The relationship between sagittal hoof conformation and hindlimb lameness in the horse.
Authors: Pezzanite L, Bass L, Kawcak C, Goodrich L, Moorman V
Journal: Equine veterinary journal
Summary
# Editorial Summary: Sagittal Hoof Conformation and Hindlimb Lameness A negative or neutral plantar angle of the distal phalanx (PADP)—where the bottom of the coffin bone is not adequately bevelled or is even horizontal—appears significantly associated with hindlimb lameness in horses, particularly when the problem originates in the distal tarsus or proximal metatarsus. Pezzanite and colleagues conducted a case-control study comparing radiographic hoof conformation in 80 lame horses (with lameness localised via regional anaesthesia) against 80 sound controls, measuring the sagittal plane angle of the distal phalanx. Horses presenting with hindlimb lameness were nearly four times more likely to have a negative or neutral PADP than controls (OR 3.87), with tarsal lameness cases showing the strongest association (OR 4.98) and proximal suspensory cases also significantly affected (OR 5.16); importantly, stifle lameness showed no such correlation. Whilst the study cannot definitively establish whether poor hoof balance predisposes to these injuries or results from them, the findings suggest that corrective farriery targeting improved PADP warrants investigation as part of a multimodal treatment approach for distal hindlimb lameness—though practitioners should recognise that hoof conformation alone is unlikely to be a complete solution. This work highlights the value of obtaining lateromedial radiographs and assessing hoof geometry when managing chronic hindlimb lameness, particularly in regions proximal to the foot.
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Practical Takeaways
- •Assess hoof balance in the sagittal plane (PADP) as part of diagnostic workup for hindlimb lameness, particularly for distal tarsal and proximal metatarsal region problems
- •Corrective farriery aimed at improving PADP may be beneficial as an adjunctive treatment for distal tarsal and proximal suspensory lameness, though causality not yet established
- •Do not rely on hoof conformation assessment alone for suspected stifle lameness, as PADP does not appear to be a significant risk factor for this location
Key Findings
- •Horses with hindlimb lameness had significantly smaller mean plantar angle of the distal phalanx (PADP) compared to non-lame controls
- •Negative/neutral PADP was associated with 3.87-fold increased odds of hindlimb lameness overall
- •Tarsal lameness showed 4.98-fold increased odds and proximal suspensory lameness showed 5.16-fold increased odds with negative/neutral PADP
- •Stifle lameness was not significantly associated with PADP, suggesting hoof conformation is not a primary risk factor for this location