Metatarsal Osteosynthesis in a Newborn Calf

Abstract

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 3rd metatarsal bone of a newborn calf, with treatment consisting of osteosynthesis using a locking plate and screws. 

Case: A 3-day-old female Nellore calf, 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 3rd of the diaphysis of the 3rd metatarsal bone. The calf underwent an osteosynthesis procedure with internal fixation using a 3.5-mm locking plate and 5 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%®️ - 0.1 mg/kg, SC, every 24 h for 3 days], dipyrone monohydrate2 [Dipirona Ibasa 50%®️ - 25 mg/kg, SC, every 24 h for 5 days], tramadol hydrochloride3 [Cronidor 2%®️ - 2 mg/kg, IM, every 12 h for 3 days], and ceftiofur sodium4 [Cef50®️ - 1 mg/kg, IM, every 24 h for 7 days]. The limb was externally immobilized for 15 days, changed every 5 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. 

Keywords: ruminant, neonatal, fracture, locking plate, internal fixation.  

Título: Osteossíntese de metatarso em uma terneira neonata

Descritores: ruminantes, neonato,  fratura, placa bloqueada, fixação interna.