Group 11 
Hypothesis 2:  Intrauterine malpositioning caused left carpal valgus  

Intrauterine malpositioning of the calf's left metacarpal-phalangeal joint led to an angular limb deformity due to asymmetric growth of the metaphysis or epiphysis.  The possibility of this etiology is increased because this calf was an embryo transfer and thus there is an increased possiblity of a mismatch in size between the calf and the cow.  The large size of the calf in-utero caused the left metacarpal-phalangeal joint to be pathologically compressed on the lateral side of the physis of metacarpal III.  This compression would have most likely have been due to the joint being pressed up against the cow's os coxae or spinal vertebrae during the calf's growth.  This pathologic compression caused a marked decrease in the chondral growth on the lateral side of this joint while the medial side of this joint grew at a normal rate.  This mismatch in chondral growth resulted in a fetlock valgus deformity at birth.  

The large size of the calf then necessitated a forced extraction at birth with obstetrical chains and a Frank's calf jack.  This device involves securing the chains around both of the calf's metacarpal-phalangeal joints and then forcibly extracting the calf from the uterus.  This process put an abnormal amount of pressure on an already compromised left metacarpal-phalangeal joint and resulted in fracture of distal metacarpal III.  In addition, the chains lacerated the soft tissue on this joint.  These lacerations predisposed the joint and the surrounding tissues to infiltration by bacteria and thus infection.  The heavy bandage that was subsequently applied to the fractured leg would not have provided adequate support to correct a deformed and fractured limb in a normal conformation.  Thus the limb could have undergone further pathologic compression and may have caused the deformity to worsen.  Additionally, the bandage caused pressure necrosis of the skin around the joint, which caused the skin to slough after 2 weeks.  Any bacterial involvement would worsen the situation by disrupting normal blood flow to the fracture and soft tissue and potentially interfering with bone/soft tissue growth and healing.  

An additional issue is the tight bands of tissue that connect the raised toes with the tissue on the dorsum of the foot.   This could have potentially been caused by extensor tendon laceration by the chains during the extraction, or improper immobilization of the limb in extension while in the bandage and cast.  Either way, the extensor tendon may have undergone fibrosis and contracture leading to the raised toes.