Fusing digits after amputations?

RE: Fusing digits after amputations?

scatty — Sat, 22 Oct 2016 13:02:27 GMT

Interesting - thanks guys and thanks for digging out those xrays Thomas!

Anna

RE: Fusing digits after amputations?

Glenn Hodgson — Tue, 18 Oct 2016 18:39:40 GMT

I have done a couple p3&4 amputations in dogs with podoplasty. Went fine and technically easy enough. A bit time consuming though.

bandaged 14d post op. Scared they would unfuse when turning a sharp corner!

I think the fusion looks neat and closer to normal anatomy than no fusion.

RE: Fusing digits after amputations?

Will McMullan — Tue, 18 Oct 2016 14:51:29 GMT

I'm afraid I don't have any pictures but I once operated on a dalmation who had very large invasive benign growths around the nailbeds/P3 of digits 3 and 4. In order to remove the masses completely and close the defect I ended up having to fuse the soft tissues around the remaining P1/2 of those digits. I was worried that if I amputated both D3 and 4 there would be functional impairment post-op, and with what I did, there wasn't. But I guess it was mainly due to the need to close the defect.

RE: Fusing digits after amputations?

Thomas Johnson — Tue, 18 Oct 2016 14:27:31 GMT

[quote user="scatty"]

Hi Thomas,

That's interesting - do you have a picture of the xray? but this was in the metacarpus not the phalanges?!? That's a bigger surgery - definitely haven't done that before!

[/quote]

I've had a hunt through our archive and found the xrays:

RE: Fusing digits after amputations?

scatty — Mon, 17 Oct 2016 20:18:06 GMT

Hi Thomas,

That's interesting - do you have a picture of the xray? but this was in the metacarpus not the phalanges?!? That's a bigger surgery - definitely haven't done that before!

Anna

RE: Fusing digits after amputations?

Thomas Johnson — Mon, 17 Oct 2016 16:51:47 GMT

[quote user="scatty"]

Hi All,

Does anyone have any experience of fusing the adjacent toes after digit amputation? I have just seen a picture in fossum of digit 4 amputation and then the adjacent toes were fused. Why would this be done - to help with weight bearing? Or do you have to do this if you amputate at the metacarpophalangeal junction? I have only every amputated through proximal P1 before.

Looking forward to hearing any of your experiences!

[/quote]

I amputated D4 of my own cat a few years ago, he had an osteochondroma in the distal metacarpal and I cut through the proximal metacarpal to amputate the digit. I just closed the skin, no fusing of any bones, and once the fur grew back you had to look carefully to see he only had 3 digits, and he had no lameness.

RE: Fusing digits after amputations?

Eilidh Corr — Sat, 15 Oct 2016 22:40:26 GMT

That's really useful, thanks for sharing.

RE: Fusing digits after amputations?

Beats — Sat, 15 Oct 2016 22:13:18 GMT

[quote user="scatty"]experience of fusing the adjacent toes after digit amputation? I have just seen a picture in fossum of digit 4 amputation and then the adjacent toes were fused. Why would this be done [/quote]

I've seen these pictures and wondered too.

I've also seen pictures of complete fusion podoplasty with excision of interdigital skin and fusion of all 4 digits.

I can't think of an advantage other than possibly greater skin margins being achievable as can remove more skin maybe?

I leave toes separate if excise digit or interdigital skin. Generally I try to follow Mike Guillard's advice: http://www.staffsderbysvetclub.co.uk/wp-content/uploads/2015/03/PedalLameness.pdf

Interested to hear of advantages from those who have done this.