Digit Amputation, PIJ Arthrodesis

Question 1

What is the prognosis for this cow?

Answer 1

Not good

She’s missing a foot. That’s not ideal.

Question 2

Digit amputation can be used as a treatment for:

Answer 2

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

Question 3

For digit amputation in cattle, a tourniquet is applied on middle of metacarpus/metatarsus and an IV block is performed. How long can you leave the tourniquet on?

Answer 3

~2 hours

• You must leave the tourniquet on in order to keep anesthesia localized around the digit and control hemorrhage!*
• Padding under the tourniquet can prevent neurapraxia*

Question 4

T/F: After digit amputation and skin flap suturing, it is important to place the pressure bandage after removing the tourniquet

Answer 4

False

It is important to place the pressure bandage before removing the tourniquet

Question 5

T/F: Using an open technique for digit amputation, the area is left open to heal by 2nd intention

Answer 5

True

However, it is bandaged, just not sutured

Question 6

T/F: In cattle, digit amputation is less successful if done on the medial digit of the thoracic limb or lateral digit of the pelvic limb

Answer 6

True

Question 7

What is the average survival time for cattle post-amputation?

Answer 7

2 years

Some cattle never recover due to rapid breakdown of supporting structures (Disruption of soft tissues, Cruciate ligaments, interdigital ligaments, flexor tendons)

Question 8

Digit amputation is generally not a good option if ________ digit or ________ digit because those are the digits that carry the most weight

Answer 8

Digit amputation is generally not a good option if lateral hind digit or medial front digit because those are the digits that carry the most weight

Question 9

Name the structures involved in septic DIJ in cattle:

Answer 9

• P3, P2
• Navicular bursa/bone
• DDFT/sheath
• PIJ

Question 10

What is the average amount of time that passes before a cow with DIJ septic arthritis presents with clinical signs?

Answer 10

4.4 weeks

Ranges from 1 day - 24 weeks

Question 11

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

Answer 11

swelling, draining tract, laceration, puncture

Question 12

What is the lay term for arthritis/osteoarthritis of the pastern joint?

Answer 12

high ring bone

Question 13

What is the lay term for arthritis/osteoarthritis of the coffin joint?

Answer 13

low ring bone

Question 14

T/F: Horses with severe high articular ringbone (pastern degenerative joint disease) have a poor prognosis for soundness, regardless of treatment

Answer 14

False

Question 15

T/F: Horses with severe high articular ringbone (pastern degenerative joint disease) have a good prognosis for soundness with conservative treatment

Answer 15

False

Question 16

T/F: Horses with severe high articular ringbone (pastern degenerative joint disease) have a good prognosis for soundness following pastern arthrodesis

Answer 16

True

Question 17

Name a few reasons for pastern arthrodesis:

Answer 17

• High ring bone
• Luxation of the pastern
• Fracture second phalanx
• Septic arthritis of the pastern

Question 18

What are the two main principles of PIP arthrodesis?

Answer 18

• Removal of all articular cartilage
• Maintenance of rigid stability in the joint

Question 19

What is the most common surgical technique for pastern arthrodesis?

Answer 19

Combination of trans-articular lag screws and dorsal plate (DCP or LCP)

• Benefits of using a combination of the two:
  
  • ​Enhanced stability
  • Improved comfort post op
  • Shorter time in a cast
  • Shorter return to function
  • Shorter hospitalization time
  • Less peri-articular new bone formation on dorsal aspect

Question 20

Surgical puncture of a bone is termed:

Answer 20

osteostixis

Question 21

What procedure is being performed here?

Answer 21

arthrodesis of proximal interphalangeal joint

The arrows in the picture are pointing to transected collateral ligaments

Question 22

T/F: In general the prognosis for return to full use after arthrodesis of the proximal interphalangeal joint is better for the forelimb than the hindlimb

Answer 22

False

In general the prognosis for return to full use after arthrodesis of the proximal interphalangeal joint is better for the hindlimb than the forelimb