2 week post operative radiographs were taken, positioned in extended right lateral and extended right caudocranial. The radiographs showed good bone alignment. The fixation plate and screws are appropriatley positioned. Healing is noted, however, continued external splint support is recommended until bridging callus formation is observed across the anterior fracture gap.

Patient was taken to VTH and anesthetized with iso via facemask. Respiratory rate and heart rate were monitored while the patient was under anesthesia. External coaptation was removed. The patient had a smooth recovery. The views that were taken include pelvis VD and pelvis R lateral. The views were taken without external coaptation. Medial deviation was noted on rads at the tibiotarsal joint. Caudal deviation was noted at this joint as well. Angulation was better than before surgery on 02-27, but was more deviated than rads taken on 03/03. It was unclear whether briding was present or not but callus formation is in progress. A small fracture line was still present as well. External coaptation was not replaced after looking at rads. The short term plan is to observe 044 in the cage to determine if patient can bear weight on both legs. The long term plan is to discuss with ortho about potentially doing further surgical correction via a wedge osteotomy.

Patient was taken to VTH and anesthetized with iso via facemask. Respiratory rate and heart rate were monitored while the patient was under anesthesia. Vitals were within normal limits. The patient had a smooth recovery. The views that were taken include extremity R lateral and extremity CrCd. Each view was taken with the splint on and with the splint off. Fracture alignment looks good and there was some briding present. There is a fracture gap present and no bony callus formation was seen at this point. A fibrous callus is suspected based on palpation.

Patient 044 was anesthetized and placed in dorsal recumbency
in the OR. The right leg was plucked, scrubbed, and isolated
via drapes and tape on the surgical table. A scalpel blade was
used to make a small incision on the plantarolateral aspect of
the tibiotarsus. The skin and subcutaneous tissue layers were
exposed via the scalpel blade. A bony callus was encountered
around the fracture site on the plantar aspect of the distal
tibiotarsus under the subcutaneous layer. The callus was isolated
and filed down until the bone was smooth to allow the tibiotarsus
and tarsometatarsus to be in a more stable alignment. A C-arm
radiography machine was used throughout the procedure to visualize
how much bony callus was left to be removed. Manipulation of
the joint was done at different stages during the procedure to
determine mobility and feel how much bony callus was left. Once
it was determined that the joint was mobile enough and the fracture
could be stabilized, the subcutaneous tissue layer was closed
using 5-0 PDS in a simple interrupted pattern. The skin was also
closed using 5-0 PDS in a simple continuous pattern. The sutures
were covered with a teflapad as the primary contact layer and
then wrapped using cast padding as the secondary layer. A thermoplastic
splint was then placed with the right leg in weight bearing position,
determined by comparing it to the non-fractured left leg. The
external fixation was completed by a layer of vet wrap. The patient
was then taken to recovery and woke up from anesthesia without
any complications. 

Patient was taken to VTH and anesthesized with iso via facemask. Respiratory rate and heart rate were monitored while the patient was under anesthesia. Vitals were within normal limits. The patient recovered in a quiet room with Becky, patient recovery was normal. The views that were taken include: whole body VD, extremity left lateral, extremity left CrCd, pelvis VD, and a pelvis right lateral. Left ulnar fracture appeared to be healed, there is a right tibiotarsal malunion fracture. 

Discussing whether to re-fracture and splint or re-fracture and put in an external fixator in the right limb.