Septic pedal osteitis

• This follows a solar penetration which penetrates distal phalanx, usually a nail. Bacteria can enter the bone and causes osteomyelitis leading to sequestrum (area of bone dies and separates). This causes a raised digital pulse (single foot), discharge and pain with hoof testers at the site of penetration. The initial radiographs may be normal and ideally you want to radiograph with nail still in place.

  • Managed with poultice, antibiotics, NSAIDs, tetanus antitoxin

  In some cases, the lameness resolves however is lameness does not resolve, septic pedal osteitis diagnosed on repeat radiographs.
• which of these nails could cause pedal osteitis?

  A

  
• Osteolysis can be seen in the radiolucency, the main circle is where the needle penetrated. The bone has separated from the pedal bone (sequestrum) and these radiolucent lines are called the involucrum

  
• Treatment is via surgical removal under GA with perineural anaesthesia. The drainage tract is enlarged via sole removal in the area over the lesion. The soft tissues are then removed down to the bone and the infected bone is removed. A curette is used to remove any soft diseased bone until hard healthy bone is met. The wound can then be lavaged, packed and bandaged. This sole defect can be easily contaminated and hence a hospital plate is used. This plate is eventually removed 3 months later and the prognosis of these cases are excellent.
• hospital plate = a normal shoe and then has a metal plate attached on