Treatment.—Prognosis is unfavorable in the majority of cases, but should attempts at treatment be undertaken in young and quiet mares which might prove valuable for breeding purposes in case of imperfect recovery, they should be put in slings and the member is to be immobilized as in tibial fracture. Authorities are agreed that prognosis is entirely unfavorable in mature animals, when the case is viewed from an economic standpoint.
Tarsal Sprains.
Etiology and Occurrence.—The hock joint is often subjected to great strain because of the structural nature of this part and its relation to the hip as well as the manner in which the tarsus functionates during locomotion. That ligamentous injuries owing to sprain frequently occur and attendant periarticular inflammations with subsequent hypertrophic changes follow, is a logical inference. Fibrillary fracture of the collateral ligaments may take place in falls or when animals make violent efforts to maintain their footing on slippery streets. In expressing opinions concerning the frequency with which the hock is found to be the seat of trouble in lameness of the pelvic members, different writers place the percentage of hock lameness at from seventy-five to ninety per cent. And when one considers the possibility that a goodly proportion of cases of tarsal exostis are the outcome of sprains, the occurrence of tarsal sprains may be more generally admitted.
Symptomatology.—A mixed type of lameness is present and the nature of the impediment varies, depending upon the location of the injury. Sprains of the mesial tarsal ligaments cause lameness somewhat similar to that of spavin. However, in establishing a diagnosis, local evidence in these cases is of greater significance than the manner of locomotion. During the acute stage of inflammation there is to be detected local hyperthermia, some hyperesthesia and a little swelling. Later, when resolution is not prompt, considerable swelling (or perhaps correctly speaking, an indurated enlargement) variable in size is developed. In some cases the entire tarsal region becomes greatly enlarged and this swelling is very slowly absorbed in part or completely. Such sub-acute cases are observed during the winter season and particularly where subjects are kept in tie stalls without exercise for weeks at a time.
Treatment.—Attention should be directed toward relief for the animal in all acute inflammations. Local applications of heat are helpful and, of course, rest is essential. Towels that are wrung out of hot water and held in position by means of a few turns of a loose bandage and this covered with an impervious rubber sheet, will serve as a practical means of application of hydrotherapy. Following this when conditions improve, as in the handling of all similar cases, counterirritation is indicated.
When proper care is given at the onset and where injury does not involve too much ligamentous tissue, recovery takes place in a few weeks but in some cases which occur during the winter season in farm horses, complete recovery does not result until several months have passed.
Curb.
The hock is said to be curbed when the normal appearance, viewed from the side, is that of bulging posteriorly at any point between the summit of the calcaneum and the upper third of the metatarsus. Among some horsemen a hock is said to be "curby" whenever there exists an enlargement of any kind on the posterior face of the tarsus whether it be due to sprain, exostosis or proliferation of tissue as a result of contusion.
French veterinarians consider under the title of "courbe," an exostosis situated on the mesial side of the distal end of the tibia. Cadiot and Almy state that this condition (courbe) is of rare occurrence. Percivall defines curb as "a prominence upon the back of the hind leg, a little below the hock, of a curvilinear shape, running in a direct line downwards and consisting of infusion into, or thickening of, the sheath of the flexor tendons." Möller's version of true curb is a thickening of the plantar ligament (calcaneocuboid or calcaneometatarsal). Hughes and Merillat consider curb as a synovitis having for its seat the synovial bursa which is situated between the superficial flexor tendon (perforatus) and the plantar ligament.
Occurrence.—Certain predisposing factors seem to favor the occurrence of curb. A malformation of the inferior part of the tarsus so that its antero-posterior diameter is considerably less than normal is a contributing cause. Such hocks are known as "tied-in." Another fault in conformation is the existence of a weak hock that is set low down on a crooked leg, especially when such a member is heavily muscled at the hip. Given such conformation in an excitable horse, and curb is usually produced before the subject is old enough for service. It is certain that in cases where conformation is bad, greater strain is put upon the plantar ligament. This structure serves to bind the tibial tarsal (calcis) bone to the metatarsus; traction exerted upon its summit by the tendo Achillis is great when animals run, jump or rear and also at heavy pulling. In animals having curby hocks, sprain is likely to result and curb supervenes.