The Steward CLOGBy EDSS, Inc.Copyright © 2003 – All Rights Reserved –Equine Digit Support System, Inc. Product Abstract The Steward Clog is an innovative piece of foot wear for horses afflicted with lameness issues, but can be useful for sound horses in some disciplines. It has been shown by prior treatments and with studies done in the treatment of lower limb pathologies, particularly laminitis and Ring Bone, that limiting the movement of the joints of the distal phalanges (D/P) while in motion is helpful to remove or minimize the pain, hence further trauma to the effected area, be it the joints of the D/P or to the attaching tissue of the lamina. It is generally thought that moving the breakover closer to the dorsal distal border of the distal phalanx (P3) will relieve stress on the lamina in cases of laminitis and the joint of the D/P when Ring Bone or Navicular problems are the issue. Hence, to increase the distance from the dorsal distal border of P3 will increase the strain on the lamina, the attaching ligaments and tendons, and the D/P joints. What has not been considered in depth with previous treatments is the ability to offer relief for horses that suffer from issue that have lateral movement strain on the above structures. Each case of laminitis or D/P joint arthritis has special needs as far as relieving medial or lateral torque on the joints above. Therefore it often is necessary to offer more breakover relief to one side of the limb than to the other, and each limb frequently has separate requirements for optimal relief. There are previous treatments that have considered medial and lateral strain, as well as the importance of breakover from the dorsal aspect of the foot. There are few treatments that offer the ability or opportunity to adjust the breakover axially to inside the peripheral distal border of P3. With the Clog, adjustments can be made to not only one aspect of the ground surface of the device be it anterior, posterior, medial, or lateral, but all aspects of adjustable relief can be altered by reducing peripheral size of the ground contact piece. Even then, the ground contact piece can be moved in all directions around the center of articulation of the D/P joint. It has been seen clearly that to effectively treat debilitating diseases of the foot that a wider range of adjustments that are available will yield better results, especially when adjustments can be made easily and results can be seen immediately. This device offers all of the above mentioned features. Many treatment systems require nailing them to the foot. This is usually extremely traumatic to the patient, especially with laminitis or Ring Bone (D/P arthritis). Gluing treatment systems are also popular in many cases. Securing the device long enough for the adhesive to set is often a problem. With the Steward Clog, attaching it to the foot is done in two unique ways that require screws alone or screws and an adhesive. The foot is generally prepared flat to accept the flat upper foot surface of the Clog. The foot is pre-drilled from the ground side of the foot similar to the location and angle used when standard nails are applied. Special screws are pre-set in the hoof wall from the top or proximal side downward into the upper foot surface of the Clog. If an adhesive is to be applied in conjunction with the screws, the outer surface of the foot is prepared prior to inserting the screws or attaching the foot to the Clog. A second method used for attaching the Clog to the foot, which is unique, is to prepare the foot flat to accept the upper flat foot surface of the Clog and prepared the outer medial and lateral wall for the adhesive. Two screws are installed at the medial and lateral toe quarters of the upper foot surface of the Clog to insure that the foot stays properly positioned while the remaining screws are inserted into the upper foot surface of the Clog downward along side of the medial and lateral hoof wall. The shaft of the screw is straight with no taper so when installed next to the hoof wall it will not move the wall inward. The screw is installed almost perpendicular to the upper foot surface of the Clog. The screw is inserted far enough so that the beveled portion of the screw head just makes contact with the outer surface of the hoof wall. Adhesive is then placed over the screw heads and hoof wall to insure a proper bond. The Steward Clog has an upper foot attaching surface as well as a ground contact surface which can be used to attach the adjustable parts. The thickness will vary with the size of the foot the Clog is being use on. The foot side is wider than the ground surface and will vary as well with size and thickness. The front and rear portions of the ground side taper inward more from the medial and lateral side portions. The rest of the ground contact surface is flat in general. The upper foot side is generally flat. It can be made with a concave area shaped similar to the peripheral distal border of the distal phalanx (coffin bone or P3). This relieved concave area is important to insure that no contact is made wit the sole beneath the distal border of P3. To better insure that this function is carried out, a line is embossed in the flat foot side of the device across the apex of the flatted foot surface inside the concaved or relieved area. It is requested that a line be drawn across the foot at the frog apex with reference marks extending outside and up onto the outer hoof wall to ensure that the frog apex is properly placed on the island formed posterior to the relieved or concaved area of the flat foot surface of the Clog. The inner arc of the concaved area serves as a support area for the frog apex, the bars, and the whole caudal aspect of the foot. The concave section that is shaped similar to the periphery of the distal border of P3 serves as a method to eliminate sole contact and relief to the fragile distal border of P3. The Clog is selected for the foot based on width and is meant to be wider than the foot. The narrower ground side is generally flat, so that the adjustment parts can be attached to this area by screws, bolts or adhesives. There is a selection of shapes that range from flat, tapered, square, round and/or crowned to make a round bottom to the ground contact surface. These adjustment pieces can be moved and attached in virtually any direction to adjust for the equilibrium of the D/P. Sole support impression material is used between the foot and the foot side of the Clog, to help support the entire caudal aspect of the foot. There are occasions when the area of the apex of the frog has prolapsed beyond the length of the ground surface of the hoof wall. This usually occurs as a result of severe rotation associated with laminitis. In these cases, a need to extend the wall ahead of the widest part of the foot or the whole wall from toe to heels is critical when the distal border of P3 is closer to the ground than the hoof wall. The wall must be extended to ensure clearance beneath the prolapsed sole area. A special piece of plastic known as hoof wall extensions are used to help with extending the wall. It is a small piece of hard plastic that is screwed or glued to the hoof wall only once the hoof was been flattened as much as possible. These pieces are made to vary in height so that the proper size can be installed to give clearance to the prolapsed center of the foot. Once the wall extension pieces are attached to the ground surface on 4 corners of the foot, enough impression material is placed in the bottom of the foot to fill the whole sole surface including the wall extended area. A hard, flat impression plate is taped to the bottom of the foot long enough for the impression material to set. When the impression pad is removed, the area only between the wall extension pieces is trimmed so space is available to add special hoof wall composite. The impression material remaining in the foot will not allow the composite to spill over on to the sensitive sole. The composite can be applied to the foot prior to attaching the device or after the screws are installed. It is preferred in most cases to apply the composite after attachment of the Clog. These wall extensions can be used for other applications and are not limited to the Clog.
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Equine Digit Support System, Inc.506 State Hwy 115 ~ Penrose, CO 81240Phone: (719) 372-7463 ~ Fax: (719) 372-7272www.edsshoofcare.com
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