Hypothesis 1:  Trauma induced Metacarpal fracture with septic metacarpal/phalangeal joint and iatrogenic valgus deformity

We think there is a metacarpal fracture because crepitance was felt around the metacarpal area and that part of the limb has extreme swelling (twice the size of the normal limb).  This fracture occurred because trauma was induced at parturition when the calf was pulled with obstetric chains and Frank's calf jack from the dam.  The chains were placed around the metacarpal bone and with excessive, forceful pulling, the bone was fractured.  Forced extraction was required because the calf was very large.

Iatrogenic valgus deformity occurred as a result of improper bandaging and casting.  Initially the trauma of the chains at parturition damaged the growth cartilage resulting asymmetric growth at the met/phal growth.  The casting/bandaging added to the asymmetric growth deformity by causing pathologic compression which caused increased pressure on the medial side of the front left leg.  The poor bandaging technique and excessive pressure is evidenced by the fact that the skin sloughed off after the bandage was removed.  The improper bandaging and subsequent disuse of the limb caused contracture due to fibrosis of surrounding ligaments especially the extensor tendons which is why the toes are raised.
The lateral side of the growth cartilage was initially damaged by the forces extraction resulting in a slower growth rate.  The bandaging added to the problem by stimulating increased growth on the medial side of the growth cartilage leading to the metacarpal valgus deformity.  The immobility of the leg and the bandage and cast restricted growth of the distal bones and buy now (at 3 months) the metacarpal/phalangeal joints have ossified into this abnormal valgus position.

We think the metacarpal/phalangeal joint is septic because there is a purulent exudate and draining tract at the area and there is limited range of motion at that joint.  There wasn't enough padding around the bandage so the cast caused wounds due to friction and rubbing.  This wound led to bacterial invasion because the bandage wasn't changed for a month and the cast wasn't changed for 3 weeks.  The moist environment under the leg aided the bacterial growth.  The calf was probably out on pasture or around other cows where lots of manure and other debris were present.  This could easily have made it under the bandage/cast and contaminated the wounds.  The massive inflammation and swelling present could be due to neutrophil and macrophage invasion to clean up the bacteria.  The wounds are also not healing because of the present infection.