A 238-day-old Holstein-Friesian heifer weighing 247 kg suffered a closed oblique fracture of the left radius and ulna and underwent transfixation pinning and casting (TPC) with a closed approach. The heifer was sedated with xylazine (0.2 mg/kg), placed in a supine position and administered a continuous infusion of medetomidine (20μg/kg/hr) during surgery. A brachial plexus block with 10 ml of 2% lidocaine was used to control pain. The fracture was reduced manually by longitudinal traction of the forelimb, and the fracture site of the radius was held using two bone reduction forceps. Two 4.0-mm pins were inserted into the radius percutaneously both proximally and distally to the fracture site using a power drill. Three 4.0-mm pins were additionally inserted percutaneously across the fracture plane to stabilize the fragments. A full-limb cast was applied over the pins. The pin ends were cut at the level of the cast surface and joined together with resin. The surgery was completed in 90 min. The heifer was able to bear weight on the left forelimb and returned to the farm on the day of surgery. The heifer was separately housed in a small pen. TPC was well-tolerated and required minimal assistance for standing. An antibiotic( cefazolin) was administered for seven days. To promote weight bearing, the distal part of the cast was truncated above the carpal joint 48 days after surgery, and TPC was removed 80 days after surgery under sedation. The heifer was able to stand and walk without lameness.
Although high success rates have been reported with internal fixation for bovine radial and ulnar fractures, TPC was beneficial for this heifer because of the lower cost, lower risks and fewer complications. While body weight can affect prognosis, the number, diameter and design of pins as well as cast length can affect firmness of the fixation and stability of the fracture ends in bovine fracture repair. Although the use of TPC is rarely reported for radial and ulnar fractures in cattle with heavier weight, the present case suggests its promising role.
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