Management Plan

Treatment of systemic bacterial infection with amoxicillin and gentamycin is indicated for at least seven days before surgery.  The antibiotics will initially be given intravenously for 2 days after which they will be administered orally.  Surgical options will have to be referred due to the limited capabilities of our rural practice.  Options 1 and 2 are typically financially restrictive for cattle owners.  Since this client has expressed interest in treating the animal two surgical options have been offered before euthanasia.

Option 1-Fracture repair- Internal Fixation 

The most desirable treatment to repair the fracture is using internal fixation, specifically the butress/lengthening plate technique. This plate is designed to bridge gaps that cannot be reconstructed. This plate is less likely to bend and should support the weight of the growing calf.  Prior to plate placement all necrotic and infected tissue should be removed from the fracture site. This procedure is not commonly utilized with cattle due to the high cost, but might be a viable option since the calf is considered valuable to the owner. 

Option 2- Fracture Repair- External Fixation

Transfixation pinning and casting is the most common external fixation technique utilized for fracture repair in large animals. This is especially advantageous in cattle since minimal post-operative care is required but stall confinement is indicated. The risk of introducing infection is significantly increased by doing an open reduction repair of the fracture.  As with option 1, all necrotic and infected tissue must be removed prior to pin placement. The site must be monitored on a regular basis after the external fixator is removed and until the wounds have healed.

Option 3- Euthanasia

Due to the severity of the fracture and ambiguity of soft tissue and skeletal damage euthanasia should be a consideration. The degree of vascular damage is also unknown which is an integral part in the healing process of bone and soft tissue.

Post Operative Plan

Radiograph affected limb immediately following surgery to ensure proper alignment and fixation.  Analgesics are indicated PRN for pain management. 

Prognosis

Depending on the treatment, chronicity of the condition, and the physiological well being of the animal the prognosis will vary significantly.   The prognosis is dependant upon what type of breeding system he will be used in.  In a pasture situation, his soundness will be more critical than it would be if he were used solely for artificial insemination.  Also, the prognosis is better for this calf than it would be for an adult bull with the same injury due to his reduced weight.  Considering all of these factors the prognosis is guarded to good.