Flexural deformity of the coffin joint, more commonly known as "club foot", is usually caused by rapid growth, over feeding, and/or pain. It is usually first observed between 3 to 6 months of age. It first may appear as a bulge at the front of the coronary band, lengthening of the heels, or failure of the heels to contact the ground. Eventually the foot develops a boxy shape with a dished appearance on the front of the hoof wall. Rapid bone growth, and then the resultant inability of the deep digital flexor tendon to elongate with this rapid bone growth phase is the likely cause of the condition. The result is a shortened muscle-tendon unit of the deep digital flexor tendon.

Early recognition and treatment are important to achieve the best outcome. If recognized early, conservative treatment with frequent heel trimming or rasping, stall rest, non-steroidal therapy with Phenylbutazone or Banamine, and decreasing the foal’s nutritional plane may be successful. Early weaning may be necessary to prevent over nutrition. If no improvement is observed after 1-2 months of conservative therapy, then surgical treatment is often necessary. Radiographs are performed in older foals to determine if there is any permanent damage to the joint or coffin bone, which can affect the future athletic soundness of the horse.

Surgery consists of desmotomy or transection/cutting of the accessory ligament of the deep digital flexor tendon. This ligament is more commonly known as the check ligament. Transection of the ligament helps relieve the forces of the contracted deep digital flexor tendon on the coffin joint. During surgery, aggressive trimming of the heels is performed and an acrylic toe extension is often placed on the hoof to achieve a more normal hoof conformation and function. Oxytetracycyline, an antibiotic with muscle and tendon relaxing properties, may also be administered in conjunction with the surgery. Surgical treatment is successful especially if the problem is recognized and treated early. A scar or blemish may occur at the surgery site where the ligament is transected, but again the cosmetic appearance is better with early intervention.

If you think your horse may have this condition, please contact us at The Equine Center for more information or evaluation.