TY - JOUR KW - ostectomy KW - bovine KW - proximal interphalangeal joint KW - septic arthritis AU - J Burgstaller AU - J Kofler AB - A five month old Brown Swiss heifer calf (212 kg body mass) with severe left hind limb lameness, caused by a wound of the lateral digit was referred to the veterinary teaching hospital. The calf showed a score 4 of 5 lameness on the left hind limb. A scarified skin lesion with a fistula formation and purulent exudate was observed at the level of the proximal interphalangeal joint (PIJ) of the lateral digit of the left hind. The PIJ region and the lateral digit were severely swollen and painful. Ultrasonography showed a moderate anechoic effusion of the lateral digital flexor tendon sheet (DFTS) and a severe heterogeneous hypoechoic effusion with some small hyperechoic areas of the plantar and dorsal pouch of the PIJ. In addition, a highly irregular contour of the dorsal and abaxial surface of the phalanx media (P2) and the distal aspect of the proximal phalanx (P1) were imaged. Based on physical examination and ultrasonographic findings, the diagnosis was chronic purulent arthritis of the PIJ, osteitis of P2 and the distal end of P1 with suspected adjacent osteomyelitis. Complete ostectomy of P2 and ostectomy of the distal part of the P1 of the lateral digit was performed with an oscillating saw through the extended debrided wound. The lameness improved subsequently and 21 days post-surgery the calf was discharged from the clinic without lameness, and with a wooden block attached to the healthy claw. A year later the heifer was pregnant and still in the herd, during this period it did not exhibit lameness. The described surgical technique resulted in an excellent long-term outcome and may be considered in cases of severe purulent joint infection of the PIJ with osteolytic processes in adjacent bones, as a digit salvage procedure especially for young cattle. BT - Berliner und Münchener Tierärztliche Wochenschrift C1 - {"oldId":94129,"title":"Complete ostectomy of middle phalanx and partial ostectomy of proximal phalanx in a Brown Swiss calf for treatment of purulent arthritis of the proximal interphalangeal joint and adjacent severe osteomyelitis","topline":"","teaserText":"Resektion des Kronbeins und Teilresektion des Fesselbeins zur Behandlung einer chronisch eitrigen Arthritis im Krongelenk und Osteomyelitis bei einem Braunviehkalb","content":"

Summary<\/span>
A five month old Brown Swiss heifer calf (212 kg body mass) with severe left hind limb lameness, caused by a wound of the lateral digit was referred to the veterinary teaching hospital. The calf showed a score 4 of 5 lameness on the left hind limb. A scarified skin lesion with a fistula formation and purulent exudate was observed at the level of the proximal interphalangeal joint (PIJ) of the lateral digit of the left hind. The PIJ region and the lateral digit were severely swollen and painful. Ultrasonography showed a moderate anechoic effusion of the lateral digital flexor tendon sheet (DFTS) and a severe heterogeneous hypoechoic effusion with some small hyperechoic areas of the plantar and dorsal pouch of the PIJ. In addition, a highly irregular contour of the dorsal and abaxial surface of the phalanx media (P2) and the distal aspect of the proximal phalanx (P1) were imaged. Based on physical examination and ultrasonographic findings, the diagnosis was chronic purulent arthritis of the PIJ, osteitis of P2 and the distal end of P1 with suspected adjacent osteomyelitis. Complete ostectomy of P2 and ostectomy of the distal part of the P1 of the lateral digit was performed with an oscillating saw through the extended debrided wound. The lameness improved subsequently and 21 days post-surgery the calf was discharged from the clinic without lameness, and with a wooden block attached to the healthy claw. A year later the heifer was pregnant and still in the herd, during this period it did not exhibit lameness. The described surgical technique resulted in an excellent long-term outcome and may be considered in cases of severe purulent joint infection of the PIJ with osteolytic processes in adjacent bones, as a digit salvage procedure especially for young cattle.<\/p>

Keywords<\/span>
ostectomy, bovine, proximal interphalangeal joint, septic arthritis <\/p>

Zusammenfassung<\/span>
Ein f\u00fcnf Monate altes Braunvieh-Kuhkalb (212 kg KM) wurde mit einer hochgradigen St\u00fctzbeinlahmheit (Score 4 von 5) an der linken Hinterextremit\u00e4t, welche durch eine Wunde an der lateralen Zehe verursacht worden war, vorgestellt. Eine vernarbte Wunde sowie ein Fistelkanal mit eitrigem Exsudat konnten auf H\u00f6he des Krongelenks an der lateralen Zehe exploriert werden. Die gesamte Zehe war umfangsvermehrt und auf Druck schmerzhaft. Mittels Sonografie konnten ein mittelgradiger anechoischer Erguss in der lateralen Beugesehnenscheide und ein inhomogener hypo- bis hyperechoischer Erguss im plantaren und dorsalen Rezessus des Krongelenks sowie eine hochgradig raue Oberfl\u00e4che des Kron- sowie des distalen Fesselbeins festgestellt werden. Als definitive Diagnose wurden eine eitrige Arthritis des Krongelenks und eine hochgradige Osteo myelitis des angrenzenden Kron- und distalen Fesselbeins gestellt. Nach einer L\u00e4ngsinzision \u00fcber die L\u00e4nge des Kronbeins, ausgehend von der Fistel, wurden die Totalresektion des Kronbeins und die Teilresektion des Fesselbeins mithilfe einer oszillierenden S\u00e4ge durchgef\u00fchrt. Postoperativ verringerte sich die Lahmheit sukzessive und 21 Tage sp\u00e4ter wurde das Kalb mit einem Holzklotz auf der gesunden Klaue entlassen. Es zeigte zu diesem Zeitpunkt keine erkennbare Lahmheit hinten links. Ein Jahr danach war die nun tr\u00e4chtige F\u00e4rse noch in der Herde. Die beschriebene Operationstechnik resultierte in einem exzellenten Behandlungserfolg und kann bei chronisch eitrigen Krongelenksentz\u00fcndungen mit Osteomyelitis der angrenzenden Knochen vor allem bei Jungrindern als klauenerhaltende Ma\u00dfnahme in Erw\u00e4gung gezogen werden.<\/p>

Schl\u00fcsselw\u00f6rter<\/span>
Resektion, Rind, Krongelenk, septische Arthritis<\/p>","categories":["Tier\u00e4rztliche Wochenschrift","Abostufe BMTW","Fachartikel"],"fromDate":"Mar 14, 2016 11:00:00 PM","oldUrls":["http:\/\/vetline.de\/complete-ostectomy-of-middle-phalanx-and-partial-ostectomy-of-proximal-phalanx-in-a-brown-swiss-calf-for-treatment-of-purulent-arthritis-of-the-proximal-interphalangeal-joint-and-adjacent-severe-osteomyelitis\/150\/3130\/94129"],"doiLanguage":"englisch","doiProductFormat":"online","doiPublisher":"Schl\u00fctersche Verlagsgesellschaft mbH & Co. KG","doiSerialWorkTitle":"Berliner und M\u00fcnchener Tier\u00e4rztliche Wochenschrift","doiDocumentUri":"http:\/\/www.vetline.de\/complete-ostectomy-of-middle-phalanx-and-partial-ostectomy-of-proximal-phalanx-in-a-brown-swiss-calf-for-treatment-of-purulent-arthritis-of-the-proximal-interphalangeal-joint-and-adjacent-severe-osteomyelitis\/150\/3130\/94129\/","doiSource":"Berl M\u00fcnch Tier\u00e4rztl Wochenschr 129, 133\u2013143 (2016) ","doiissn":"0005-9366","doiNr":"10.2376\/0005-9366-129-133","doiFirstPage":"133","doiLastPage":"143","doiTransmitted":true,"doiAuthor":"Burgstaller J, Kofler J","pdf":{"path":"http:\/\/data\/BMW_2016_03_04_0138.pdf","title":"BMW_2016_03_04_0138.pdf","description":"Complete ostectomy of middle phalanx and partial ostectomy of proximal phalanx in a Brown Swiss calf for treatment of purulent arthritis of the proximal interphalangeal joint and adjacent severe osteomyelitis"},"authors":[{"firstName":"J","middleName":"","lastName":"Burgstaller"},{"firstName":"J","middleName":"","lastName":"Kofler"}],"contentOptimised":"

Summary<\/strong>
A five month old Brown Swiss heifer calf (212 kg body mass) with severe left hind limb lameness, caused by a wound of the lateral digit was referred to the veterinary teaching hospital. The calf showed a score 4 of 5 lameness on the left hind limb. A scarified skin lesion with a fistula formation and purulent exudate was observed at the level of the proximal interphalangeal joint (PIJ) of the lateral digit of the left hind. The PIJ region and the lateral digit were severely swollen and painful. Ultrasonography showed a moderate anechoic effusion of the lateral digital flexor tendon sheet (DFTS) and a severe heterogeneous hypoechoic effusion with some small hyperechoic areas of the plantar and dorsal pouch of the PIJ. In addition, a highly irregular contour of the dorsal and abaxial surface of the phalanx media (P2) and the distal aspect of the proximal phalanx (P1) were imaged. Based on physical examination and ultrasonographic findings, the diagnosis was chronic purulent arthritis of the PIJ, osteitis of P2 and the distal end of P1 with suspected adjacent osteomyelitis. Complete ostectomy of P2 and ostectomy of the distal part of the P1 of the lateral digit was performed with an oscillating saw through the extended debrided wound. The lameness improved subsequently and 21 days post-surgery the calf was discharged from the clinic without lameness, and with a wooden block attached to the healthy claw. A year later the heifer was pregnant and still in the herd, during this period it did not exhibit lameness. The described surgical technique resulted in an excellent long-term outcome and may be considered in cases of severe purulent joint infection of the PIJ with osteolytic processes in adjacent bones, as a digit salvage procedure especially for young cattle.<\/p>

Keywords:<\/strong>
ostectomy, bovine, proximal interphalangeal joint, septic arthritis <\/p>

Zusammenfassung<\/strong>
Ein f\u00fcnf Monate altes Braunvieh-Kuhkalb (212 kg KM) wurde mit einer hochgradigen St\u00fctzbeinlahmheit (Score 4 von 5) an der linken Hinterextremit\u00e4t, welche durch eine Wunde an der lateralen Zehe verursacht worden war, vorgestellt. Eine vernarbte Wunde sowie ein Fistelkanal mit eitrigem Exsudat konnten auf H\u00f6he des Krongelenks an der lateralen Zehe exploriert werden. Die gesamte Zehe war umfangsvermehrt und auf Druck schmerzhaft. Mittels Sonografie konnten ein mittelgradiger anechoischer Erguss in der lateralen Beugesehnenscheide und ein inhomogener hypo- bis hyperechoischer Erguss im plantaren und dorsalen Rezessus des Krongelenks sowie eine hochgradig raue Oberfl\u00e4che des Kron- sowie des distalen Fesselbeins festgestellt werden. Als definitive Diagnose wurden eine eitrige Arthritis des Krongelenks und eine hochgradige Osteo myelitis des angrenzenden Kron- und distalen Fesselbeins gestellt. Nach einer L\u00e4ngsinzision \u00fcber die L\u00e4nge des Kronbeins, ausgehend von der Fistel, wurden die Totalresektion des Kronbeins und die Teilresektion des Fesselbeins mithilfe einer oszillierenden S\u00e4ge durchgef\u00fchrt. Postoperativ verringerte sich die Lahmheit sukzessive und 21 Tage sp\u00e4ter wurde das Kalb mit einem Holzklotz auf der gesunden Klaue entlassen. Es zeigte zu diesem Zeitpunkt keine erkennbare Lahmheit hinten links. Ein Jahr danach war die nun tr\u00e4chtige F\u00e4rse noch in der Herde. Die beschriebene Operationstechnik resultierte in einem exzellenten Behandlungserfolg und kann bei chronisch eitrigen Krongelenksentz\u00fcndungen mit Osteomyelitis der angrenzenden Knochen vor allem bei Jungrindern als klauenerhaltende Ma\u00dfnahme in Erw\u00e4gung gezogen werden.<\/p>

Schl\u00fcsselw\u00f6rter:<\/strong>
Resektion, Rind, Krongelenk, septische Arthritis<\/p>","primaryLanguage":"englisch","summary":"A five month old Brown Swiss heifer calf (212 kg body mass) with severe left hind limb lameness, caused by a wound of the lateral digit was referred to the veterinary teaching hospital. The calf showed a score 4 of 5 lameness on the left hind limb. A scarified skin lesion with a fistula formation and purulent exudate was observed at the level of the proximal interphalangeal joint (PIJ) of the lateral digit of the left hind. The PIJ region and the lateral digit were severely swollen and painful. Ultrasonography showed a moderate anechoic effusion of the lateral digital flexor tendon sheet (DFTS) and a severe heterogeneous hypoechoic effusion with some small hyperechoic areas of the plantar and dorsal pouch of the PIJ. In addition, a highly irregular contour of the dorsal and abaxial surface of the phalanx media (P2) and the distal aspect of the proximal phalanx (P1) were imaged. Based on physical examination and ultrasonographic findings, the diagnosis was chronic purulent arthritis of the PIJ, osteitis of P2 and the distal end of P1 with suspected adjacent osteomyelitis. Complete ostectomy of P2 and ostectomy of the distal part of the P1 of the lateral digit was performed with an oscillating saw through the extended debrided wound. The lameness improved subsequently and 21 days post-surgery the calf was discharged from the clinic without lameness, and with a wooden block attached to the healthy claw. A year later the heifer was pregnant and still in the herd, during this period it did not exhibit lameness. The described surgical technique resulted in an excellent long-term outcome and may be considered in cases of severe purulent joint infection of the PIJ with osteolytic processes in adjacent bones, as a digit salvage procedure especially for young cattle.<\/p>

","keywords":["ostectomy","bovine","proximal interphalangeal joint","septic arthritis"],"zusammenfassung":"Ein f\u00fcnf Monate altes Braunvieh-Kuhkalb (212 kg KM) wurde mit einer hochgradigen St\u00fctzbeinlahmheit (Score 4 von 5) an der linken Hinterextremit\u00e4t, welche durch eine Wunde an der lateralen Zehe verursacht worden war, vorgestellt. Eine vernarbte Wunde sowie ein Fistelkanal mit eitrigem Exsudat konnten auf H\u00f6he des Krongelenks an der lateralen Zehe exploriert werden. Die gesamte Zehe war umfangsvermehrt und auf Druck schmerzhaft. Mittels Sonografie konnten ein mittelgradiger anechoischer Erguss in der lateralen Beugesehnenscheide und ein inhomogener hypo- bis hyperechoischer Erguss im plantaren und dorsalen Rezessus des Krongelenks sowie eine hochgradig raue Oberfl\u00e4che des Kron- sowie des distalen Fesselbeins festgestellt werden. Als definitive Diagnose wurden eine eitrige Arthritis des Krongelenks und eine hochgradige Osteo myelitis des angrenzenden Kron- und distalen Fesselbeins gestellt. Nach einer L\u00e4ngsinzision \u00fcber die L\u00e4nge des Kronbeins, ausgehend von der Fistel, wurden die Totalresektion des Kronbeins und die Teilresektion des Fesselbeins mithilfe einer oszillierenden S\u00e4ge durchgef\u00fchrt. Postoperativ verringerte sich die Lahmheit sukzessive und 21 Tage sp\u00e4ter wurde das Kalb mit einem Holzklotz auf der gesunden Klaue entlassen. Es zeigte zu diesem Zeitpunkt keine erkennbare Lahmheit hinten links. Ein Jahr danach war die nun tr\u00e4chtige F\u00e4rse noch in der Herde. Die beschriebene Operationstechnik resultierte in einem exzellenten Behandlungserfolg und kann bei chronisch eitrigen Krongelenksentz\u00fcndungen mit Osteomyelitis der angrenzenden Knochen vor allem bei Jungrindern als klauenerhaltende Ma\u00dfnahme in Erw\u00e4gung gezogen werden.<\/p>

","schluesselwoerter":["Resektion","Rind","Krongelenk","septische Arthritis"],"translatedTitle":"Resektion des Kronbeins und Teilresektion des Fesselbeins zur Behandlung einer chronisch eitrigen Arthritis im Krongelenk und Osteomyelitis bei einem Braunviehkalb","abstractE":"A five month old Brown Swiss heifer calf (212 kg body mass) with severe left hind limb lameness, caused by a wound of the lateral digit was referred to the veterinary teaching hospital. The calf showed a score 4 of 5 lameness on the left hind limb. A scarified skin lesion with a fistula formation and purulent exudate was observed at the level of the proximal interphalangeal joint (PIJ) of the lateral digit of the left hind. The PIJ region and the lateral digit were severely swollen and painful. Ultrasonography showed a moderate anechoic effusion of the lateral digital flexor tendon sheet (DFTS) and a severe heterogeneous hypoechoic effusion with some small hyperechoic areas of the plantar and dorsal pouch of the PIJ. In addition, a highly irregular contour of the dorsal and abaxial surface of the phalanx media (P2) and the distal aspect of the proximal phalanx (P1) were imaged. Based on physical examination and ultrasonographic findings, the diagnosis was chronic purulent arthritis of the PIJ, osteitis of P2 and the distal end of P1 with suspected adjacent osteomyelitis. Complete ostectomy of P2 and ostectomy of the distal part of the P1 of the lateral digit was performed with an oscillating saw through the extended debrided wound. The lameness improved subsequently and 21 days post-surgery the calf was discharged from the clinic without lameness, and with a wooden block attached to the healthy claw. A year later the heifer was pregnant and still in the herd, during this period it did not exhibit lameness. The described surgical technique resulted in an excellent long-term outcome and may be considered in cases of severe purulent joint infection of the PIJ with osteolytic processes in adjacent bones, as a digit salvage procedure especially for young cattle.","date":{"year":2016,"date":"03\/2016","accepted":"2016-03-14"},"volume":"129","openAccess":false,"journal":"Berliner und M\u00fcnchener Tier\u00e4rztliche Wochenschrift","titleImageId":944,"pages":"133-143","redirects":["complete-ostectomy-of-middle-phalanx-and-partial-ostectomy-of-proximal-phalanx-in-a-brown-swiss-calf-for-treatment-of-purulent-arthritis-of-the-proximal-interphalangeal-joint-and-adjacent-severe-osteomyelitis\/150\/3130\/94129"],"tierartCategories":[],"artikelartCategories":["Tier\u00e4rztliche Wochenschrift","Abostufe BMTW","Fachartikel"]} CY - Hannover DA - 03/2016 DO - 10.2376/0005-9366-129-138 ET - 3/4 LA - English N2 - A five month old Brown Swiss heifer calf (212 kg body mass) with severe left hind limb lameness, caused by a wound of the lateral digit was referred to the veterinary teaching hospital. The calf showed a score 4 of 5 lameness on the left hind limb. A scarified skin lesion with a fistula formation and purulent exudate was observed at the level of the proximal interphalangeal joint (PIJ) of the lateral digit of the left hind. The PIJ region and the lateral digit were severely swollen and painful. Ultrasonography showed a moderate anechoic effusion of the lateral digital flexor tendon sheet (DFTS) and a severe heterogeneous hypoechoic effusion with some small hyperechoic areas of the plantar and dorsal pouch of the PIJ. In addition, a highly irregular contour of the dorsal and abaxial surface of the phalanx media (P2) and the distal aspect of the proximal phalanx (P1) were imaged. Based on physical examination and ultrasonographic findings, the diagnosis was chronic purulent arthritis of the PIJ, osteitis of P2 and the distal end of P1 with suspected adjacent osteomyelitis. Complete ostectomy of P2 and ostectomy of the distal part of the P1 of the lateral digit was performed with an oscillating saw through the extended debrided wound. The lameness improved subsequently and 21 days post-surgery the calf was discharged from the clinic without lameness, and with a wooden block attached to the healthy claw. A year later the heifer was pregnant and still in the herd, during this period it did not exhibit lameness. The described surgical technique resulted in an excellent long-term outcome and may be considered in cases of severe purulent joint infection of the PIJ with osteolytic processes in adjacent bones, as a digit salvage procedure especially for young cattle. PB - Schlütersche Verlagsgesellschaft mbH & Co. KG PP - Hannover PY - 2016 SP - 133 EP - 143 T1 - Complete ostectomy of middle phalanx and partial ostectomy of proximal phalanx in a Brown Swiss calf for treatment of purulent arthritis of the proximal interphalangeal joint and adjacent severe osteomyelitis T2 - Berliner und Münchener Tierärztliche Wochenschrift TI - Complete ostectomy of middle phalanx and partial ostectomy of proximal phalanx in a Brown Swiss calf for treatment of purulent arthritis of the proximal interphalangeal joint and adjacent severe osteomyelitis TT - Resektion des Kronbeins und Teilresektion des Fesselbeins zur Behandlung einer chronisch eitrigen Arthritis im Krongelenk und Osteomyelitis bei einem Braunviehkalb VL - 129 SN - 0005-9366 ER -