Femoral Fracture Repair in a 3 day old Holstein Heifer Calf
April 23, 2014
William C. Smith
Clinical Advisor: Dr. Wade Walker
Basic Science Advisor: Dr. Norm Ducharme
A 3 day old Holstein heifer calf was presented to the Cornell Farm Animal
Emergency service on April 6, 2014 for treatment and evaluation a large swelling of
the left hip. The owner also noted that the calf was acutely down and unable to
stand. Upon arrival to the Farm Animal Hospital, radiographs were taken of the left
hind limb and a closed, comminuted, complete, transverse, mid-diaphyseal femoral
fracture with proximocaudal displacement was diagnosed. The calf was admitted to
the hospital and scheduled for surgery to repair the fractured femur. The owner
elected for surgical repair of the fracture because of the economic value that this calf
exhibited because of her high scoring dam and grand dam according to Genomics
scoring.
On presentation, physical exam was unremarkable except for the calf’s
inability to rise. Packed cell volume, total protein and glucose levels were all within
normal limits and the calf did not appear painful. Full bloodwork was performed
and no obvious abnormalities were noted. Radiographs were assessed to determine
the type and size of plate to be used. Upon examination of the radiographs, an
obvious primary fracture was seen as well as a secondary fracture site, a superficial
butterfly fragment, was present on the distal fragment, that would be addressed
during surgery. A discussion was led by Dr. Nixon about the different types of
human plates that could be used in this surgery to allow for weight bearing and
maintaining structural integrity.
The calf was placed under general anesthesia for the procedure in right
lateral recumbency. An approximate 10 inch incision was made on the lateral aspect
of the left hind limb extending from the greater trochanter of the femur to the
metaphysis of the distal femur. A tibial buttress plate was used on the lateral aspect
of the femur using 6-5 cancellous screws to secure the plate to the bone. A second
bone plate was placed on the cranial aspect of the femur using a six hole LC/DC
(limited contact/dynamic compression) plate. The two plates were placed 90
degrees to one another to help with stabilization of mechanical forces. The calf
recovered uneventfully from anesthesia and was able to fully stand unassisted
within twelve hours, bearing full weight on the left hind limb.
The goal of this presentation is to highlight the fracture repair that was
performed, with a focus on why these plates were used instead of other methods of
repairing the fracture.
Selected References:
1. Anderson, David. "Bovine Orthopedics, An Issue of Veterinary Clinics of North
America: Food Animal Practice." Elsevier Is a World-leading Provider of
Scientific, Technical and Medical Information Products and Services. N.p., Mar.
2014. Web. 14 Apr. 2014.
2. Andrews, A.H. "Bovine Medicine: Diseases and Husbandry of Cattle." Bovine
Medicine. Google Books, Jan. 2004. Web. 14 Apr. 2014.
3. Bellon, Jacques. "Use of a Novel Intramedullary Nail for Femoral Fracture Repair
in Calves: 25 Cases (2008–2009)." AVMA. N.p., 1 June 2011. Web. 14 Apr. 2014.