Digit Amputation Flashcards
What species has a very reactive periosteum?
Cattle
What is the treatment for septic arthritis in the coffin joint of the cow?
Digit amputation or surgical arthrodesis
What are the 4 pros to digit amputation?
Good short term results
Cheap
Simple/fast
Rapid return to production
What is a pro to arthrodesis?
Good long term results
What are the 3 general steps to arthrodesis?
Treat infection
Remove articular cartilage
Immobilize the joint
What is the benefit of “blocking the sound digit”?
It helps keep the animal comfortable
What are 4 indications for using a digit amputation?
Septic coffin joint
Infection of P2 or P3
Fracture of P2 or P3
Injury or sepsis distal to P1
How long can you leave the tourniquet on for when performing a locoregional block for a digit amputation?
2 hours
What can you do when placing a tourniquet to prevent neurapraxia?
Place padding under the tourniquet.
When performing a locoregional block on a limb, what is the benefit of injecting abx at the same time?
It increases the concentration of abx at the site while the tourniquet is on.
When performing a digit amputation, why do you want to leave as much bone as possible?
To have as much supporting soft tissue as possible.
What is the benefit to cutting the bone with gigly wire when amputating a digit?
Because it’s fast and the heat cauterizes the bone as it cuts.
When amputating a digit, where is your amputation line?
Diagonally (distomedial to proximolateral) through the first phalanx.
What do you need to do BEFORE you remove the tourniquet for a digit amputation?
Place the bandage.
What is the average survival time post-digit amputation?
2 years
NOTE: Some cattle never recover due to rapid breakdown of supporting structures.
What are the 2 more successful digit amputations?
Lateral digit of the thoracic limb
Medial digit of the pelvic limb
How does body weight affect the success of a digit amputation?
Decreases success.
NOTE: Less than 750lbs is ok.
What 4 supporting structures do we see breakdown in a digit amputation?
Soft tissues
Cruciate ligaments
Interdigital ligaments
Flexor tendons
What does amputation of a rear lateral digit increase stress on?
The medial digit
What does amputation of a front medial digit increase stress on?
The lateral digit
What is digit amputation less successful with?
Rear lateral digit
What results in less amputations and better overall outcome in cases of septic arthritis of the distal interphalangeal joint in cattle?
Prompt aggressive treatment of septic arthritis.
What are the 4 structures involved in septic arthritis in the distal interphalangeal joint?
P3/P2
Navicular bursa/bone
Deep digital flexor tendon and sheath
Proximal interphalangeal joint
Why is acute septic arthritis of the distal interphalangeal joint in cattle so rare?
Because owners don’t bring them in right away.
NOTE: The mean time to presentation to a vet is 4.4 weeks
What are 2 treatment options for acute septic arthritis of the distal interphalangeal joint in cattle?
Intraarticular Lavage
Systemic antibiotics
What are 3 treatment options for chronic septic arthritis of the distal interphalangeal joint in cattle?
Facilitated ankylosis
Amputation
Culling
What are the 4 clinical signs of septic arthritis of the DIJ in cattle?
Swelling
Draining tracts
Lacerations
Punctures
What are 4 ways to diagnose septic arthritis of the DIJ in cattle?
PE
Probing of draining tract
Fistulograms
Radiographs
What are 5 causes of DIJ in cattle?
Pododermatitis White line disease Peri-articular wounds Interdigital wounds Interdigital necrobacillosis
What is facilitated ankylosis of DIJ in cattle?
An arthrotomoy is created with a trephine and all the infected cartilage and bone is removed with a curette. The joint space is then lavaged with high volume and the digit is bandaged while the opposite digit is blocked.
What abx can you use locoregionally during facilitated ankylosis?
Chloramphenicol
What are 3 advantages of ankylosis of a digit?
Longer productive life
Better ambulation
Improved longevity
What are 3 disadvantages of ankylosis of a digit?
Expense
Slower return to production
Prolonged treatment/recovery
What are 4 reasons to choose surgical ankylosis?
Value of the animal
Weight of the animal
Digit affected
Longer production potential
