Osteossíntese de Metatarso em uma Terneira Neonata

Resumo

Background: In ruminants, metacarpal and metatarsal fractures are more frequent in young animals, typically due to trauma during dystocia management, improper handling, or maternal trampling. Diagnosis is based on history, clinical signs, and radiographic examination. In most cases, initial assessment consists of determining the location and type of fracture and the cost of treatment. This study reports the case of a complete transverse fracture in the distal third of the diaphysis of the third metatarsal bone of a bovine, with treatment consisting of osteosynthesis using a locking plate and screws.

Case: A three-day-old female Nelore cattle, weighing 30 kg, presented with functional impotence of the right pelvic limb stemming from being trampled by its mother. X-ray examination revealed a complete transverse fracture of the distal third of the diaphysis of the third metatarsal bone. The calf underwent an osteosynthesis procedure with internal fixation using a 3.5-mm locking plate and five screws, extending from the proximal to the distal region of the metatarsal. After internal fixation, bone positioning and joint motion range were evaluated and found to be within normal limits. In the post-operative period, the calf received meloxicam¹ (Maxicam 2%^®️ at a dose of 0.1mg/kg, subcutaneously, every 24 hours for three days), dipyrone monohydrate² (Dipirona Ibasa 50%^®️, 25mg/kg, subcutaneously, every 24 hours for five days), tramadol hydrochloride³ (Cronidor 2%^®️, 2mg/kg, intramuscularly, every twelve hours for three days), and ceftiofur sodium⁴ (Cef50^®️, 1mg/kg, intramuscularly, every 24 hours for seven days). The limb was externally immobilized for 15 days, changed every five days. X-rays were taken immediately and 30 days after surgery to assess the apposition, alignment, apparatuses, and biological activity of the healed area. The implant was removed 86 days after surgery due to both good bone healing of the fragments and the absence of a fracture line.

Discussion: There is a high prevalence of metacarpal and metatarsal bone fractures in cattle due to the lack of protective soft tissue and vulnerability to external trauma. Their occurrence is often associated with inadequate handling practices, dystocia, or accidents such as maternal trampling. Fractures are identified by clinical signs such as swelling, pain, lameness, crepitus, and limb impotence. Imaging tests are essential to confirm the diagnosis and determine the appropriate treatment, which depends on factors such as fracture type and extent, soft tissue damage, and economic viability. The choice of treatment methods varies between confinement, external coaptation, and external or internal fixation. In the present case, the use of a locking plate and screws was chosen due to the weight of the calf, which was similar to that of a large dog. This approach presents advantages essential for proper fracture healing, such as lower tissue damage, preservation of periosteal irrigation, and bone stability. The combination of internal fixation and external immobilization using synthetic plaster was strategic, ensuring stability and facilitating walking during the recovery period. The report emphasizes the importance of an individualized choice of treatment, considering not only the surgical technique but also post-operative monitoring and environmental management to prevent complications. The case illustrates the effectiveness of using a locking plate in specific situations, highlighting the progress achieved in fracture management in cattle.