Curb (horse)

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Curb is defined in older literature as enlargement secondary to inflammation and thickening of the long plantar ligament in horses. [1] However, with the widespread use of diagnostic ultrasonography in equine medicine, curb has been redefined as a collection of soft tissue injuries of the distal plantar hock region. Curb is a useful descriptive term when describing swelling in this area.

Contents

Structures affected

Besides swelling in the long plantar ligament, injury to the deep digital flexor tendon, superficial digital flexor tendon, tarsocrural lateral collateral ligament or peritendonous/periligamentous tissues in this region can contribute to the appearance of curb. Sickle-hocked conformation is a predisposing risk factor for the development of curb. (See hind leg conformation)

Fluid accumulation and/or swelling are almost always found in the peritendonous/periligamentous tissues in curb, often with no additional underlying injuries. Injury to the superficial digital flexor tendon as a cause of curb is as common as injury to the long plantar ligament. Injury to the deep digital flexor tendon as a cause of curb is less common, and collateral ligament desmitis in the tarsocrural joint is uncommon. Combination of injury to the long plantar ligament and tendon of the gastrocnemius is also seen.

Diagnosis

Curb as a visible blemish is an easy diagnosis, as swelling in the distal lateral hock region is, by definition, curb. However, ultrasound is an essential tool in the diagnosis and in establishing a treatment plan. Diagnostic anesthesia (local or nerve blocks) can be helpful, but is not perfectly specific in this area.

Ultrasound vibrations with frequencies above the human hearing range

Ultrasound is sound waves with frequencies higher than the upper audible limit of human hearing. Ultrasound is not different from "normal" (audible) sound in its physical properties, except that humans cannot hear it. This limit varies from person to person and is approximately 20 kilohertz in healthy young adults. Ultrasound devices operate with frequencies from 20 kHz up to several gigahertz.

Treatment

Treatment generally consists of rest, followed by a controlled exercise program, based on clinical and ultrasound findings. Many other treatments related to tendon and ligament injuries have been tried. (See tendinitis)

Related Research Articles

Human leg lower extremity or limb of the human body (foot, lower leg, thigh and hip)

The human leg, in the general meaning, is the entire lower limb of the human body, including the foot, thigh and even the hip or gluteal region. However, the definition in human anatomy refers only to the section of the lower limb extending from the knee to the ankle, also known as the crus. Legs are used for standing, and all forms of locomotion including recreational such as dancing, and constitute a significant portion of a person's mass. Female legs generally have greater hip anteversion and tibiofemoral angles, but shorter femur and tibial lengths than those in males.

Ankle region where the foot and the leg meet

The ankle, or the talocrural region, is the region where the foot and the leg meet. The ankle includes three joints: the ankle joint proper or talocrural joint, the subtalar joint, and the inferior tibiofibular joint. The movements produced at this joint are dorsiflexion and plantarflexion of the foot. In common usage, the term ankle refers exclusively to the ankle region. In medical terminology, "ankle" can refer broadly to the region or specifically to the talocrural joint.

Navicular bone bone of the ankle

The navicular bone is a small bone found in the feet of most mammals.

Hock (anatomy) anatomical region

The hock, or gambrel, is the joint between the tarsal bones and tibia of a digitigrade or unguligrade quadrupedal mammal, such as a horse, cat, or dog. This joint may include articulations between tarsal bones and the fibula in some species, while in others the fibula has been greatly reduced and is only found as a vestigial remnant fused to the distal portion of the tibia. It is the anatomical homologue of the ankle of the human foot. While homologous joints occur in other tetrapods, the term is generally restricted to mammals, particularly long-legged domesticated species.

Navicular syndrome, often called navicular disease, is a syndrome of lameness problems in horses. It most commonly describes an inflammation or degeneration of the navicular bone and its surrounding tissues, usually on the front feet. It can lead to significant and even disabling lameness.

Bowed tendon

Tendinitis/tendonitis is inflammation of a tendon. Many times, the tendon tissue is torn. A bowed tendon is a horseman's term for a tendon after a horse has sustained an injury that caused the tendon fibers to be torn, and then healed with "bowed" appearance.

Ringbone is exostosis in the pastern or coffin joint of a horse. In severe cases, the growth can encircle the bones, giving ringbone its name. It has been suggested by some authors that such a colloquial term, whilst commonly used, might be misleading and that it would be better to refer to this condition as osteoarthritis of the inter-phalangeal joints in ungulates.

Flexor hallucis longus muscle

The flexor hallucis longus muscle (FHL) is one of the three deep muscles of the posterior compartment of the leg that attaches to the plantar surface of the distal phalanx of the great toe. The other deep muscles are the flexor digitorum longus and tibialis posterior; the tibialis posterior is the most powerful of these deep muscles. All three muscles are innervated by the tibial nerve which comprises half of the sciatic nerve.

Plantaris muscle muscle

The plantaris is one of the superficial muscles of the superficial posterior compartment of the leg, one of the fascial compartments of the leg.

Horse hoof structure surrounding distal phalanx in limbs of horses

A horse hoof is a structure surrounding the distal phalanx of the 3rd digit of each of the four limbs of Equus species, which is covered by complex soft tissue and keratinised (cornified) structures. Since a single digit must bear the full proportion of the animal's weight that is borne by that limb, the hoof is of vital importance to the horse. The phrase "no hoof, no horse" underlines how much the health and the strength of the hoof is crucial for horse soundness.

Interphalangeal joints of foot

The interphalangeal joints of the foot are between the phalanges (bones) of the toes. Since the great toe only has two phalanx bones, it only has one interphalangeal joint, which is often abbreviated as the "IP joint." The rest of the toes each have three phalanx bones, so they have two interphalangeal joints: the proximal interphalangeal joint between the proximal and middle phalanges and the distal interphalangeal joint between the middle and distal phalanges. All interphalangeal joints are ginglymoid (hinge) joints, and each has a plantar (underside) and two collateral ligaments. In the arrangement of these ligaments, extensor tendons supply the places of dorsal ligaments, which is similar to that in the metatarsophalangeal articulations.

Skeletal system of the horse

The skeletal system of the horse has three major functions in the body. It protects vital organs, provides framework, and supports soft parts of the body. Horses typically have 205 bones. The pelvic limb typically contains 19 bones, while the thoracic limb contains 20 bones.

Lameness is an abnormal gait or stance of an animal that is the result of dysfunction of the locomotor system. In the horse, it is most commonly caused by pain, but can be due to neurologic or mechanical dysfunction. Lameness is a common veterinary problem in racehorses, sport horses, and pleasure horses. It is one of the most costly health problems for the equine industry, both monetarily for the cost of diagnosis and treatment, and for the cost of time off resulting in loss-of-use.

Pes anserine bursitis

Pes anserine bursitis is an inflammatory condition of the medial (inner) knee at the anserine bursa, a sub muscular bursa, just below the pes anserinus.

Posterolateral corner injuries of the knee are injuries to a complex area formed by the interaction of multiple structures. Injuries to the posterolateral corner can be debilitating to the person and require recognition and treatment to avoid long term consequences. Injuries to the PLC often occur in combination with other ligamentous injuries to the knee; most commonly the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL). As with any injury, an understanding of the anatomy and functional interactions of the posterolateral corner is important to diagnosing and treating the injury.

Medial knee injuries

Medial knee injuries are those to the medial side – the inside of the knee – are the most common. The medial ligament complex of the knee is composed of the superficial medial collateral ligament (sMCL), deep medial collateral ligament (dMCL), and the posterior oblique ligament (POL). These ligaments have also been called the medial collateral ligament (MCL), tibial collateral ligament, mid-third capsular ligament, and oblique fibers of the sMCL, respectively. This complex is the major stabilizer of the medial knee. Injuries to the medial side of the knee are most commonly isolated to these ligaments. A thorough understanding of the anatomy and function of the medial knee structures, along with a detailed history and physical exam, are imperative to diagnosing and treating these injuries.

Limbs of the horse

The limbs of the horse are structures made of dozens of bones, joints, muscles, tendons and ligaments that support the weight of the equine body. They include two apparatuses: the suspensory apparatus, which carries much of the weight, prevents overextension of the joint and absorbs shock, and the stay apparatus, which locks major joints in the limbs, allowing horses to remain standing while relaxed or asleep. The limbs play a major part in the movement of the horse, with the legs performing the functions of absorbing impact, bearing weight, and providing thrust. In general, the majority of the weight is borne by the front legs, while the rear legs provide propulsion. The hooves are also important structures, providing support, traction and shock absorption, and containing structures which provide blood flow through the lower leg. As the horse developed as a cursorial animal, with a primary defense mechanism of running over hard ground, its legs evolved to the long, sturdy, light-weight, one-toed form seen today.

The treatment of equine lameness is a complex subject. Lameness in horses has a variety of causes, and treatment must be tailored to the type and degree of injury, as well as the financial capabilities of the owner. Treatment may be applied locally, systemically, or intralesionally, and the strategy for treatment may change as healing progresses. The end goal is to reduce the pain and inflammation associated with injury, to encourage the injured tissue to heal with normal structure and function, and to ultimately return the horse to the highest level of performance possible following recovery.

Stay apparatus

The stay apparatus is a group of ligaments, tendons and muscles which "lock" major joints in the limbs of the horse. It is best known as the mechanism by which horses can enter a light sleep while still standing up. It does, however, exist in other large land mammals, where it plays a role in reducing fatigue while standing. The stay apparatus allows animals to relax their muscles and doze without collapsing.

References

  1. Stashak (1987) Adams' Lameness in Horses, Philadelphia, Lea & Febiger, pp. 715-718, ISBN   0-8121-0980-5

Sources

Ross et al. (2002), Curb: A Collection of Plantar Tarsal Soft Tissue Injuries, in Proceedings of the American Association of Equine Practitioners, 48(337-342)