Digit Amputation

Digit amputation is indicated when severe foot abscesses or septic arthritis of the interphalangeal joints have caused unmanageable damage to a single digit (Figure 22-1). Radiography, if elected, may show the extent of the lesion (Figure 22-2A and B). These injuries are most commonly caused by wounds from trauma on concrete flooring or metal side panels. The decision for amputation should not be delayed. Digit amputation will not be curative if the infection extends to the fetlock or more proximally on the limb. Also, the soundness of the opposite digit should be assessed to determine whether the pig will be able to ambulate on the remaining digit after amputation.

Figure 22-1 Pig with severe septic arthritis of the distal interphalangeal joint. Note that the claw is sloughing.

(Courtesy of Dr. Christopher Beinlich; Cornell University.)

Figure 22-2 A, Dorsoproximal and B, lateral radiographs of the left thoracic-limb digit in a 2-year old female-intact porcine with left thoracic-limb lameness. Note the fractures in the middle and distal phalanges of the third digit and the distal phalanx of the fourth digit (white arrows). Also, in the soft tissues of the claw, there are multiple gas opacities (black arrows). The diagnosis in this patient was chronic pathologic fractures secondary to osteomyelitis and cellulitis.

(Courtesy of Dr. Anthony Pease; Cornell University.)

After induction of general anesthesia, the affected digit is cleaned and prepared for surgery. A tourniquet is placed proximal to the surgery site to prevent extensive hemorrhage during surgery. A circumferential incision is made through the skin and soft tissues at a 45-degree angle to the coronary band, starting at the axial aspect of the digit and continuing proximally to the abaxial surface. The skin is reflected proximal to the site being amputated, and a sterile obstetrical wire is used to amputate the digit. The distal phalanx and a portion of the middle phalanx are removed by this procedure. The remaining tissues are debrided and cleaned thoroughly. The foot is placed in a padded bandage for 10 to 14 days. The foot is cleaned daily with water until the wound is healed. Perioperative antibiotics and antiinflammatory drugs are indicated.