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Today we continue our new excerpt from Equine ER, the nonfiction book from Eclipse Press by Leslie Guttman. Last week, a young colt named Sid was examined and found to have the worst case of clubfoot syndrome his vet had ever seen. Today: What's to be done?

During the evaluation, Dr. Scott Morrison inspected each of Sid's coronary bands, the circles of vascular tissue located on the hoof wall’s upper end. A hoof’s growth springs from there, and the doctor was checking to see if the colt had laminitis, which he did not. Morrison shot radiographs to look at the health of the coffin bone and the degree of luxation, or misalignment, in the joint. The coffin bone, or third phalanx, is the primary bone in a horse’s foot. Located inside the hoof capsule (like a body in a coffin), it bears much of a horse’s weight.

Sid's feet would cause him severe problems if left uncorrected.

Sid’s coffin bone was healthy. He didn’t have bone disease from it being loaded abnormally for a long time. Yet he would need a coffin bone realignment, with shoeing and trimming by Morrison. Then surgeon Brett Woodie would perform a tenotomy, in which Sid’s tendons would be cut to release them. Doing so would create a gap that would eventually fill in with scar tissue, creating artificial length and allowing the heels to lower and position properly. (In less severe cases of clubfoot syndrome, special shoeing alone over time will straighten out the problem.)

After a coffin bone realignment, Sid would have a tenotomy, where the tendons would be cut to release them.

With Sid being young and healthy, the prognosis was good for him to be pasture sound, barring any complications. He’d never be a high-level performance horse, but that wasn’t his path anyway.

Normally, Morrison could numb a colt and do his part with the animal standing. But Sid wasn’t accustomed to standing for anyone so he was put under anesthesia.

With Sid on an operating table, Morrison started taking the colt’s heels down with a regular battery-powered sander and sandpaper; they had grown too much to counteract the toes that were wearing off from the pressure of walking on them. It only took a couple of minutes. Wilson, watching from the observation window, thought, “Oh my God. There’s just little stubs left.” Then the doctor sanded the entire hoof wall. With a rubbery acrylic-like substance, similar to Bondo, plus a material made of carbon fiber and Kevlar (the material used to make bulletproof vests), Morrison built a layer of toe, wrapped it tightly in plastic wrap, let it dry for five minutes, and started over. He often thought the process was like fixing a dent in a car. After about six layers, the new toe was built.

Then, an aluminum egg-bar, or round, shoe with a horizontal heel extension was nailed on for further stability. With the reconstruction, not only would Sid look more normal, he’d land normally on his feet, and the weight would be distributed correctly, keeping the coffin bone aligned. He’d need to come back to make sure everything was progressing correctly while the surgery he was about to have healed.

Nurses moved Sid into another sterile operating room where Woodie would perform the tenotomy. For Woodie, Sid’s clubfeet were also some of the most troublesome he had ever seen. The surgeon made an incision on the outside of the colt’s left front leg. The doctor dissected down to the deep digital flexor tendon in the mid-cannon region, isolated it, and severed the tendon. Then he did the other leg. The worry in the operation is undercorrection – not enough release – or overcorrection, where the toe would rise off the ground from the heel. Woodie flexed and extended Sid’s lower limbs on the table. He’d gotten a four- to five-inch release. He gave Wilson the thumbs-up and closed Sid up. Now everyone would have to wait to see how the colt did over the coming weeks to determine if the operation was a success. Woodie was both worried and optimistic, a normal state for him.

Next: How was Sid after his procedures?