Digital amputation and Arthrodesis surgery

Question 1

What are the indications for digital amputation?

Answer 1

• Because chronic lesions have been left for too long…
• Deep digital sepsis/ Septic arthritis of the distal interphalangeal joint
• Complications associated with sole ulcers, white line abscesses, foul in the foot, penetrating injuries)
• Retroarticular abscess
• ‘Non healing’ wall lesions
• Toe necrosis (amputation)

Question 2

Describe method 1 of digital amputation

Answer 2

Disarticulation of the proximal interphalangeal joint
- Foot should be washed and disinfected
- Intravenous regional block should be performed

Question 3

Why are other methods of digital amputation not indicated?

Answer 3

Disrupts the blood supply to the second phalanx which leads to prolonged recovery

Question 4

Describe the treatment prep for arthrodesis

Answer 4

Foot should be washed and disinfected
Intravenous regional block should be performed

Question 5

Describe the post operative care needed following amputation or arthrodesis

Answer 5

Aftercare is crucial!!!!
Dressing changes
Antibiotics
Analgesia!

Question 6

What can go wrong in amputation/arthrodesis procedures?

Answer 6

Poor post operative care
Problems with remaining claw (amputation)
Ascending infections
Chronic pain
Failure to achieve ankylosis of the joint (arthrodesis)