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J Vet Clin 2022; 39(4): 156-161

https://doi.org/10.17555/jvc.2022.39.4.156

Published online August 31, 2022

Study on the Treatment of Fractures in Korean Native Calves: 52 Cases (2017-2020)

Hoon Kim , Jinsu Kang , Suyoung Heo , Namsoo Kim

College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea

Correspondence to:*namsoo@jbnu.ac.kr

Received: December 13, 2021; Revised: June 7, 2022; Accepted: June 28, 2022

Copyright © The Korean Society of Veterinary Clinics.

The objective of the present study was to assess the prevalence, occurrence pattern, and clinical outcomes of transfixation pinning and casting (TPC) for fractures in Korean native calves, and to identify the advantages of the procedure. The study investigated 52 cases of bone fractures documented from January 2017 to December 2020. Hindlimb fractures (72%) were the most common in bone fractures (n = 50). The distribution of fractures was highest in the tibia (n = 15), followed by the metatarsal (n = 12), femur (n = 9), radius/ulna (n = 8), metacarpal (n = 3), humerus (n = 3), mandible (n = 1), and caudal vertebrae (n = 1). All cases were diagnosed via radiographic evaluation. Closed fractures (86%) were the most common, followed by open fractures (14%). Surgery was performed on 34 calves using intramedullary pin (IM pin), TPC, cross pin, flexible wire (F-wire), and/or plate fixation. The rest of the calves were treated with external coaptation (n = 12) or were not treated (n = 6). Subsequently, 24 calves with follow-up records were evaluated in the bone fracture cases (n = 50). Bone union was observed in 15 (62%) calves; 3 (12%) calves showed non-union; 4 (16%) calves were dead after surgery; and 2 (8%) calves were euthanized at the owner’s request. Among the 24 follow-up surgery cases, the most successful cases were tibia fractures (75%) surgically treated using TPC and/or IM pin. These findings suggest that TPC surgery is effective in the management of fractures in Korean native calves.

Keywords: Korean native calves, bone fracture, bone union, transfixation pinning and casting (TPC).

Calf bone fractures are common orthopedic problems. The incidence of fractures in cattle varies according to the breeding environment of each calf. The most common causes of fractures are assisted childbirth trauma, especially in dystocia or incorrect manipulations during dystocia (1). Holstein cattle are separated from newborn calves within the first few days for milk production. Unlike Holstein cattle, which are primarily used for individual breeding, Korean native calves live with their mothers. Their fractures are predominantly caused by kicking from other animals or the extremities being pressed by their mothers (14).

Although the fracture occurrence patterns vary slightly among reported studies, the metacarpal and metatarsal are the most common sites of bone fractures. Fractures of the femur, tibia, radius/ulna, and, more rarely, the humerus are commonly observed in calves. In cattle, fractures of the mandible, rib, vertebrae, pelvis, and phalanges are relatively rare (2,3,10).

Many methods have been used to repair the above calf fractures. Treatment depends on the size, age, and economic value of the animal, fracture type and location, prognosis of treatment, and the behavioral characteristics of the animal (9). Cast or Tomas splints or splint-cast combinations can be used to immobilize fractures. Internal fixation, such as bone plates and screws, intramedullary (IM) pins, and flexible wires, provide strong stabilization and early recovery of fractures (13). On the other hand, newborn calf bones have low bone densities and thin bone cortical, and the ability of immature bones to sustain internal fixation implants, such as bone plates and screws, is limited, leading to surgical failure (4,9,14). The application of external skeletal fixation (ESF) to farm animals has some advantages for stabilization: ESF uses an external frame to connect the pins; removal of the fixation device is simple; the preservation of local blood assists in the early return of functions to the fracture site. Therefore, ESF methods can be applied, even if the fracture sites are open, comminuted, or infected; they can also be used in nonunion cases (2,15).

The present study evaluated the prevalence and occurrence patterns of fractures in Korean native calves and the clinical treatment outcomes. These findings would be relevant to clinicians in understanding the efficacy of fracture treatment methods.

Case selection criteria

The medical records of Korean native calves at Jeonbuk Animal Medical Center (JAMC) between January 2017 and December 2020 were reviewed retrospectively, and 52 cases were identified. All records that had clinical signalment and orthopedic examination findings, with the diagnosis being made via radiographic evaluation, were included. Data obtained from the medical records included age, seasonal occurrence, fracture distribution, fracture localization, fracture type, treatment method, implant distribution in surgery cases, clinical outcomes, review of open and closed cases, and characteristics of young calves before and after the TPC treatment.

Treatments

Forty-six calves in 52 cases received external coaptation or surgical treatment of fractures. The remaining six cases did not undergo any treatment. Gauze roll bandages and fiberglass cast products were used as part of the external coaptation methods. All surgery cases were given inhalation anesthesia. The patients were premedicated cefazolin (20 mg/kg, intravenous, Cefazolin®, Chongkundang, Korea) and meloxicam (0.1 mg/kg, subcutaneous, Metacam®, Boehringer Ingelheim, Spain) injections. General anesthesia was induced with propofol (6 mg/kg, Intravenous, Provive®, Myung-moon Pharm, Korea) and maintained with isoflurane. Experienced surgeons performed the treatment.

Bone plate and screws

Two bone plates with an IM pin were placed in the radius (Fig. 1), and two bone plates were placed in femoral fracture cases (Fig. 2). Only one bone plate was placed in metacarpal and mandible fracture cases (Universal Locking plate). Cortical screws and locking screws were used.

Figure 1.Radiographs of a radius and ulna fracture in 3-days-old bovine. Preoperative mediolateral view (A) and craniocaudal view (B) shows a short oblique radius and ulna fracture with small fragments. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using one intramedullary pin and two bone plates and screws.

Figure 2.Radiographs of a femoral fracture in 1-day-old bovine. Preoperative mediolateral view (A) and craniocaudal view (B) show that severe displacement and comminution at the fracture site. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using two bone plates and screws.

ESF (external skeletal fixation)

The fixation pin was inserted as parallel to the fracture plane as possible. Methyl methacrylate and volatile monomer solvent were mixed into the liquid state, attached to the inner and outer fixing pins of the fractured legs for hardening and fixation.

TPC (transfixation pinning and casting)

The calves were placed in lateral recumbency and aseptically prepared for surgery. Two 1-cm long skin incisions were made from the craniolateral aspect of the long bone to the caudolateral side. Two holes were drilled in the long bones using drill bits. Subsequently, two Steinmann pins were inserted through the center of the medullary cavity as full pins. Clamps were then inserted into the pin, and ring circular fixators were attached. Sidebars were used at the two rings to retract the bone, and if necessary, an IM pin was inserted into the long bone. The cast encased the bone to the joint level, and the exposed ends of the transfixing pins were trimmed (Fig. 3).

Figure 3.Radiographs of a tibial fracture in 4-days-old bovine. Preoperative radiographs of the tibia (A, B) show a comminuted proximal tibial fracture. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using transfixation pinning and casting. (E) Radiograph taken after removal of the pin 4 weeks after surgery.

Postoperative treatment and prognosis

Antibiotic administration consisted of a 20 mg/kg Cefazolin sodium (Cefazolin®, Chongkundang, Korea), twice daily for one week, and analgesic administration comprised of Meloxicam (Metacam®, Boehringer Ingelheim, Spain) injections, once daily for three days. Of the 46 cases treated, follow-up information was obtained through visits, postoperative radiography, or telephone conversations with the owners.

Age distribution

Young calves less than 10 days old accounted for most of the fractures (n = 25, 48.0%), followed by 31-90-day-old calves (n = 12, 23.1%). There were seven calves (13.5%) aged 21-30 days, five calves (9.6%) aged 91-150 days, and three (5.8%) calves aged 11-20 days.

Seasonal occurrence

The seasonal occurrence was divided into four categories. Spring (34.6%) and summer (26.9%) represented higher percentages of fracture occurrences than winter (15.4%) and autumn (23.1%).

Fracture distribution and localization

The most common fractured bones were the tibia (n = 15, 28.9%), followed by the metatarsal (n = 12, 23.0%). Femur fractures (n = 9, 17.3%), radius/ulna fractures (n = 8, 15.4%), and humerus or metacarpal fractures were less common (n = 3, 5.7%). Mandibular fractures and caudal vertebral fractures were present in once case each.

In the bone fracture cases (n = 50), the hindlimb (n = 36, 72%) was injured more frequently than the forelimb (n = 14, 28%). When comparing the left and right limbs, the left-sided limbs (n = 29, 58%) showed a higher fracture distribution than the right-sided limbs (n = 21, 42%). In the forelimbs, the left and right limbs showed the same distribution (n = 7, 14%), but the hindlimb showed more frequent left-limb injuries (n = 22, 44%) than the right limb (n = 14, 28%). Left-sided limb fractures occurred more frequently, particularly in the tibia and metacarpal.

Mid-diaphyseal fractures accounted for more than a third (36%) of all bone fractures. These were followed by distal diaphyseal (28%) and proximal diaphyseal fractures (24%). Physeal fractures accounted for 12% of all bone fractures. In the hindlimb, mid-diaphyseal fractures were the most common. Apart from those in the forelimb, distal diaphyseal fractures were the most frequent. Tibia physeal fractures (n = 4) were predominant among the physeal fractures (n = 6).

Fracture type

Oblique (78%) was the most common fracture type, followed by transverse (12%), spiral (6%), and compression (4%). There were six cases of physeal fracture, Salter-Harris type 2 in the femur, Salter-Harris type 2 in the radius and ulna, and Salter-Harris type 1, 2, and 4 in the tibia.

Method of treatment

Of the 52 fracture cases, 34 calves were operated on, and 12 underwent external coaptation. Six clients did not accept calf treatment. The surgical repair procedures (n = 34) were performed using IM pin, TPC, ESF, cross pin (CP), bone plate and screws, or flexible wire, alone or in combination. TPC was the most common fracture repair treatment (n = 17). IM pinning and TPC (n = 14), TPC (n = 2), and CP and TPC (n = 1) were also used. The other methods were used in 1-3 cases each.

Prognosis after surgery

Among the 44 calves that underwent surgical treatment or external coaptation in bone fractures (n = 50), 34 calves had follow-up records. Bone union occurred in 19 calves. Among the 26 calves that underwent surgery and follow-up, 65.4% (17 of 26 cases) experienced bone union, and 34.6% (9 of 26 cases) had a poor prognosis, experiencing nonunion (n = 3), death (n = 4), or euthanasia (n = 2). Among the surgical cases, 85.7% (12 of 14 cases) of the TPC surgery cases led to bone union, while only 41.7% (5 of 12 cases) of the other surgeries led to bone union.

In eight of the external coaptation cases, 25% (2 of 8 cases) of the calves experienced bone union, and 75% (6 of 8 cases) had a poor prognosis, experiencing nonunion (n = 4) or malunion (n = 2). Eight calves were lost to follow-up (one mandible, one vertebral, and six bone fractures) due to owner non-compliance.

Review of open fracture cases

In seven open fracture cases, 57% (4 of 7 cases) of the calves experienced severe malunion to nonunion, and 43% (3 of 7 cases) of the calves experienced delayed union.

In the present study, neonatal calves younger than 10 days of age comprised the group with the highest frequency of bone fracture cases, at 48%. According to previous reports, 71% of fracture cases were recorded in calves younger than 10 days of age (3). The rate of inappropriate manipulation during birth assistance was 60% among dystocia cases (1). Dairy cattle are raised for individual breeding, but Korean native calves live with their mothers. In the present study, 36 cases of long bone fractures (72%) in Korean native calves resulted from being stepped on by their mothers or other animals. Therefore, veterinarians need to educate clients on proper treatment during dystocia and the careful management of calves.

Previous studies found that the most common bone fractures are metacarpal and metatarsal (approximately 50%). Fractures of the femur (14%), tibia (12%), radius/ulna (6%), and rarely humerus (3%) are commonly seen in calves, and forelimb fracture (69.9%) was more frequent than hindlimb fractures (30.8%) (3). In the present study, hindlimb fractures (72%) were more frequent than forelimb fractures (28%). This difference was attributed to Korean native calves living with their mothers, and the fracture is caused by being pressed by their mothers and other animals (14).

ESF devices have several advantages, including minimal soft tissue trauma, less disruption to the blood supply, and a versatile method for rigid immobilization. TPC is an adaptation of ESF; it prevents interfragmentary movement and bending resistance more effectively than traditional ESF devices (15). In the present study, TPC was used for 17 calves with bone fractures, with 14 follow-ups being conducted. Of these, 12 cases (85.7%) showed bone union and two cases (14.3%) showed nonunion. This suggests that TPC surgery for bone fractures leads to a good prognosis in Korean native calves.

Several studies have reported that internal devices, such as bone plates and screws, have excellent outcomes in the stability of surgical fixation (5,7,12). On the other hand, there are some limitations to using plate devices in neonatal calve fractures. Young calves may be more susceptible to fractures because of their weak, immature bones with a low density and cortical thickness. This leads to the poor holding power of the bone plate and screws in neonatal calves resulting in implant loosening and screw migration (2,9). The treatment cost is an important factor in the decision of surgical methods. Plate fixation is challenging in cattle because of its economic value (8,16).

The fractures mostly occurred during spring (34.6%) and summer (26.9%). These findings are similar to previous studies (10,11). Most calf producers use a spring calving season because the feeding costs are low, and the feeding is more straightforward (6). Many calves born in the spring experience fracture accidents related to physical activity, during which they are more prone to falls or kicks.

Open fractures with severely traumatized soft tissues often become infected, significantly complicating their repair. Simultaneous infection and instability are usually not tolerated. Instability and failure of the repair are highly probable if contamination of the fracture site occurs and a persistent infection develops. Open fractures (which occurred in seven cases in the present study) can sometimes be resolved with full casting, but the prognosis for a successful outcome is diminished substantially compared to closed fractures, and the expense of fracture management is significantly higher (10). In the present study, three cases were treated using a cast. All of them experienced nonunion. In contrast, four cases were treated with TPC, and 75% of cases showed good progress, including delayed union.

In conclusion, among the fractures with follow-up surgery data available, the most successful cases were tibia fractures (85.7%) operated on with TPC and IM pin. These results suggest that TPC surgery is effective in managing calf fractures. Furthermore, the present study provides useful information on bone fractures in Korean native calves and the diagnosis and repair of such fractures.

The authors have no conflicting interests.

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Article

Original Article

J Vet Clin 2022; 39(4): 156-161

Published online August 31, 2022 https://doi.org/10.17555/jvc.2022.39.4.156

Copyright © The Korean Society of Veterinary Clinics.

Study on the Treatment of Fractures in Korean Native Calves: 52 Cases (2017-2020)

Hoon Kim , Jinsu Kang , Suyoung Heo , Namsoo Kim

College of Veterinary Medicine, Jeonbuk National University, Iksan 54596, Korea

Correspondence to:*namsoo@jbnu.ac.kr

Received: December 13, 2021; Revised: June 7, 2022; Accepted: June 28, 2022

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The objective of the present study was to assess the prevalence, occurrence pattern, and clinical outcomes of transfixation pinning and casting (TPC) for fractures in Korean native calves, and to identify the advantages of the procedure. The study investigated 52 cases of bone fractures documented from January 2017 to December 2020. Hindlimb fractures (72%) were the most common in bone fractures (n = 50). The distribution of fractures was highest in the tibia (n = 15), followed by the metatarsal (n = 12), femur (n = 9), radius/ulna (n = 8), metacarpal (n = 3), humerus (n = 3), mandible (n = 1), and caudal vertebrae (n = 1). All cases were diagnosed via radiographic evaluation. Closed fractures (86%) were the most common, followed by open fractures (14%). Surgery was performed on 34 calves using intramedullary pin (IM pin), TPC, cross pin, flexible wire (F-wire), and/or plate fixation. The rest of the calves were treated with external coaptation (n = 12) or were not treated (n = 6). Subsequently, 24 calves with follow-up records were evaluated in the bone fracture cases (n = 50). Bone union was observed in 15 (62%) calves; 3 (12%) calves showed non-union; 4 (16%) calves were dead after surgery; and 2 (8%) calves were euthanized at the owner’s request. Among the 24 follow-up surgery cases, the most successful cases were tibia fractures (75%) surgically treated using TPC and/or IM pin. These findings suggest that TPC surgery is effective in the management of fractures in Korean native calves.

Keywords: Korean native calves, bone fracture, bone union, transfixation pinning and casting (TPC).

Introduction

Calf bone fractures are common orthopedic problems. The incidence of fractures in cattle varies according to the breeding environment of each calf. The most common causes of fractures are assisted childbirth trauma, especially in dystocia or incorrect manipulations during dystocia (1). Holstein cattle are separated from newborn calves within the first few days for milk production. Unlike Holstein cattle, which are primarily used for individual breeding, Korean native calves live with their mothers. Their fractures are predominantly caused by kicking from other animals or the extremities being pressed by their mothers (14).

Although the fracture occurrence patterns vary slightly among reported studies, the metacarpal and metatarsal are the most common sites of bone fractures. Fractures of the femur, tibia, radius/ulna, and, more rarely, the humerus are commonly observed in calves. In cattle, fractures of the mandible, rib, vertebrae, pelvis, and phalanges are relatively rare (2,3,10).

Many methods have been used to repair the above calf fractures. Treatment depends on the size, age, and economic value of the animal, fracture type and location, prognosis of treatment, and the behavioral characteristics of the animal (9). Cast or Tomas splints or splint-cast combinations can be used to immobilize fractures. Internal fixation, such as bone plates and screws, intramedullary (IM) pins, and flexible wires, provide strong stabilization and early recovery of fractures (13). On the other hand, newborn calf bones have low bone densities and thin bone cortical, and the ability of immature bones to sustain internal fixation implants, such as bone plates and screws, is limited, leading to surgical failure (4,9,14). The application of external skeletal fixation (ESF) to farm animals has some advantages for stabilization: ESF uses an external frame to connect the pins; removal of the fixation device is simple; the preservation of local blood assists in the early return of functions to the fracture site. Therefore, ESF methods can be applied, even if the fracture sites are open, comminuted, or infected; they can also be used in nonunion cases (2,15).

The present study evaluated the prevalence and occurrence patterns of fractures in Korean native calves and the clinical treatment outcomes. These findings would be relevant to clinicians in understanding the efficacy of fracture treatment methods.

Materials and Methods

Case selection criteria

The medical records of Korean native calves at Jeonbuk Animal Medical Center (JAMC) between January 2017 and December 2020 were reviewed retrospectively, and 52 cases were identified. All records that had clinical signalment and orthopedic examination findings, with the diagnosis being made via radiographic evaluation, were included. Data obtained from the medical records included age, seasonal occurrence, fracture distribution, fracture localization, fracture type, treatment method, implant distribution in surgery cases, clinical outcomes, review of open and closed cases, and characteristics of young calves before and after the TPC treatment.

Treatments

Forty-six calves in 52 cases received external coaptation or surgical treatment of fractures. The remaining six cases did not undergo any treatment. Gauze roll bandages and fiberglass cast products were used as part of the external coaptation methods. All surgery cases were given inhalation anesthesia. The patients were premedicated cefazolin (20 mg/kg, intravenous, Cefazolin®, Chongkundang, Korea) and meloxicam (0.1 mg/kg, subcutaneous, Metacam®, Boehringer Ingelheim, Spain) injections. General anesthesia was induced with propofol (6 mg/kg, Intravenous, Provive®, Myung-moon Pharm, Korea) and maintained with isoflurane. Experienced surgeons performed the treatment.

Bone plate and screws

Two bone plates with an IM pin were placed in the radius (Fig. 1), and two bone plates were placed in femoral fracture cases (Fig. 2). Only one bone plate was placed in metacarpal and mandible fracture cases (Universal Locking plate). Cortical screws and locking screws were used.

Figure 1. Radiographs of a radius and ulna fracture in 3-days-old bovine. Preoperative mediolateral view (A) and craniocaudal view (B) shows a short oblique radius and ulna fracture with small fragments. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using one intramedullary pin and two bone plates and screws.

Figure 2. Radiographs of a femoral fracture in 1-day-old bovine. Preoperative mediolateral view (A) and craniocaudal view (B) show that severe displacement and comminution at the fracture site. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using two bone plates and screws.

ESF (external skeletal fixation)

The fixation pin was inserted as parallel to the fracture plane as possible. Methyl methacrylate and volatile monomer solvent were mixed into the liquid state, attached to the inner and outer fixing pins of the fractured legs for hardening and fixation.

TPC (transfixation pinning and casting)

The calves were placed in lateral recumbency and aseptically prepared for surgery. Two 1-cm long skin incisions were made from the craniolateral aspect of the long bone to the caudolateral side. Two holes were drilled in the long bones using drill bits. Subsequently, two Steinmann pins were inserted through the center of the medullary cavity as full pins. Clamps were then inserted into the pin, and ring circular fixators were attached. Sidebars were used at the two rings to retract the bone, and if necessary, an IM pin was inserted into the long bone. The cast encased the bone to the joint level, and the exposed ends of the transfixing pins were trimmed (Fig. 3).

Figure 3. Radiographs of a tibial fracture in 4-days-old bovine. Preoperative radiographs of the tibia (A, B) show a comminuted proximal tibial fracture. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using transfixation pinning and casting. (E) Radiograph taken after removal of the pin 4 weeks after surgery.

Postoperative treatment and prognosis

Antibiotic administration consisted of a 20 mg/kg Cefazolin sodium (Cefazolin®, Chongkundang, Korea), twice daily for one week, and analgesic administration comprised of Meloxicam (Metacam®, Boehringer Ingelheim, Spain) injections, once daily for three days. Of the 46 cases treated, follow-up information was obtained through visits, postoperative radiography, or telephone conversations with the owners.

Results

Age distribution

Young calves less than 10 days old accounted for most of the fractures (n = 25, 48.0%), followed by 31-90-day-old calves (n = 12, 23.1%). There were seven calves (13.5%) aged 21-30 days, five calves (9.6%) aged 91-150 days, and three (5.8%) calves aged 11-20 days.

Seasonal occurrence

The seasonal occurrence was divided into four categories. Spring (34.6%) and summer (26.9%) represented higher percentages of fracture occurrences than winter (15.4%) and autumn (23.1%).

Fracture distribution and localization

The most common fractured bones were the tibia (n = 15, 28.9%), followed by the metatarsal (n = 12, 23.0%). Femur fractures (n = 9, 17.3%), radius/ulna fractures (n = 8, 15.4%), and humerus or metacarpal fractures were less common (n = 3, 5.7%). Mandibular fractures and caudal vertebral fractures were present in once case each.

In the bone fracture cases (n = 50), the hindlimb (n = 36, 72%) was injured more frequently than the forelimb (n = 14, 28%). When comparing the left and right limbs, the left-sided limbs (n = 29, 58%) showed a higher fracture distribution than the right-sided limbs (n = 21, 42%). In the forelimbs, the left and right limbs showed the same distribution (n = 7, 14%), but the hindlimb showed more frequent left-limb injuries (n = 22, 44%) than the right limb (n = 14, 28%). Left-sided limb fractures occurred more frequently, particularly in the tibia and metacarpal.

Mid-diaphyseal fractures accounted for more than a third (36%) of all bone fractures. These were followed by distal diaphyseal (28%) and proximal diaphyseal fractures (24%). Physeal fractures accounted for 12% of all bone fractures. In the hindlimb, mid-diaphyseal fractures were the most common. Apart from those in the forelimb, distal diaphyseal fractures were the most frequent. Tibia physeal fractures (n = 4) were predominant among the physeal fractures (n = 6).

Fracture type

Oblique (78%) was the most common fracture type, followed by transverse (12%), spiral (6%), and compression (4%). There were six cases of physeal fracture, Salter-Harris type 2 in the femur, Salter-Harris type 2 in the radius and ulna, and Salter-Harris type 1, 2, and 4 in the tibia.

Method of treatment

Of the 52 fracture cases, 34 calves were operated on, and 12 underwent external coaptation. Six clients did not accept calf treatment. The surgical repair procedures (n = 34) were performed using IM pin, TPC, ESF, cross pin (CP), bone plate and screws, or flexible wire, alone or in combination. TPC was the most common fracture repair treatment (n = 17). IM pinning and TPC (n = 14), TPC (n = 2), and CP and TPC (n = 1) were also used. The other methods were used in 1-3 cases each.

Prognosis after surgery

Among the 44 calves that underwent surgical treatment or external coaptation in bone fractures (n = 50), 34 calves had follow-up records. Bone union occurred in 19 calves. Among the 26 calves that underwent surgery and follow-up, 65.4% (17 of 26 cases) experienced bone union, and 34.6% (9 of 26 cases) had a poor prognosis, experiencing nonunion (n = 3), death (n = 4), or euthanasia (n = 2). Among the surgical cases, 85.7% (12 of 14 cases) of the TPC surgery cases led to bone union, while only 41.7% (5 of 12 cases) of the other surgeries led to bone union.

In eight of the external coaptation cases, 25% (2 of 8 cases) of the calves experienced bone union, and 75% (6 of 8 cases) had a poor prognosis, experiencing nonunion (n = 4) or malunion (n = 2). Eight calves were lost to follow-up (one mandible, one vertebral, and six bone fractures) due to owner non-compliance.

Review of open fracture cases

In seven open fracture cases, 57% (4 of 7 cases) of the calves experienced severe malunion to nonunion, and 43% (3 of 7 cases) of the calves experienced delayed union.

Discussion

In the present study, neonatal calves younger than 10 days of age comprised the group with the highest frequency of bone fracture cases, at 48%. According to previous reports, 71% of fracture cases were recorded in calves younger than 10 days of age (3). The rate of inappropriate manipulation during birth assistance was 60% among dystocia cases (1). Dairy cattle are raised for individual breeding, but Korean native calves live with their mothers. In the present study, 36 cases of long bone fractures (72%) in Korean native calves resulted from being stepped on by their mothers or other animals. Therefore, veterinarians need to educate clients on proper treatment during dystocia and the careful management of calves.

Previous studies found that the most common bone fractures are metacarpal and metatarsal (approximately 50%). Fractures of the femur (14%), tibia (12%), radius/ulna (6%), and rarely humerus (3%) are commonly seen in calves, and forelimb fracture (69.9%) was more frequent than hindlimb fractures (30.8%) (3). In the present study, hindlimb fractures (72%) were more frequent than forelimb fractures (28%). This difference was attributed to Korean native calves living with their mothers, and the fracture is caused by being pressed by their mothers and other animals (14).

ESF devices have several advantages, including minimal soft tissue trauma, less disruption to the blood supply, and a versatile method for rigid immobilization. TPC is an adaptation of ESF; it prevents interfragmentary movement and bending resistance more effectively than traditional ESF devices (15). In the present study, TPC was used for 17 calves with bone fractures, with 14 follow-ups being conducted. Of these, 12 cases (85.7%) showed bone union and two cases (14.3%) showed nonunion. This suggests that TPC surgery for bone fractures leads to a good prognosis in Korean native calves.

Several studies have reported that internal devices, such as bone plates and screws, have excellent outcomes in the stability of surgical fixation (5,7,12). On the other hand, there are some limitations to using plate devices in neonatal calve fractures. Young calves may be more susceptible to fractures because of their weak, immature bones with a low density and cortical thickness. This leads to the poor holding power of the bone plate and screws in neonatal calves resulting in implant loosening and screw migration (2,9). The treatment cost is an important factor in the decision of surgical methods. Plate fixation is challenging in cattle because of its economic value (8,16).

The fractures mostly occurred during spring (34.6%) and summer (26.9%). These findings are similar to previous studies (10,11). Most calf producers use a spring calving season because the feeding costs are low, and the feeding is more straightforward (6). Many calves born in the spring experience fracture accidents related to physical activity, during which they are more prone to falls or kicks.

Open fractures with severely traumatized soft tissues often become infected, significantly complicating their repair. Simultaneous infection and instability are usually not tolerated. Instability and failure of the repair are highly probable if contamination of the fracture site occurs and a persistent infection develops. Open fractures (which occurred in seven cases in the present study) can sometimes be resolved with full casting, but the prognosis for a successful outcome is diminished substantially compared to closed fractures, and the expense of fracture management is significantly higher (10). In the present study, three cases were treated using a cast. All of them experienced nonunion. In contrast, four cases were treated with TPC, and 75% of cases showed good progress, including delayed union.

In conclusion, among the fractures with follow-up surgery data available, the most successful cases were tibia fractures (85.7%) operated on with TPC and IM pin. These results suggest that TPC surgery is effective in managing calf fractures. Furthermore, the present study provides useful information on bone fractures in Korean native calves and the diagnosis and repair of such fractures.

Conflicts of Interest

The authors have no conflicting interests.

Fig 1.

Figure 1.Radiographs of a radius and ulna fracture in 3-days-old bovine. Preoperative mediolateral view (A) and craniocaudal view (B) shows a short oblique radius and ulna fracture with small fragments. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using one intramedullary pin and two bone plates and screws.
Journal of Veterinary Clinics 2022; 39: 156-161https://doi.org/10.17555/jvc.2022.39.4.156

Fig 2.

Figure 2.Radiographs of a femoral fracture in 1-day-old bovine. Preoperative mediolateral view (A) and craniocaudal view (B) show that severe displacement and comminution at the fracture site. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using two bone plates and screws.
Journal of Veterinary Clinics 2022; 39: 156-161https://doi.org/10.17555/jvc.2022.39.4.156

Fig 3.

Figure 3.Radiographs of a tibial fracture in 4-days-old bovine. Preoperative radiographs of the tibia (A, B) show a comminuted proximal tibial fracture. Postoperative mediolateral view (C) and craniocaudal view (D) show that previously described fracture repaired by using transfixation pinning and casting. (E) Radiograph taken after removal of the pin 4 weeks after surgery.
Journal of Veterinary Clinics 2022; 39: 156-161https://doi.org/10.17555/jvc.2022.39.4.156

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Vol.39 No.4 August, 2022

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