Management

We will treat this fracture with external fixation (with acrylic 
sidebars) with transfixation pinning and casting under regional 
anesthesia (brachio-plexus block) and post-operative analgesia as 
necessary.  The pins should hold the fractures ends in proper 
alignment which should correct the vlagus deformity.  First we would 
flush out the wounds and draining tracts and administer local 
antibiotics.  Both of the cultured organisms are sensitive to 
second and third generation cephalosporins.  We're going to use a third generation cephalosporin because of it's broad spectrum and lack of renal toxicity (also, Gentamycin is not approved for use in cattle and requires an exceptionally long withdrawal time, so this drug is clearly a bad choice).  We would inject the antibiotic subcutaneously at 
the fracture site.  The antibiotics would be continued orally for at 
least two weeks. The fracture would be checked for progress in six 
weeks.  At this time the cast would be removed so that the area can 
be re-radiographed.  We would recheck sooner if there was evidence that the infection was not resolving or that the cast was causing irritation.

Other alternatives to surgery include stabilization of the fracture 
with stall rest.  The fracture should be stabilized with a Robert 
Jones bandage from the ground up to at least the mid radius.   Another 
alternative would be euthanasia.