Friday, June 6, 2008

Fixing Broken Toe Bones by Jeffrey Low (April 2007)

I think the toes of our caged shamas are more commonly involved in mishaps than their other body parts. We sometimes see shamas with missing toes or claws or other defects of the toes, caused by the toes getting caught in the gaps of the doors of cages or some parts of the aviaries. Usually, the front toes are more prone to these accidents. It will be a shame if a good shama's overall posture, movements or its ability to grip is affected by these accidents. The following is written from my limited experience which may be of some use to others.

A toe that got caught in a gap of the cage door or some parts of the aviary could result in a broken toe bone. If the break is severe, it may damage the blood vessels around the area. This will cut off blood supplies to the broken toe and it will gradually turn black from below the point of breakage and this will eventually drop off. Most of the time, the broken toe bone will heal on its own if the blood vessels are not damaged. If the toe bone is left to heal on its own, the toe may end up twisted or crooked and this will affect its grip. Depending on the severity and the direction towards which the toe bone had snapped at the time of breakage, it may be twisted or bent in the same direction when healed. When the breakage occurred too high up the toe (very near to the ‘ankle’) and if at the time of breakage, it had snapped towards the direction of the adjacent toe, it may even end up overlapping or crossing with the adjacent toe, when left to heal on its own. This may also affect the functions of the adjacent toe and its ability to grip. When two toes are affected this way, it will result in the bird suffering from a certain degree of discomfort or pain each time it lands on the perch or on the cage floor.

A freshly broken front toe can be fixed and set to heal perfectly if the blood vessels at the point of breakage are not badly damaged. The broken toe can be super glued to the adjacent good toe. The good toe will act as a splint to prop the broken one and allow it to set (both claws should be clipped short). If it is done well, a freshly broken toe can heal perfectly. A good brand of super glue should be used in order for it to be able to hold the toes together for the period of time to let the broken bone set. Eventually, the glue will wear off and the toes will separate.

In the course of the treatment for the shama with the broken toe, Jeffrey kindly kept me informed of the progress. His emails on the treatment he administered and the problems he encountered are so informative that I thought I would share them with you. I have edited and re-arranged the information so that they are in chronological order.

12th April - Bird was caught and taken out of cage for closer examination of the broken toe. The extreme right front toe (of the right leg) was broken just below the 'wrist'. It had been snapped inwards towards the middle toe at the time of breakage. As a result, it had gone underneath the middle toe and had been stepped on all this time by the middle toe.

The damaged toe had healed to some extent but unfortunately, had also set in such a manner as to cross underneath the middle toe. This also affects the grip of the middle toe. This situation was more difficult than the freshly broken toe bone I had mended for the other shama which I had mentioned to you earlier. The difficulty lies in the fact that this damaged toe had already healed considerably and was set in a crooked and bent position underneath the adjacent good toe.

In order to be assured that the damaged toe is reset to its original position, it will require the toe bone to be broken again as it had already set and had bent underneath the other toe. However, due to my lack of experience in such a delicate procedure, I had decided only to manipulate it into position and super-glued it to the adjacent toe for leverage. The manipulation may cause some damage to the cartilage of the toe bone but it will heal. The use of super glue in my past experience to successfully fix a freshly broken toe bone may not work as well in this case. This is because by propping the bent toe with the adjacent good toe, without breaking the toe bone first, there is a certain amount of force exerted onto the supporting good toe. Will the supporting middle toe be strong enough to prop the bent toe back into position? Will the force exerted from the bent of the damaged toe cause the glue to give way before sufficient time has passed to set it into position? I am keeping my fingers crossed.

13th April – I had taken a day off from work today to observe the bird closely. Bird seems to be unaffected by the ordeal. It was singing its sub-song every now and then and breaks into its loud song occasionally during the day. It had been eating very well too. I had also continued with your feeding regime of live food for the time being and will only convert him to dry food later, after it had healed. Vitamins and calcium will be smeared on the live food every other day. Glucosamine sulfate (aids in repair of cartilage) and methysulfonylmethane (aids in maintaining flexibility and elasticity of joint connective tissues and ligaments) will also be used as supplements during this period.

14th April – Thanks again for the bird you gave me. A long time ago, I succeeded in setting a broken toe bone of a shama to perfect condition. However, that particular bird had a freshly broken toe bone and it was quite easy to reset. I am trying the same with this bird but I am not as confident this time because the bone has been broken for sometime. It is also twisted and has gone underneath another toe and set there. Nevertheless, I am trying to set it back and it is 2 days now since I started doing it.

It looks good so far and the 3 toes are all in the correct place, not overlapping. The bird is very active and that may be a disadvantage at this moment as I am afraid that it will interfere with the healing and growth of the toe bone. I will keep you posted of the outcome. If the positioning of the 3 toes remain for 1 month, than it will probably be permanently ok. It may or may not be perfect but I am hoping for at least a significant improvement.

This particular shama is a very active bird. It will jump up and down the side of the cage speedily (like a puteh). By this morning, it had started to do that and I am beginning to worry that this active nature of his may affect the setting of the toe.

18th April – Close observation revealed that the damaged toe could be causing some pain to the bird as seen in the bird resting only on its left leg and the affected right leg was withdrawn. The frequent jumping up and down the side of the cage was the cause of this. I had observed that during the past few days the damaged toe at this stage was unable to 'grip and release' whenever the bird jumps to the side of the cage. This causes the toe nail of this affected toe to get caught on the cage bars sometimes, as the bird leaves the side of the cage to return to the perch/cage-floor, resulting in pain.

19th April

I would like to share with you some experience I had regarding fixing broken toe bones of birds:

When a toe bone is broken, it may sometimes heal by itself. However, most of the time, the affected toe will be twisted to a greater or lesser extent when left to heal on its own. It really depends on how the bone broke and also towards which direction when it snapped. For example, if at the time of breakage, the toe was snapped towards the left, than if it heals on its own, it will heal with a twist towards the left.

On some occasions, the blood flow to the affected toe may be cut off due to the blood vessels supplying blood to this area being too badly damaged by the breakage. When this happens, the affected toe will turn black after sometime and will eventually drop off.

If a broken toe bone is noticed early, the freshly broken bone can be trained to heal in the correct direction. This is based on the same principle used by bone specialists for humans - by supporting the broken bone and letting it heal on its own. In the case of a bird, it is impossible to use a splint or put a cast around the broken toe bone as support.

What I did in the past was to use super glue to bind the broken toe to the adjacent good toe. The good toe will act as a support during the time of healing. Eventually, the effect of the glue will wear off and the toes will come apart. The tricky part is to have the glue wear off only after the bone has set to a certain extent. A good brand of super glue is Selleys. Those 2 pack epoxy glues should not be used as their bonding strength is too strong.

I caught the bird twice - firstly, to access the damage to the toe and then to treat it.

Damage: The extreme right toe of the right leg was broken at a point close to the 'wrist'. It was also snapped inwards at the time of breakage. It had healed considerably but due to nature of the breakage, it had gone underneath the middle toe. The point of contact between the middle toe and the damaged toe has a blood clot due to pressure and weight constantly being exerted by the middle toe stepping on the damaged toe.

After very careful and close observations, I concluded that if left on its own, the damaged toe may drop off eventually due to the blood supply being restricted by the pressure from the middle toe stepping on it. Also, as the middle toe tries to grip the perch, each time it lands on it, it will be exerting irregular sudden pressures on the damaged toe under it, thereby further restricting a smooth blood flow. The good middle toe itself may also be affected in the long run due to being unable to grip the perch properly.

After weighing the pros and cons, I decided to go ahead with treating the toe. At this moment, the glue is holding well and the setting looks good. The bird is not affected at all by the treatment and is singing and having very good appetite. I am not switching him to dry food yet as I do not want to put any stress on him right now. I put in enough live food in the morning to last the whole day and change fresh ones in the evening when I come home from work. I am not bathing him much at present as the skin on the toes are quite porous and can hold moisture for a while and this will affect the bonding of the glue. Later on, when it is time to let the glues come off, I will start bathing him daily and let the toes soak a little longer.

20th April – Pain seems to be gone and bird is again active. I was contemplating on clipping off at least the hooked part of the toe nail of the damaged toe to minimize the chance of it getting caught at the cage bars again. The bleeding from the quick of the nail, if any, could be easily stopped if I were to do this. The nail will grow back to its normal length later. However, I am very reluctant to have to catch the bird again. We will see how it goes.

30th April – Everything looks good. Part of the glue had worn off and the toes had not crossed back like it was before treatment. I am hoping that the remaining glued areas remain intact until the toe is set. The damaged toe is observed to start gripping the perch. Bird is eating and singing well. It is a very active bird but at this stage, I am wishing that it is not as active.

9th May – Just one day after I had thought that the toe is completely restored to its original position, I was very disappointed today to see that it is closing up on the middle toe, although not crossing underneath it like it was before treatment. Very careful observations had indicated that the bone is not fully set yet and the constant jumping up and down the sides of the cage may have disrupted the healing and setting.

10th May – Regarding the smaller cage, I think even if we were to put him in a smaller cage, he will still jump about but only shorter distance. The problem lies in each time he hits the side of the cage and each time he lands on the cage floor, the impacts will affect the setting of the toe bone. The number of times such impacts occur per day is too much. I had tried covering him up with a cloth but he still jumps about. What do you think if we were to put him back into one of your aviaries during the healing period. Will there be less impact of this nature?

After our phone discussion today, I had re-glued the toes together again. This time, I had applied more glue on the damaged toe to form a cast hoping that this will help to set it better. If need be, nail polish remover (acetone based) can be used to remove this cast later after the toe bone is already well set.

This evening, I spent 3 hours padding the inside of a bath cage with cardboard. Two small areas at the side near to the door were left unpadded to hook on the feeder and water cups. The lower portions of the front and back were left unpadded for better air circulation. The centre of the roof was also padded but the two ends of the roof were left out also for the purpose of air circulation.

With most of the cage padded from the inside, he will have no cage bars to cling to if he tries to jump. The soft cardboard will also protect him from any injuries should he be spooked and tries to bash around in such a small cage.

Someday David, between the two of us, we may even invent a 'straight jacket' to restraint problem birds.

13th May – Your suggestion to transfer the bird to a small and low cage, I think is a brilliant one. This will lessen the impact on the toes caused by the bird jumping down from the side of the tall shama cage to the cage floor. The bird is now in a bath cage. The bath cage is almost fully padded from the inside with cardboards covering up the cage bars to discourage jumping and to provide cushion should the bird be spooked when in such a small and low cage. The perch is only about 2.5 inches from the floor. Some areas on the roof and the lower part of the front and back of the cage was left unpadded to allow for good ventilation.

14th May – All is well so far. The bird can only hop from the perch to the cage floor (2.5 inches) every now and then as there is no cage bars available for him to cling to. I would expect the tail feathers to be damaged from the confinement in this bath cage but that is not a concern at all. As expected, he had stopped singing totally in such an uncomfortable situation. Let's hope that the toe will set well this time. The tail feathers and the form of the bird can be taken care of later during his next molt.

22nd May – All is well this far with the toe treatment. Since the day when you told me that a young bird will re-grow its toe nail, I had been looking out for it and this few days, I had noticed some indication that a new claw is growing from the damaged toe. I hope that I am right. Most important of all is the repositioning of the toes to their original position and I hope this time round, with your advice to use a smaller cage, we will succeed.

26th may – It's been almost half a month since treating the toe for the second time round. I gave him a bath today as I had not taken the risk to bath him so far in case it may interfere with the adhesion of the super glue. There was no harm done after the bath and surprisingly, the slightly damaged primary tail feathers were more or less restored after the bath. They had become slightly twisted and scissors like due to the small cage he is kept in. All the three front toes of the right leg are gripping well and the super glue is still intact. He is already getting quite use to the small cage and is singing loudly in the early mornings before I left for work. I am tempted to put him back to his usual shama cage but I know I will have to resist the temptation for sometime more.

Over last 2 weeks, I had taught him to eat dry food but he is still given lots of live food daily. When would you expect his next molt ? My plans are to give top priority to fixing up the toe. After which, I will convert him to dry food supplemented with live ones. As soon as his next molt is approaching, he will be loaded with live food again. This loading of live food from a diet of dry food come molting time will, I hope, trigger his form.

6th June - By now, I am quite sure that a new claw is growing from the damaged toe. From the look of the toes, it seems like this second treatment to glue the toes together again and to keep him in a small cage had worked very well. I think the toe were already partially set after the first treatment but was not done well enough and this second additional treatment had further strengthened and improved it.

I had looked very closely today and I think most of the glue holding the two toes together is gone although there are some remnants left on other parts of the toes. I don't think the toes will overlap again.


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