A study of some sequelae of amputation of the digit using three operative techniques

The effect of digit amputation or arthrodesis surgery on culling and milk production in holstein dairy cows

The objectives of the study were to evaluate the effects of digit amputation and arthrodesis surgery performed in the field on culling and milk production during the early postsurgical period. Cows from 3 commercial dairy farms in New York State were recruited for the study. A total of 49 cows on which digit amputation (AMP) was performed were matched with 68 controls (MC-AMP), and 17 cows on which arthrodesis surgery (ARTHRO) was performed were matched with 20 controls (MC-ARTHRO) according to lactation, DIM, and lactation at the time of surgery. Performance was not directly comparable between the AMP and ARTHRO groups because cows were not randomly assigned to the 2 treatment groups. Therefore, each surgical group was evaluated relative to its respective matched control group. Cows with AMP had a significantly lower estimated median survival of 68 d (95% confidence interval; lower = 35 d, upper = 156 d) compared with 585 d (95% confidence interval; lower = 469 d, upper = 699 d) for the MC-AMP group. Total milk production for the first 60 d postsurgery was significantly lower for the AMP (1,533 +/- SE = 101 kg) group compared with the MC-AMP (2,121 +/- 101 kg) group and for the ARTHRO (1,883 +/- 86 kg) group compared with the MC-ARTHRO (2,250 +/- 88 kg) group. Septic arthritis of the distal interphalangeal joint was the most common condition treated by surgery, accounting for 70.5% of ARTHRO cases and 73.5% for AMP. Toe necrosis accounted for 14.3% of AMP cases, and retroarticular abscess made up the rest of the AMP (12.2%) cases and 29.5% of the ARTHRO cases. Results suggest that cows that had undergone ARTHRO had a lower culling rate and a faster return to production compared with those that had undergone AMP. Arthrodesis should be considered as a treatment option for deep sepsis of the bovine foot.

Alternatives to amputation

Amputation of the digit of valuable animals is an inappropriate technique for resolving the serious infective processes that involve the important structures of the distal interphalangeal region. Surgeons should be able to recognize the early clinical signs and radiographic indications of three distinct, but interrelated, phenomena--the septic joint, the retroarticular abscess, and the complication of tenovaginitis. Tenovaginitis depends on either the septic joint or retroarticular abscess for its etiology. In any of these complications, the effective treatment will be based on the removal of diseased tissue and on irrigation with drainage of the area, followed by the elimination of mechanical forces or movement in the affected region.