A way to improve or resolve a condition or diagnosis. This might include resolving the underlying cause or treating the signs of disease (symptomatic treatment).

YOUR VET MAY Recommend

Deep Digital Flexor Tenotomy


DDFT tenotomy is the surgical cutting of the deep digital flexor tendon at one of two locations in the lower limb, either the pastern or the mid cannon level.

The deep digital flexor tendon attaches to P3 within the hoof. When this tendon is cut, the rotational forces pulling P3 away from the hoof wall are reduced.

Depending on the surgeon's preference, the procedure can be performed standing or with the horse under general anesthesia. My preference is to perform the surgery under general anesthesia, and at the level of mid metacarpus.

This surgical procedure is performed as a salvage procedure for horses with unmanageable, chronic laminitis of certain types. By removing the pull of the deep digital flexor tendon, the hoof and P3 can be realigned with corrective trimming or shoeing. Lameness is significantly reduced.

Following the procedure, the hoof is trimmed to align P3 with the ground. In most cases, an egg bar or extended heel shoe is placed to keep the hoof on the ground and prevent the toe from raising.


Horses that have undergone DDFT tenotomy must be stall confined with minimal hand walking for 4-6 months, or until the newly formed ring of hoof wall has grown down 3/4 of the way to the ground.

After surgery, a horse needs to be closely monitored, especially the digital pulse and degree of lameness. Be sure you understand what to expect long-term after this procedure is performed and the kind of hoof care and maintenance that will be required.

my vet's role


Overloading of the heel from improper trimming after surgery can result in compressed heels and bruising.

In some cases, DDFT tenotomy in horses that are sinking may actually worsen the problem.

Overcorrection with hyperextension of the lower limb could result in loss of blood supply to the hoof.

Under-correction (under-trimming or inadequate de-rotation) during the finite time period following surgery may reduce the effectiveness of the procedure.


Poor candidates for this procedure include any horse with ongoing uncompensated endocrine disease. Overweight horses are also poor candidates.

Horses that have penetration of P3 through the sole of the hoof and true "sinkers" are also not good candidates for this procedure.

your role

Is it working? Timeframe for effect.
Horses undergoing this procedure should show improvement in pain within a few days.

It takes a full year for the new hoof to grow out completely. Horses can handle limited turnout and increased loading once 1/2 to 3/4 of the new hoof wall has grown out.
Questions To Ask Your Vet:
  • What is the prognosis considering my intended use for my horse?
  • Is my horse a good candidate for this procedure?
  • What is the long-term follow up after this procedure?
  • How long must I keep my horse in a stall after the procedure?
  • What shoeing will the horse need during convalescence & long-term?

further reading & resources

Related References:

Dryden V. Managing the Critical and Complicated Laminitis Case from a Podiatry Perspective. AAEP Proceedings, Focus on the Foot 2013, 59-60.

Author: Doug Thal DVM Dipl. ABVP