Management In order to adequately fix this fracture we are going to open the site and remove fibrous, cartilaginous or necrotic (avascular) tissue to facilitate hypertrophy and new bone growth. We are also going to remove the abscess and lavage the site with saline. Taking advantage of the invasiveness of this procedure, we are going to align the bone. We are then going to use an external fixation device to provide stability and divert stress from the fracture (open reduction). We have chosen external fixation over internal fixation to decrease cost. The external fixation device we are going to use is threaded pins and sidebars with acrylic (PMM). We are going to use at least three pins on each side of the fracture. The first and last pins in each major frament should be as far from each other as possible. All other pins can be placed at regular, convenient intervals. Muscles, tendons, arteries, veins and nerves should not be pinned to the bone. We will pre-drill the bone and drive the pins in slowly to avoid burning the bone. Pin insertion should be through a small incision in the skin, which will allow pin tract drainage from the site. The pins are cut to equal lengths on either side of the leg and the last centimeter is bent to better hold in the acrylic. Corrugated plastic tubing is impaled on the tube so that the pins go through the center of the tube. The lower end of the tube is closed with a carmalt clamp. The mold is positioned at least one centimeter away from the skin to allow for swelling and cleaning. The acrylic is poured into the mold and by using a temporary KE on the opposite side of the pins we will be able to align the fixator better. As the acrylic hardens, the carmalt can be removed, the column can be trimmed and on the other side the same procedure can be repeated. We are then going to place of modified Robert Jones bandage over the site to provide further stability and protect from further contamination. This bandage will need to be changed every 24-48 hours. When the bandage is cleaned, the fracture site and draining tracts should be gently cleaned diluted iodine or chlorhexidine scrub to remove necrotic tissue and pus. We will periodically radiograph the limb and remove the external fixation device when sufficient bone healing has occurred. We are going to place the calf on systemic antibiotics. We will use either a second or third generation cephalosporin or a combination of amoxicillin and gentimicin. The calf will remain on stall confinement until the external fixator can be removed and bone healing has occurred. Initially, the calf will also need to be on analgesics which would most likely incorporate a non-steroidal anti-inflammatory such as flunixin meglumine (Banamine). Special care must be taken not to ease the calfÕs pain to the point that he uses his leg too much. In all essence, the edge of the calfÕs pain should be taken off while leaving him hurting enough to limit his activity. Due to the size and weight of large animals rigid stabilization of the fracture usually does not occur. In addition implants available are not strong enough to withstand the stresses placed upon the bones. Although the prognosis for large animals is usually poor, we are going to attempt this procedure because the owner wants the calf to survive and young age and relative light weight will improve the prognosis. We will however offer euthanasia as an option to the owner.