Effect of heel elevation on breakover phase in horses with laminitis

Elevating the heels is a time honored method to help horses with laminitis. Most often applied to horses with mild to moderate laminitis it is difficult and questionable to apply it to a severely laminitic horse. Below the abstract I have put in more information on the techniques used.

Effect of heel elevation on breakover phase in horses with laminitis
BMC Vet Res. 2020 Oct 1;16(1):370. doi: 10.1186/s12917-020-02571-5.
Authors
Mohamad Al Naem 1 , Lutz-Ferdinand Litzke 2 , Florian Geburek 3 , Klaus Failing 4 , Johanna Hoffmann 2 , Michael Röcken 2
Affiliations

1 Clinic for Horses (Surgery, Orthopaedics), Faculty of Veterinary Medicine, Justus-Liebig-University, Giessen, Frankfurter str. 108, 35392, Giessen, Germany. Mohamad.
2 Clinic for Horses (Surgery, Orthopaedics), Faculty of Veterinary Medicine, Justus-Liebig-University, Giessen, Frankfurter str. 108, 35392, Giessen, Germany.
3 Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Hannover, Bünteweg 9, 30559, Hannover, Germany.
4 Unit for Biomathematics and Data Processing, Justus-Liebig-University, Giessen, Frankfurter Str. 95, 35392, Giessen, Germany.

PMID: 33004040
DOI: 10.1186/s12917-020-02571-5

Abstract

Background: In a laminitic horse, the maximal loading of the toe region occurs during the breakover phase. To date, no kinetic data demonstrates the effect of supportive orthopaedic therapy in horses with laminitis on breakover phase. Thus, the purpose of this study was to examine the effect of heel elevation on the breakover phase. Eight horses with acute laminitis treated medically as well as with application of a hoof cast with heel wedge (HCHW) were included in this study. Immediately following cessation of clinical signs of acute laminitis, two measurements using the Hoof™ System were taken: the first with HCHW and the second immediately following removal of the HCHW, i.e. in barefoot condition (BFC). The hoof print was divided into three regions: toe, middle hoof, and heel. Kinetic parameters included vertical force (VF), stance duration, contact area (CA) for all hoof regions during stance phase, duration of breakover, VF in the toe region at onset of breakover and location of centre of force.

Results: The VF and CA were higher in the heel region (63 and 61%, respectively) and decreased significantly after removal of the HCHW (43 and 28% after removal, respectively). The breakover phase in horses with HCHW lasted 2% of stance phase and was significantly shorter than that in BFC, which lasted 6% of stance phase. The VF at onset of breakover for the toe region in horses with HCHW was significantly lower than that in BFC. The centre of the force was located at the heel region in all horses with the HCHW, and at the middle the hoof region in BFC.

Conclusions: Heel elevation in horses with laminitis as examined on a concrete surface significantly shortens breakover phase and decreases the vertical force in the toe region during breakover. HCHW provides adequate support to the palmar hoof structures by increasing the contact area in the heel region and incorporating the palmar part of frog and sole into weight bearing, thus decreasing the stress on the lamellae. Hoof cast with heel elevation could be a beneficial orthopaedic supportive therapy for horses suffering from acute laminitis.

With permission taken from Veterinary Surgery 34:630–636, 2005
Evaluation Using Hoof Wall Strain Gauges of a Therapeutic Shoe
and a Hoof Cast with a Heel Wedge as Potential Supportive Therapy
for Horses with Laminitis
NICOLAS HANSEN, MS, HH, FLORIAN BUCHNER, DVM, PhD, JU¨RGEN HALLER, Ing., and
GERHARD WINDISCHBAUER, DI Dr

The therapeutic shoe was a reversed shoe with a bar to shift
support to the quarter and palmar aspects of the frog. The bar
ended approximately 3 cm palmar to the apex of the frog. The
space between the bar and frog was filled with compressed tow
for even distribution of the support. The shoe ended at the
border between dorsal and lateral hoof wall, and led to an
unsupported toe (Fig 1B) consistent with Moyer.19
The hoof cast we examined was made from 2 rolls of plaster cast (Biplatrix, BSN medical SAS, Vibraye, France).14 The
first third of 1 roll of cast material was unrolled and carefully
molded into the collateral and central grooves of the frog until
the support was some millimeters higher than the weight
bearing surface of the hoof wall. The rest of the plaster cast
was placed as a roll from quarter wall to quarter wall leaving
2 cm of the apex of the frog unsupported, resulting in a wedge
between hoof and ground with an angle between 15 and 20 degrees.
The 2nd roll of cast material was used to secure the wedge by
encasing the hoof and the wedge in cast material.