Exam 2: Arthrodesis of the PIJ (Proximal Interphalangeal Joint) Flashcards

1
Q

surgical immobilization of a joint by fusion of the adjacent bones

A

Arthrodesis

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2
Q

What are the indications for

arthrodesis of the PIJ (pastern joint)?

A

High ring bone

Pastern luxation

P2 fracture

Pastern septic arthritis

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3
Q

What are the 3 surgical techniques that can be used to

accomplish arthrodesis of the PIJ (pastern joint)?

A

Trans-articular lag screws

Dorsal plate (DCP or LCP)

Screws AND Plate

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4
Q

What is the best way to accomplish

arthrodesis of the PIJ (pastern joint) and why?

A

Transarticular lag screws + dorsal plate

  • better stability and comfort*
  • less time in cast and hospital*
  • less periarticular bone formation on dorsal aspect*
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5
Q

What type of incision is used in

arthrodesis of the PIJ (pastern)?

A

Inverted T incision

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6
Q

What are the landmarks for the longitudinal portion

of the inverted T incision?

A

Junction of the proximal and middle third of the proximal phalanx

to

2 cm above the coronary band

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7
Q

What structure is visualized upon

inverted T incision?

A

Common Digital Extensor (CDE) tendon

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8
Q

This type of incision is used to transect the

common digital extensor tendon

in order to elevate and reflect it distally

A

Inverted V incision

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9
Q

For arthrodesis of the PIJ/Pastern joint,

after removing any bony proliferations on the dorsal

surface and the cartilage in the joint capsule,

__________ of the subchondral (P1,P2) bone plates

is done using a 2.5 mm drill bit

A

Osteostixis (surgical puncture of a bone)

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10
Q

How many osteostixis are made

in P1 and P2 for screw placement

in arthrodesis procedure?

A

TWO glide holes in P1

ONE thread hole in P2

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11
Q

After drilling the holes in P1 and P2,

you need to _______ and tap

and enter P1 at an angle to get into P2

A

countersink

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12
Q

What has a better success rate for pastern arthrodesis?

Forelimb or Hindlimb?

A

HIND limb = 95% success

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13
Q

What is the forelimb success rate for pastern arthrodesis?

A

81%

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14
Q

This type of imaging is a must

intra and post op for

pastern arthrodesis sx.

A

RADS

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15
Q

Even though the success rate for pastern arthrodesis

is so high, complications are life threatening and costly.

Name some complications associated with this sx.

A

cast discomfort

implant (plate) failure

instability

infection (staphylococcus)

pressure sores

ischemia of distal limb

laminitis

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16
Q

_______ are the mainstay for

management of complications for pastern arthrodesis

A

NSAIDS

17
Q

What meds are used to manage complications of

pastern arthrodesis sx?

A

Nsaids

Morphine, Butorphanol

Bupivicaine

Lidocaine

Gabapentin

Aspirin, Acepromazine, Pentoxyphylline