Fig. 1. A, Venogram study before DDF tenotomy with evidence of severe compromised blood supply. The distal phalanx apex has descended distal to the circumflex vessel (arrow) and contrast is absent distal to the apex identifying poor perfusion of the solar plexus and absent terminal papillae. The coronary plexus (arrow) is also compromised with poor perfusion and absent papillae. B, Venogram study 6 weeks post DDF teno- tomy shows that contrast has returned to the coronary plexus, and papillae are evident (arrow). The distal phalanx apex and the lamellar-circumflex junction has returned to a normal ori- entation (arrow). Contrast is slightly reduced distal to the distal phalanx palmar processes. (Images courtesy of Dr. Amy Rucker.)
ing until radiographic evidence confirms that sig- nificant displacement has occurred. By re-establishing vascular perfusion, the ulti-
mate goal is to maintain health of the coffin bone and eventually re-establish normal coffin bone align- ment and adequate sole depth. Transection of the DDF tendon allows immediate re-alignment of the coffin bone in relation to the ground surface. Tim-
Fig. 2. A, Horse with derotation/re-alignment shoe and DDF tenotomy. B, Evidence of a positive response to DDF tenot- omy 6 weeks later with significant sole growth. C, The ulti- mate goal has been achieved when health of the coffin bone and re-establishing normal coffin bone alignment with adequate sole depth has been maintained.
ing of the DDF tenotomy and re-alignment shoeing procedure is critical. The procedure should be performed before the patient experiences ad- vanced structural failure. The most important
