Medio-lateral balance refers to the symmetry and alignment of the axes of the limb and the hoof as seen from the front or the back. A mediolaterally balanced limb and hoof is aligned on a central axis that is perpendicular to the bearing surface of the hoof, the hoof is symmetrical in size and shape and is evenly divided by the axis of the limb. Deviations of stance or limb conformation (e.g. a rotational or axial deviation in the region of the fetlock) can influence the mediolateral balance.