Advances in surgical treatment of septic arthritis of the
distal interphalangeal joint in cattle: A review
, J. Koﬂer
, H. Meyer
, J. Rehage
, A. Starke
Clinic for Cattle, University of Veterinary Medicine Hannover, Foundation, Bischofsholer Damm 15, D-30173 Hannover, Germany
Clinic of Orthopaedics in Large Animals, Clinical Department for Horses and Small Animals, University of Veterinary Medicine Vienna,
Veterinaerplatz 1, 1210 Vienna, Austria
Accepted 13 June 2008
This review describes the indications for surgical treatment of distal interphalangeal joint (DIJ) infection in cattle and presents an
overview of former surgical methods that have been modiﬁed for current use, including arthrotomy, resection of the distal sesamoid
bone, resection of the DIJ and digital amputation. The post-operative life span, reasons for culling, pros and cons of claw-preserving
techniques versus digital amputation, and pain management in general are also discussed. It would appear that severe claw diseases that
result in septic arthritis of the DIJ do not necessarily lead to a reduced life span if cows are adequately treated and thorough aftercare is
Ó 2008 Elsevier Ltd. All rights reserved.
Keywords: Cattle; Septic arthritis; Surgery; Amputation; Joint resection; Lameness
Lameness continues to be one of the largest economic
drains on dairy farming and is one of the three most com-
mon reasons for culling, preceded only by reproductive
failure and mastitis (Coulon et al., 1996; Enting et al.,
1997; Seegers et al., 1998; Fourichon et al., 1999; Whitaker
et al., 2000; Warnick et al., 2001; Green et al., 2002;
Hernandez et al., 2002; Landwirtschaftskammer
Hannover, 2003; Booth et al., 2004; Van Amstel and
Shearer, 2006; Wangler et al., 2006). In addition to direct
losses via culling, lameness causes indirect losses through
decreased production of milk, milk fat and protein, repro-
ductive failure and treatment costs (Enting et al., 1997;
Seegers et al., 1998; Fourichon et al., 1999; Kossaibati
and Esslemont, 2000; Whitaker et al., 2000; Hernandez et
al., 2001, 2002; Green et al., 2002; Landwirtschaftskammer
Hannover, 2003; Booth et al., 2004; Feldmann et al., 2006;
Guard, 2006; Wangler et al., 2006).
Ninety per cent of all limb disorders in cattle result from
claw diseases, independent of breed, use or housing
(Barkema et al., 1994; Clarkson et al., 1996; Hernandez
et al., 2002; Van Amstel and Shearer, 2006). Lameness is
often chronic, causes pain (Green et al., 2002; Van Amstel
and Shearer, 2006) and is a welfare concern (O’Callaghan,
2002). Lameness is most easily and eﬀectively treated if
detected at an early stage but appropriate treatment is
often delayed or not provided at all because the problem
is not recognised by owners and veterinarians lacking
expertise in this ﬁeld (O’Callaghan, 2002).
Infection of the distal interphalangeal joint (DIJ) usually
results from localised purulent processes that spread to the
deeper structures of the claw, such as sole ulcer, white line
disease (WLD) or interdigital phlegmon (necrobacillosis).
Penetrating injuries and haematogenous or lymphogenous
spread of infection are other less common causes. In the
majority of cases with infection of the DIJ, other adjacent
anatomical structures, including the deep digital ﬂexor
1090-0233/$ - see front matter Ó 2008 Elsevier Ltd. All rights reserved.
Corresponding author. Tel.: +43 1 25077 5501; fax: +43 1 25077 5590.
E-mail address: Johann.Koﬂer@vu-wien.ac.at (J. Koﬂer).
Available online at www.sciencedirect.com
The Veterinary Journal 182 (2009) 162–175