Transposition d'un coussinet digital par une technique de filet phalangien pour le traitement d'une plaie majeure du coussinet métatarsien

Wounds with major loss of metacarpal or metatarsal pads usually require a reconstructive surgery. These techniques include paw pad grafts, microvascular paw pad transfer and local paw pad transposition (phalangeal fillet technique). The goal of such a surgery is to restore a specialized weight-bearing surface resistant to abrasion, shear forces and acting as a shock absorber. A German Shepherd dog presented for evaluation of an infected wound with major loss of the metatarsal pad. This wound appeared secondary to an inaccurate management of a splint placed to stabilize a fracture of the proximal phalange of the fifth digit of the right hind limb. The wound was debrided and managed with a wet-to-dry bandage until granulation tissue filled the wound. A phalangeal fillet technique with local transposition of the digital pad after excision of the phalanges was performed to address the loss of the metatarsal pad. This technique provided at the same time a palliative treatment of the phalangeal fracture. A well-padded bandage was initially placed and progressively lightened during the first 2 postoperative months. The patient went back to a normal activity at that time. A telephone interview 6 months after the surgery revealed no abnormality and absence of any lameness. This technique allowed restoration of a specialized resistant weight-bearing surface.