Management Plan Given the nature of the limb injury in this calf, we have two main options for treatment. First, the owner has the option of euthanizing the animal instead of treating it. Considering the extent of the limb injury, protracted healing time, potential complications, and the cost that will be required to medically treat the animal, euthanasia is certainly a viable option. However, the owner has indicated that he wants to save the calf if at all possible. Therefore, we can present the following suggestions for treatment. Assuming that the affected limb has adequate blood supply (indicated by bone proliferation around the area of the fracture), our recommendation would be to perform both internal and external fixation. First, it will be necessary to open the fracture site, remove the fibrous, cartilagenous, or necrotic tissue from the fracture ends and medullary canal, and reset the fracture in proper anatomic reduction using buttress plates to span the gap in the fracture. Following the internal fixation procedure, we can apply an external fixator to further support the fracture repair and prevent the animal from reinjuring the limb. Because this is an open fracture, an external fixator stabilizer will allow easy access to the wound for topical debridement and lavage, while still holding the fracture stable for bone healing to proceed. Complications in this patient include septic arthritis, osteomyelitis, proud flesh, and chronic lameness. Since the culture of the fracture site revealed the presence of Staph aureus and E. coli, sensitive to second or third generation cephalosporins and a combination of amoxicillin and gentamicin. Prognosis This calf has a viable delayed union which is classified as atrophicÑcharacterized by widespread loss of bone with a segmental gap at the fracture site. While some osteogenic potential is still present, the prognosis is guarded to good if the appropriate treatments are applied, including proper wound care and antibiotic administration. If dead tissue is discovered during the surgery, recovery of bone health will be slow at best and may leave some compromise in function due to muscle atrophy, adhesions, or bony defects. It is important for the owner to understand that healing will be very slow at best, and may not occur at all.