A 37-yr-old, female, long-term captive African elephant developed a persistent nail lesion of the second digit on the left fore foot. The initial lesion was a soft spot along the coronary band, with subsequent undermining of the face of the nail. The severity of the lesion waxed and waned for 2 yr. It was treated primarily with aggressive debridement and nail trimming, and applications of various topical products. Late in the second year, several attempts at maintaining a bandage were made. Serial radiographs of the digit were taken to monitor for signs of bony involvement. After 2 yr, radiolucent lesions were seen in P3 of that digit and the decision was made to remove P3. P3 was removed via the defect in the face of the nail and antibiotic-impregnated polymethylmethacrylate beads placed in the surgery site. No attempt was made at primary closure and the surgical site closed slowly over the course of several weeks. Histopathology of the removed P3 showed necrosis and fibrosis, but no osteomyelitis. At the time of surgery, radiology showed no radiolucencies in P2 of that affected digit, however within several months after surgery, radiolucencies were observed in P2. It was decided not to attempt any further surgeries. At necropsy, 6 yr after surgery, histology of P2 showed evidence of previous bony remodeling, but no inflammation. Based on this experience, clinicians should be cautious in interpreting radiolucent lesions of the elephant phalanges as indicative of infection.
The authors would like to thank Dr. Phil Boschler and the elephant staff at the Knoxville Zoo for their efforts with this case.