Digit Amputation

Question 1

What species has a very reactive periosteum?

Answer 1

Cattle

Question 2

What is the treatment for septic arthritis in the coffin joint of the cow?

Answer 2

Digit amputation or surgical arthrodesis

Question 3

What are the 4 pros to digit amputation?

Answer 3

Good short term results
Cheap
Simple/fast
Rapid return to production

Question 4

What is a pro to arthrodesis?

Answer 4

Good long term results

Question 5

What are the 3 general steps to arthrodesis?

Answer 5

Treat infection
Remove articular cartilage
Immobilize the joint

Question 6

What is the benefit of “blocking the sound digit”?

Answer 6

It helps keep the animal comfortable

Question 7

What are 4 indications for using a digit amputation?

Answer 7

Septic coffin joint
Infection of P2 or P3
Fracture of P2 or P3
Injury or sepsis distal to P1

Question 8

How long can you leave the tourniquet on for when performing a locoregional block for a digit amputation?

Answer 8

2 hours

Question 9

What can you do when placing a tourniquet to prevent neurapraxia?

Answer 9

Place padding under the tourniquet.

Question 10

When performing a locoregional block on a limb, what is the benefit of injecting abx at the same time?

Answer 10

It increases the concentration of abx at the site while the tourniquet is on.

Question 11

When performing a digit amputation, why do you want to leave as much bone as possible?

Answer 11

To have as much supporting soft tissue as possible.

Question 12

What is the benefit to cutting the bone with gigly wire when amputating a digit?

Answer 12

Because it’s fast and the heat cauterizes the bone as it cuts.

Question 13

When amputating a digit, where is your amputation line?

Answer 13

Diagonally (distomedial to proximolateral) through the first phalanx.

Question 14

What do you need to do BEFORE you remove the tourniquet for a digit amputation?

Answer 14

Place the bandage.

Question 15

What is the average survival time post-digit amputation?

Answer 15

2 years

NOTE: Some cattle never recover due to rapid breakdown of supporting structures.

Question 16

What are the 2 more successful digit amputations?

Answer 16

Lateral digit of the thoracic limb

Medial digit of the pelvic limb

Question 17

How does body weight affect the success of a digit amputation?

Answer 17

Decreases success.

NOTE: Less than 750lbs is ok.

Question 18

What 4 supporting structures do we see breakdown in a digit amputation?

Answer 18

Soft tissues
Cruciate ligaments
Interdigital ligaments
Flexor tendons

Question 19

What does amputation of a rear lateral digit increase stress on?

Answer 19

The medial digit

Question 20

What does amputation of a front medial digit increase stress on?

Answer 20

The lateral digit

Question 21

What is digit amputation less successful with?

Answer 21

Rear lateral digit

Question 22

What results in less amputations and better overall outcome in cases of septic arthritis of the distal interphalangeal joint in cattle?

Answer 22

Prompt aggressive treatment of septic arthritis.

Question 23

What are the 4 structures involved in septic arthritis in the distal interphalangeal joint?

Answer 23

P3/P2
Navicular bursa/bone
Deep digital flexor tendon and sheath
Proximal interphalangeal joint

Question 24

Why is acute septic arthritis of the distal interphalangeal joint in cattle so rare?

Answer 24

Because owners don’t bring them in right away.

NOTE: The mean time to presentation to a vet is 4.4 weeks

Question 25

What are 2 treatment options for acute septic arthritis of the distal interphalangeal joint in cattle?

Answer 25

Intraarticular Lavage | Systemic antibiotics

Question 26

What are 3 treatment options for chronic septic arthritis of the distal interphalangeal joint in cattle?

Answer 26

Facilitated ankylosis Amputation Culling

Question 27

What are the 4 clinical signs of septic arthritis of the DIJ in cattle?

Answer 27

Swelling Draining tracts Lacerations Punctures

Question 28

What are 4 ways to diagnose septic arthritis of the DIJ in cattle?

Answer 28

PE Probing of draining tract Fistulograms Radiographs

Question 29

What are 5 causes of DIJ in cattle?

Answer 29

``` Pododermatitis White line disease Peri-articular wounds Interdigital wounds Interdigital necrobacillosis ```

Question 30

What is facilitated ankylosis of DIJ in cattle?

Answer 30

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.

Question 31

What abx can you use locoregionally during facilitated ankylosis?

Answer 31

Chloramphenicol

Question 32

What are 3 advantages of ankylosis of a digit?

Answer 32

Longer productive life Better ambulation Improved longevity

Question 33

What are 3 disadvantages of ankylosis of a digit?

Answer 33

Expense Slower return to production Prolonged treatment/recovery

Question 34

What are 4 reasons to choose surgical ankylosis?

Answer 34

Value of the animal Weight of the animal Digit affected Longer production potential