Wounds on the left front leg after cast removal that have not healed.  Limb is uniformly 
swollen approximately 2 times the size of normal limb and there are 2 granulating 
wounds. Draining tract on the DM side of the leg, and purulent exudate comes out.

- Wounds have been apparent for more than two months.  May be due to bacterial/fungal 
infection.  Also possible is that they are due to local areas of necrosis due to a 
compromised vascular endothelium.  Wounds take 3-5  days to granulate.  Swelling is 
most likely due to a local area of inflammation that has been persisting.  Pustular exudate 
supports the fact that neutrophils have migrated to that site.  Swelling may be inhibiting 
the normal gait of the calf.  Draining tract indicates either a bacterial or fungal infection.

The calf seems healthy otherwise and is nursing well.  

- Probably not a FPT, appears to have had adequate colostrum since vitals are near 
normal.  Main problems started after removal of the second cast that caused valgus 
deformity.

Dam had a difficult delivery.  Calf was very large and forced extraction was necessary.  
Calf was pulled using FrankÕs calf jack.   The left front leg was injured during the 
process.

- Since this was an embryo transfer and a large calf, this most likely caused the dystocia 
and resulted in a forced pulling.   Dystocia from the operation necessitated the use of the 
FrankÕs calf jack.  It is a mechanical jack that attaches to the obstetrical chains and the 
calf limbs.  Overexertion from forced pulling may have caused the initial insult 
(fracture/muscle tear).  Since this was an embryo transfer, it is possible that this resulted 
in abnormal configurations of joints.  Abnormal bandaging could have exacerbated this 
condition. 

Leg was kept in a heavy bandage for one month.  Some areas of skin fell off at about 2 
weeks. The area is covered with pink epithelium.

- Most likely the bandage (whatever kind that was) was applied too tightly and 
compromised the underlying skin and musclesÕ blood supply.  Sloughing of the necrotic 
skin followed after 2 weeks.  Revascularization followed after blood supply was restored 
and regeneration of new skin tissue resulted (pink skin).

At that time the leg was not stable so a half-limb cast was applied for 3 weeks.  Upon 
removal from the cast the leg was uniformly enlarged and crooked.  The limb is turned 
outward (valgus deformity) The calf has not been using the leg since then.

- A half-limb cast is applied distal to the Mc/phylangeal joint for stabilization of the bone.  
However, it appears that the bone fracture was not set in the proper alignment, and 
abnormal compressive forces resulted in an abnormal pathologic valgus deformity.  This 
severely compromised the calfÕs ability to walk.

Crepitance is heard with manipulation. 

- Crepitance could be caused by fracture fragments of the metacarpus or phylangeal joint.  
Other etiologies include osteophyte formation (<3 months) +/- ankylosis,  bacterial 
infection, and granulation/fibrosis due to an abnormal joint configuration.

Mc/phylangeal joint has a limited ROM

- Metacarpal/phylangeal joint is a hinge joint.  There are several supporting ligaments 
that may be compromised, resulting in lameness.  These ligaments include: M/L 
collateral ligaments; suspensory ligament; annular ligament; collateral sesamoidean 
ligament; intersesamoidean ligament; distal sesamoidean ligament.

Tight bands of tissue are palpated that connect the raised toes with the tissue on the 
dorsum on the foot.

- Fibrin deposition and subsequent adhesions between the skin and the extensor 
tendons/ligaments most likely has caused the raised toes via contracture.