry.com (click on podiatry, then click on flexure deformities in foals).
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    On the Forehand

    by: Les Sellnow
    March 01 2006, Article # 6623

    The foreleg of the horse is, for the most part, a model of good engineering. It is structured in such a fashion that the horse can move slowly or at speed with the concussion of each footfall minimized by a sophisticated shock absorbing system.
    The system works very well when the horse is doing what nature intended--wandering about over large expanses, grazing, drinking, breeding, and resting. But today's horse often soars over multiple six-foot jumps, runs at speed for a mile or more around an oval course, slides to a stop suddenly and spins, or performs intricate dressage movements.
    These disciplines often put undue stress on the legs that can render even a well-conformed horse unsound. A horse with improper conformation is at much greater risk for unsoundness when competing in arduous disciplines. This doesn't mean a horse with poor conformation will always become unsound or lame. What it does mean is that poor conformation is a warning sign that something might go awry.
    It also should be noted that a horse puts more stress on its front legs than its rear limbs because it carries 60-65% of its weight up front. It seems incredible that when a horse is running at speed, there is a split second in every stride where all of the animal's weight, plus the additional impact involved when running all out, lands on one front leg.
    We will take an in-depth look at just how the forelimb is constructed, what constitutes good conformation, and what can go awry when poor conformation is involved.
    The information presented comes from many sources. A key source for researchers, veterinarians, and horse owners in the study of equine limbs is the late O.R. Adams' book Lameness In Horses.
    No Connections? Shocking!
    An interesting aspect of front limb construction in the horse is that the front legs are not connected to the rest of the skeleton. If one were so inclined, one could amputate the entire front leg--from scapula (shoulder blade) on down--without the scalpel ever touching bone. Instead of bone and joints, the horse's front legs are connected to its body by a network of muscles, ligaments, and tendons. Basically, the horse's front legs help form a sling that supports the front part of the animal's body.
    A prime purpose of the front leg is to serve as a shock absorber. If the impact of each stride were transmitted upward in a straight line, joints, muscles, tendons, and perhaps even bones would not remain healthy. The key to proper shock absorption here is angle. The proper angle of the fetlock, for example, makes it possible for a large portion of the shock forces to be dissipated before traveling up to the knee, forearm, and shoulder. The rest of the force is absorbed along the way, but much of it is absorbed at the fetlock level.
    The Right Angles
    Forelimb angles begin at the shoulder (see illustration at right). If the animal has good conformation, the shoulder will be angled back at an appropriate degree. Just exactly what that "appropriate" degree is will vary from horse to horse, but the angle is key to the horse's stride.
    If the shoulder is aligned appropriately, the horse will step out with a long, even stride that is comfortable for the rider and produces the least amount of concussion. But if the shoulder angle is steep, the horse's stride will be short and choppy. This will make for an uncomfortable ride, but worst of all, it means the front feet will hit the ground more often over a prescribed course and each time they do, the force of concussion will be greater than for a horse with a properly angled shoulder. This is because the shoulder angle dictates other angles involved in dissipation of concussion. For example, a straight shoulder normally means a horse will have a straight or upright pastern. The straighter the pastern, the less shock absorbed during each stride.
    Dem Bones
    Let's look at each of the forelimb bones, traveling from top to bottom. We start with the shoulder bone or scapula. This is a broad bone that connects to the next in line--the humerus, which is analogous to the human upper arm bone. This bone angles down and rearward until it joins up with the radius (forearm) at the elbow. The radius extends downward to the knee or carpus, which compares to the human wrist. One can almost liken the many little bones of the knee to building blocks arranged in two rows. The radius connects at the upper portion of this structure and the metacarpus (cannon bone) connects to the lower or distal aspect. The cannon bone extends downward to the pastern.
    The fetlock joint connects the cannon with the first of three pastern bones. The first pastern bone is known as the first phalanx or P1. It fits into the second pastern bone via the pastern joint, with the second bone known as the second phalanx or P2. The second phalanx fits into the third phalanx (P3 or coffin bone) at the coffin joint. The coffin bone is housed completely within the hoof capsule.
    While the above could be described as the key bones in the front limb, others serve equally important functions. For example, just behind the cannon bone, where it joins the long pastern bone, are two proximal sesamoid bones. They serve as pulleys for the flexor tendons as the tendons bend around the fetlock joint; these tendons help flex the legs and generate propulsion.
    Another bone completely encapsulated by the hoof is the distal sesamoid bone, more commonly called the navicular bone. It is located at the junction of the short pastern bone and the coffin bone and provides another pulley-type surface for the deep digital flexor tendon as it angles towards its end on the bottom of the coffin bone.
    Two other bones in the front leg must be mentioned--the splint bones that extend downward from the knee. Known as the second and fourth metacarpal (front legs) or metatarsal (hind legs) bones, these help support the cannon bones. Most authorities speculate they are evolutionary remnants from the prehistoric three-toed horse. Splint bones can be fractured or broken, causing pain and unsightly blemishes.
    Good, Bad, and Ugly
    We have mentioned "good" conformation and "bad" conformation several times in this article. Let's define just what is meant by those terms. To do that, we must examine a front leg from at least two vantage points--from the front and from the side.
    First, we stand in front of the horse and look at the front leg. In our mind's eye, we will superimpose a vertical line that travels in a straight path from the point of the shoulder down through the middle of the forearm, through the middle of the knee, and down the center of the cannon bone, fetlock, and hoof.
    The purpose of superimposing this line is to determine how much deviation there is to one side or the other. If, when we study our superimposed line, we find that it truly does run through the center of the limb, we likely have a horse with the basics of good forelimb conformation.
    But what if it doesn't? What are we dealing with? Let's look at some of these conditions and what they might mean, noting as we do so that few, if any, horses have perfect forelimb conformation:
    Toeing Out--If this is the case, the horse's front feet will literally be pointed outward and our superimposed line will run down through the inside or medial aspect of the foot. These horses will put extra stress on the inside of the knees and fetlocks with every stride. Of course, stress increases when the horse travels at speed or lands after a jump. In addition, as the horse travels, it will tend to wing inward with each foot during each stride, particularly at the trot. When this is the case, the horse is in danger of striking the sesamoid and splint bones of the opposing limb.
    Toeing In--As the name implies, this is the direct opposite of toeing out, and it often has less severe consequences. A toed-in horse often will paddle, which means the feet rotate outward or laterally as it travels, especially at the trot. This is a waste of energy and means the horse does not travel forward efficiently. Its danger of self-injury is limited, but this defect does cause additional strain on the ligaments of the fetlock and pastern joints; problems such as ringbone and sidebone can result. In this case, when examining the leg from in front, the bulk of the foot will be inside or at the medial aspect of our superimposed line.
    Bench knee--In these horses, the forearm enters the knee on the medial side and the cannon bone exits the knee on the lateral side, so they don't line up. They are believed to be prone to knee injuries or problems, especially if exposed to stressful competition. However, some studies have found that mildly affected racing Thoroughbreds can do quite well, depending on what other conformational problems are present.
    Base-wide--These horses stand with their hooves farther apart than the legs are at the chest. They often have narrow chests, toe out, wing in, and excessively wear the inner side of the foot.
    Base-narrow--These animals stand with their hooves closer together than the legs are at the chest. They usually have wide chests, toe in, paddle out, and wear the outside of the foot lower than the inside.
    Carpal valgus--Also called knock knees, this angular limb deformity occurs when one or both carpi (knees) deviate medially (inward) when viewed from the front. If left uncorrected, this results in a great deal of stress placed on the ligaments and small bones of the knee, especially on its medial or inner side. Toeing out often accompanies this problem.
    Carpus varus--Also called bow legs, this occurs when one or both knees deviates laterally, or outward, when viewed from the front. Abnormally high stresses on the lateral or outer side result from this problem, and toeing in often is also present.
    The last two problems occur commonly in foals, but are usually easily corrected either with rest and trimming/shoeing or surgery while the limbs are still growing.
    These are seven basic conformational faults that can be observed when viewing the leg from the front. Sometimes they are combined with other conformational faults of the front limb, and that increases the potential for lameness problems.
    Now, let's step to the side and look at that same front limb. Again, we will superimpose, in our mind's eye, a vertical line that runs down the center of the limb perpendicular to the ground, reaching the ground just behind the heel. Here are some poor conformations that might be observed:
    Calf knee--Horse owners familiar with cattle can easily envision this condition. It also is referred to as "behind at the knee." The knee appears to bend backward from our superimposed line when viewed from the side. These knees place a great deal of stress on ligaments and tendons as well as on the knee joint. A calf-kneed horse would be poorly suited for jumping or racing.
    Buck knee--Also called "over at the knee," this is the opposite of calf knee. When viewed from the side, the knee protrudes over our line as if it is always bent to some degree. It isn't as severe as calf knee, but is a definite fault that will put excess stress on joints, ligaments, and tendons.
    Standing under--In this conformation, the entire forelimb from elbow on down is consistently placed back too far under the body, behind our superimposed line. Overloading of the front limbs and more frequent stumbling result.
    Camped in front--This is the opposite of standing under, with the forelimb from the body to the ground being consistently placed too far forward--in front of the superimposed line. It often occurs with bilateral navicular disease and laminitis.
    Short, upright pasterns--In this condition, there is little or no angle to the pastern, which means little dissipation of concussion as the horse travels.
    Long, sloping pasterns--This can be a severe problem if the pasterns are so long, sloping, and weak that the fetlock strikes the ground as the horse travels. Neither pastern fault is unique to the forelimbs; they can occur in the hind limbs as well.
    Take-Home Message
    The key to good front limb conformation is balance, with all parts flowing smoothly together so that there is both appropriate propulsion and adequate shock absorption. Since no horse has perfect conformation, it is necessary to rely on experts to determine which conformation is best suited to a particular discipline or use. This will enable us to select horses that are more successful and sounder in their careers, and cause fewer lameness problems for the owner.


    Forelimb Conformation Problems
    Much as we would like to believe otherwise, it is very rare to find a perfectly conformed horse. Most have at least one deviation from what is considered "ideal" conformation, and many have two or more. Horses can still be successful riding or working horses with most of these abnormalities if they are not very severe. This depends on the particular problem and the horse's intended use.
    When viewed from either the front or the side, a line bisecting the horse's limb shound be straight. Here, the green lines show the angles of the horses' bones with normal conformation and various problems. -Les Sellnow
    ejforrest-

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