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1.
J Feline Med Surg ; 26(5): 1098612X241243134, 2024 May.
Article in English | MEDLINE | ID: mdl-38717791

ABSTRACT

CASE SERIES SUMMARY: A total of 13 cases of cats with a caudal mandibular fracture treated with a novel surgical technique using the Ramus Anatomical Plate system were reviewed. Preoperative, immediate postoperative and a minimum of 8 weeks postoperative CT images were required as inclusion criteria. The outcome and complications were determined from clinical data and radiographic follow-up examinations. All cases achieved adequate anatomical reduction, resulting in a functional and atraumatic occlusion postoperatively. No intraoperative complications were reported. Time to voluntary food intake was in the range of 1-25 days. No evidence of disruptions to the implants or screw loosening was observed in the 8-week postoperative CT imaging, with radiographic evidence of complete osseous union in all fractures. The most common postoperative complication was swelling at the surgical site. Two cats had postoperative exophthalmos due to retrobulbar haemorrhage, and one cat exhibited partial wound dehiscence 5 days postoperatively, which resolved with medical management. Longer-term complications included intraoral plate exposure in one cat, which required plate removal 10 months postoperatively. RELEVANCE AND NOVEL INFORMATION: In this case series, rigid internal fixation of caudal mandibular fractures using the Ramus Anatomical Plate osteosynthesis system was associated with a minimal complication rate, and satisfactory radiographic and clinical outcomes. The reported outcomes of this novel technique are favourable when compared with previous techniques described for the management of these fracture types.


Subject(s)
Bone Plates , Fracture Fixation, Internal , Mandibular Fractures , Cats/injuries , Animals , Bone Plates/veterinary , Fracture Fixation, Internal/veterinary , Fracture Fixation, Internal/methods , Mandibular Fractures/veterinary , Mandibular Fractures/surgery , Male , Female , Treatment Outcome , Postoperative Complications/veterinary , Tomography, X-Ray Computed/veterinary , Cat Diseases/surgery
2.
J Am Vet Med Assoc ; 262(1): 1-7, 2024 Jan 01.
Article in English | MEDLINE | ID: mdl-38103371

ABSTRACT

OBJECTIVE: To report the prevalence of presumed concurrent medial coronoid process fractures in a series of cases of humeral condylar fractures and evaluate factors influencing the presence of a suspected fracture of the medial coronoid process. ANIMALS: 48 dogs and 7 cats, with a total of 57 humeral fractures. METHODS: Medical records of dogs and cats diagnosed with a humeral condylar fracture with radiographs were reviewed between October 2013 and March 2022. Species, sex, neutered status, age, weight, and the nature of the trauma were noted. Radiographs were assessed for the configuration of humeral condylar fracture, the presence of a suspected fractured medial coronoid process (MCP), number of MCP fragments, nature of fracture, degree of radioulnar incongruity, soft tissue swelling, and elbow luxation/subluxation. RESULTS: A presumed fracture of the MCP was seen in 26 of 57 cases. Comminution of the condylar fracture was the only parameter that had a positive effect on the presence of a possible fractured MCP. Body weight was significantly associated with size of the suspected fractured MCP. The presence of this fracture was not associated with the type of humeral condylar fracture. The size of the presumed fractured MCP fragment was positively correlated with body weight. CLINICAL RELEVANCE: There was a high prevalence of presumed fractured MCPs in dogs with humeral condylar fractures (almost 50%) and even more so in animals with comminuted fractures. The consequences of suspected fractured MCP associated with humeral condylar fractures and whether dogs and cats would benefit from removal of the fragment remain unknown.


Subject(s)
Cat Diseases , Dog Diseases , Fractures, Comminuted , Humeral Fractures , Mandibular Fractures , Cats , Dogs , Animals , Cat Diseases/diagnostic imaging , Dog Diseases/diagnostic imaging , Humeral Fractures/diagnostic imaging , Humeral Fractures/veterinary , Humerus , Mandibular Fractures/veterinary , Fractures, Comminuted/veterinary , Body Weight
3.
J Am Vet Med Assoc ; 261(10): 1-4, 2023 10 01.
Article in English | MEDLINE | ID: mdl-37451679

ABSTRACT

OBJECTIVE: To describe a treatment for a mandibular fracture in a guinea pig (Cavia porcellus). ANIMAL: A 6-month-old sexually intact male guinea pig referred for a 24-hour history of hyporexia. CLINICAL PRESENTATION, PROGRESSION, AND PROCEDURES: Physical examination showed lateral displacement of the incisors and inflammation and crepitation during mandible lateralization. Imaging tests revealed a minimally displaced complete oblique fracture of the left mandible with fracture of the left mandibular first premolar tooth and incisor tooth. TREATMENT AND OUTCOME: Conservative treatment was established by placing a chin sling (CS) to immobilize the jaw and a nasogastric tube for nutritional support. Imaging tests repeated 3 weeks later showed initial callus formation, and the conservative treatment was discontinued. Follow-up examinations showed appetite and progressive weight gain. Five months later, the clinical crown of the left mandibular incisor was absent and a resorptive lesion on the left mandibular first premolar tooth was detected. Complete ossification of the fracture without premolar and moler teeth elongation was observed on control imaging tests. Ten months after initial examination, the patient was reportedly healthy with no signs of pain or dental disease. CLINICAL RELEVANCE: Jaw fracture treatments in guinea pigs are poorly described in the literature. Surgical treatment can be challenging in this species due to its skull and dental anatomy. Although CS was originally employed to increase the congruency of premolar and molar teeth after coronal reduction, this device yielded satisfactory results as a noninvasive, inexpensive treatment of a mandibular fracture in this guinea pig. Alopecia on the back of the head was the only undesired adverse effect associated with the CS.


Subject(s)
Mandibular Fractures , Swine Diseases , Guinea Pigs , Male , Animals , Swine , Chin , Mandibular Fractures/surgery , Mandibular Fractures/veterinary , Conservative Treatment/veterinary , Mandible , Skull
4.
J Feline Med Surg ; 25(2): 1098612X231152521, 2023 02.
Article in English | MEDLINE | ID: mdl-36744847

ABSTRACT

PRACTICAL RELEVANCE: Feline head trauma injuries are common in general practice, often resulting in mandibular fracture. An understanding of the recent advances in the field of mandibular fracture repair will facilitate evidence-based decision-making in clinical practice. CLINICAL CHALLENGES: Feline maxillofacial and oral anatomy brings unique challenges in comparison with dogs. It has been commonplace to adapt techniques and equipment that are better suited to other body regions or are species-inappropriate for use in feline maxillofacial surgery, and this has traditionally resulted in high morbidity. AIMS: This review presents an overview of the diagnosis of, and decison-making for, maxillofacial trauma in cats, specifically with reference to the feline mandible. The challenges associated with the management of these injuries are presented. Techniques for repair that can be employed in general practice, as well as more advanced surgical options, are discussed, as well as the indications for invasive vs non-invasive management. Underutilised methods involving composite dental materials and their versatility for the repair of mandibular fractures in cats, and miniplates for caudal mandibular fractures in cats, are specifically covered, as well as other recent advances in the field, including three-dimensional printing and custom-printed implants. EVIDENCE BASE: Management of feline facial fractures is an often neglected topic, with very few published studies choosing to focus on head trauma outcomes in cats. Where available, however, this review draws on the published literature, as well as the authors' own clinical experience.


Subject(s)
Craniocerebral Trauma , Mandibular Fractures , Animals , Cats , Humans , Craniocerebral Trauma/veterinary , Dentists , Mandibular Fractures/surgery , Mandibular Fractures/veterinary
5.
J Vet Dent ; 40(1): 75-80, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36259149

ABSTRACT

This report describes the combination of two surgical fracture repair techniques and the postoperative management of a mandibular diastemal fracture in a two-year-old mare. The mare was referred to a veterinary hospital with a laceration over the body of the right mandible. Radiographic assessment revealed two mesial fracture lines involving the second premolar tooth and a ventrally displaced bone fragment. The mare was treated under general anesthesia and the fracture was corrected using open reduction and plate fixation. A 3.5 mm narrow 15-hole locking compression plate with seven locking screws were used in a bridge form. Cerclage wire was also used to anchor the incisor teeth to the second and third premolar teeth. The cerclage wire and incisor teeth were covered with polymethylmethacrylate to prevent implant failure and avoid injury to the oral mucosa. Implants were removed 55 days after surgery and the mare was discharged from hospital five days later. The mare returned for cerclage wire removal after 90 days and was allowed to resume exercise thereafter. The combination of two surgical techniques, proper implant choice and appropriate postoperative management, including use of pelleted feed, contributed to successful bone healing and return to function.


Subject(s)
Horse Diseases , Mandibular Fractures , Animals , Horses , Female , Fracture Fixation, Internal/veterinary , Fracture Fixation, Internal/methods , Mandibular Fractures/surgery , Mandibular Fractures/veterinary , Bone Wires/veterinary , Bone Plates/veterinary , Mandible
6.
J Vet Dent ; 40(1): 81-88, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36177536

ABSTRACT

An approach to caudal mandibular fracture stabilization is described along with three cases wherein the approach was applied in relatively young cats with traumatic mandibular fractures caudal to or involving the mandibular first molar. This approach was well-tolerated and facilitated a quick return to function as supported by minimal or no reliance on esophageal feeding tubes.


Subject(s)
Cats , Mandibular Fractures , Orthopedic Procedures , Animals , Mandibular Fractures/surgery , Mandibular Fractures/veterinary , Molar , Cats/injuries , Orthopedic Procedures/veterinary
7.
Article in German | MEDLINE | ID: mdl-36323292

ABSTRACT

The first part of this case report describes the surgical treatment of a unilateral mandibular fracture in the standing horse by using a fixateur type I. By the time of implant removal, the fracture had completely healed. However, during implant removal, an implant failure of 2 of the 4 implants occurred with fragments remaining in the bone. The second part of the report focuses on the development of a special surgical instrument that was designed for removal of the implant fragments. Furthermore, the surgical method allowing the entire extirpation of the fragments within a second surgery is described.According to the authors' knowledge, this is the first case report showing the use of the presented surgical technique for the treatment of a mandibular fracture in the standing horse. Additionally, this report also provides an approach for removing implant fragments from the depth of the bone which may occur in case of implant breakage as a potential complication of the described surgery.


Subject(s)
Device Removal , Mandibular Fractures , Animals , Device Removal/adverse effects , Device Removal/instrumentation , Device Removal/veterinary , Equipment Failure/veterinary , Horses , Mandibular Fractures/surgery , Mandibular Fractures/veterinary
8.
Schweiz Arch Tierheilkd ; 164(9): 609-622, 2022 Sep.
Article in German | MEDLINE | ID: mdl-36047817

ABSTRACT

INTRODUCTION: Mandibular fractures are among the most common fractures in cattle. The medical records of 108 cattle with a mandibular fracture, that were referred to the University of Zurich Veterinary Hospital from 2005 to 2019, were analysed to document the types of treatment, complications and long-term outcomes. Cattle, still alive at the time of retrospective analysis, underwent clinical and radiographic examinations. A fall was the single most common cause of a mandibular fracture (48,1 %), and a third of all cattle had a concomitant disease at the time of referral. Seventy-five cattle (69,4 %) had a single fracture, 26 (24,1 %) had two fractures and seven (6,5 %) had three fractures of the mandible. The molar part of the mandibular body was most commonly (40,7 %) fractured followed by the diastema (23,6 %), the pars incisiva (13,4 %), the ramus (12,1 %) and the symphysis (10,2 %) of the mandible. The majority of cattle (84/108, 77,8 %) had open fractures. Treatment was instituted in 63/108 animals (58,3 %) with 77/148 fractures. Of these fractures, 28 were treated with plate osteosynthesis, 25 with an external fixator, 8 with cerclage wire, 7 using mixed techniques, 4 with fragment excision, 4 underwent conservative treatment and one a mucosal suture. In total, 45/108 animals (41,7 %) were culled because of multiple fractures, concomitant diseases and because of economic reasons. Complications occurred in 34 (54,0 %) treated cattle; 22 had abnormal wound healing of which 18 developed osteomyelitis complicated by a sequestrum (14). Of the treated 63 cattle, 56 (88,9 %) were discharged. The mean postoperative productive life was 46 ± 29,2 months for animals that were deceased at the time of the study. Thirteen of the cattle with a sequestrum remained in the herd for 15 to 92 months (mean, 47 months) and one for 2 months. The life expectancy after treatment did not differ significantly from that of the Brown Swiss and Swiss Holstein dairy cattle populations, where the cattle of this study mainly came from. Eleven cattle were available for long-term follow-up; all had a good general health status but nine had dental abnormalities including missing teeth, steps or enamel points, which did not noticeably affect the body condition of the animals. Surgical treatment of selected mandibular fractures had a favourable prognosis (52/63 healed, 82,5 %) in cattle.


INTRODUCTION: Les fractures mandibulaires font partie des fractures les plus fréquentes chez les bovins. Les dossiers médicaux de 108 bovins présentant une fracture mandibulaire, référés à l'hôpital vétérinaire de l'Université de Zurich entre 2005 et 2019, ont été analysés afin de documenter les types de traitement, les complications et les résultats à long terme. Les bovins, encore vivants au moment de l'analyse rétrospective, ont subi des examens cliniques et radiographiques. Une chute était la cause la plus fréquente d'une fracture mandibulaire (48,1 %), et un tiers des bovins présentaient une maladie concomitante au moment de la consultation. Septante-cinq bovins (69,4 %) avaient une seule fracture, 26 (24,1 %) avaient deux fractures et sept (6,5 %) avaient trois fractures de la mandibule. La partie molaire du corps mandibulaire était le plus souvent (40,7 %) fracturée, suivie du diastème (23,6 %), de la pars incisiva (13,4 %), du ramus (12,1 %) et de la symphyse (10,2 %) de la mandibule. La majorité des bovins (84/108, 77,8 %) présentaient des fractures ouvertes. Un traitement a été institué chez 63/108 animaux (58,3 %) avec 77/148 fractures. Parmi ces fractures, 28 ont été traitées par une ostéosynthèse par plaque, 25 par un fixateur externe, 8 par cerclage, 7 par des techniques mixtes, 4 par une excision du fragment, 4 par un traitement conservateur et une par une suture muqueuse. Au total, 45/108 animaux (41,7 %) ont été abattus en raison de fractures multiples, de maladies concomitantes et pour des raisons économiques. Des complications sont survenues chez 34 (54,0 %) des bovins traités ; 22 ont présenté une cicatrisation anormale dont 18 ont développé une ostéomyélite compliquée par un séquestre (14). Sur les 63 bovins traités, 56 (88,9 %) sont sortis de clinique. La vie productive postopératoire moyenne était de 46 ± 29,2 mois pour les animaux qui étaient décédés au moment de l'étude. Treize des bovins avec un séquestre sont restés dans le troupeau pendant 15 à 92 mois (moyenne, 47 mois) et un pendant 2 mois. L'espérance de vie après traitement ne différait pas significativement de celle des populations de vaches laitières Brown Swiss et Swiss Holstein d'où provenaient principalement les bovins de cette étude. Onze bovins étaient disponibles pour un suivi à long terme ; tous avaient un bon état de santé général mais neuf présentaient des anomalies dentaires, notamment des dents manquantes, des différences de niveau de la table dentaire ou des pointes d'émail, ce qui n'a pas affecté de manière notable l'état corporel des animaux. Le traitement chirurgical de certaines fractures mandibulaires a donc eu un pronostic favorable (52/63 guéries, 82,5 %) chez les bovins.


Subject(s)
Cattle Diseases , Mandibular Fractures , Animals , Bone Plates , Cattle , Cattle Diseases/surgery , Fracture Fixation, Internal/veterinary , Mandibular Fractures/diagnostic imaging , Mandibular Fractures/surgery , Mandibular Fractures/veterinary , Retrospective Studies , Treatment Outcome
9.
Am J Vet Res ; 83(8)2022 Jun 29.
Article in English | MEDLINE | ID: mdl-35895785

ABSTRACT

OBJECTIVE: To evaluate the biomechanical properties of the mandibles of cats with experimentally created osteotomies simulating oblique ramus fractures, which were stabilized with malleable L-miniplates with either locking screws [locking construct (LC)] or nonlocking screws [nonlocking construct (NLC)], compared with those for intact mandibles. SAMPLES: 20 mandibles from 10 adult cat cadavers. PROCEDURES: A block study design was adopted to allocate the mandibles of each cadaver to 2 of the 3 test groups (LC, NLC, or intact mandible). Mandibles within each cadaver were allocated systematically to a test group. For mandibles assigned to an LC and an NLC, a complete oblique osteotomy was performed from the mid rostral aspect of the ramus in a caudoventral direction. All mandibles were loaded in a single-load-to-failure test through cantilever bending. Load and actuator displacement were recorded simultaneously. Mode of failure and radiographic evidence of damage to tooth roots and the mandibular canal were evaluated. Biomechanical properties were compared among the groups. RESULTS: No iatrogenic tooth root damage was evident, but all mandibles with an LC and an NLC had evidence of screw invasion into the mandibular canal. Plated mandibles had significantly less stiffness and bending moment than intact mandibles. Stiffness was not significantly different between the LC and the NLC; the NLC had a greater bending moment at failure than the LC. The pre-yield stiffness of plated mandibles decreased when the number of screw holes overlapping the mandibular canal increased. CLINICAL RELEVANCE: The use of a malleable L-miniplate in a caudal mandibular fracture model is feasible. Both the LC and the NLC were inferior mechanically to intact mandibles. Type of construct used did not affect the construct stiffness significantly in tested mandibles.


Subject(s)
Bone Plates/veterinary , Cats/injuries , Mandibular Fractures/veterinary , Animals , Biomechanical Phenomena , Bone Plates/classification , Bone Screws/veterinary , Cadaver , Cats/surgery , Fracture Fixation, Internal/methods , Fracture Fixation, Internal/veterinary , Mandibular Fractures/physiopathology , Mandibular Fractures/surgery , Weight-Bearing
10.
Vet Comp Orthop Traumatol ; 35(4): 255-262, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35839837

ABSTRACT

OBJECTIVE: The goal of this study was to generate mandibular fractures in three regions of the diastema using a metal impactor to simulate a kick from a horse and to determine the mean deceleration in the initial phase of the impact event, the maximum contact force, the impact energy necessary to create a fracture and the duration of the impact. STUDY DESIGN: Thirty heads of horses aged between 5 and 20 years and euthanatized for various reasons were used. The heads were attached to a steel bar at the occiput at an axial angle of 45 degrees so that the body of the mandible was positioned horizontally and directly under the trajectory of the impactor. A 2 kg solid impactor was dropped with velocities of 6 to 14 m/s to simulate a kick from a horse. The impact was recorded using a high-speed video camera with a frame rate of 30,000 frames per second. Radiographs of the heads were obtained before and after the simulated kick. RESULTS: Mandibular fractures with configurations similar to those seen in clinical practice were generated at all three locations. The mean deceleration increased with impact velocity and with more cranially located impact positions. Absorbed energy increased with increasing impact velocity when no fracture was generated. CONCLUSION: The susceptibility to experimental fracture of the diastema increased from rostral to caudal locations, which is most probably caused by decreasing mandibular bone strength and an increase in the curvature at the lateroventral aspect of the mandible in that region. Physical parameters depended on fracture occurrence and type.


Subject(s)
Diastema , Horse Diseases , Mandibular Fractures , Animals , Horses , Mandible , Mandibular Fractures/veterinary , Steel
11.
J Zoo Wildl Med ; 53(2): 448-454, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35758587

ABSTRACT

Following a case of mandibular fracture in a giraffe (Giraffa camelopardalis) at the Budapest Zoo, a survey was conducted across European zoological institutions with the support of the European Association of Zoos and Aquariums Giraffe Ex situ Programme (EAZA Giraffe EEP) to help identify the incidence, potential causes, and management of such injuries. Two hundred sixteen zoos keeping giraffes were invited to participate in the survey. Eighty-six responses were received, 14 of which (16.3%) reported jaw fractures with various causes in their giraffes. Of these responses, hay racks, where the muzzle of the giraffe could fit between the grid of feeding contraptions, were associated with mandibular fractures in seven cases (50.0%). Most giraffes were managed surgically (10/14; 71.4%), two were managed medically (14.3%), one was euthanized because of the severity of the injury (7.1%), and one was only diagnosed with a mandibular fracture postmortem. One giraffe died owing to postanesthetic complications; all other individuals had a full recovery. Most mandible fractures occurred in relatively young giraffes (between 5 wk and 8 yr with an average of 3.4 yr). Based on these findings, facilities with giraffe should evaluate their hay feeders for mandible entrapment risk, especially if they house young individuals.


Subject(s)
Giraffes , Mandibular Fractures , Animals , Giraffes/physiology , Mandibular Fractures/veterinary
12.
J Vet Dent ; 39(2): 173-181, 2022 Jun.
Article in English | MEDLINE | ID: mdl-35293801

ABSTRACT

This study was performed to report the dental abnormalities encountered in immature dogs with a history of mandibular fracture. Dogs were included in the study if mandibular fractures were diagnosed by means of oral examination and diagnostic imaging, they were treated with non-invasive or minimally invasive methods, and there was a follow-up examination of at least 90 days after the initial presentation with the last follow-up visit occurring at 6 months of age or older. Eleven dogs met the inclusion criteria. Dental abnormalities occurred exclusively in those dogs that had sustained fracture of the mandibular body or fracture at the transition of mandibular body and mandibular ramus. A high number of developing permanent teeth located in or near the mandibular fracture were affected (73.5%). The most common dental abnormalities were failure of eruption or partial eruption (29.0%), resorption (22.6%), abnormal shape (19.4%), and enamel hypoplasia (16.1%). The majority of deciduous teeth (64.3%) in or near the mandibular fracture exfoliated uneventfully. Ten out of 11 dogs needed a surgical procedure to treat dental abnormalities after mandibular fracture healing. The development of the tooth germs located in or near a mandibular fracture is frequently affected. Radiographic evaluation of the area of trauma is recommended until eruption and full development of the teeth are completed.


Subject(s)
Dental Enamel Hypoplasia , Dog Diseases , Mandibular Fractures , Animals , Dental Enamel Hypoplasia/veterinary , Dentition, Permanent , Dog Diseases/diagnostic imaging , Dog Diseases/etiology , Dogs , Mandibular Fractures/diagnostic imaging , Mandibular Fractures/surgery , Mandibular Fractures/veterinary , Tooth Eruption , Tooth Germ , Tooth, Deciduous
13.
J Vet Dent ; 39(1): 78-88, 2022 Mar.
Article in English | MEDLINE | ID: mdl-35060787

ABSTRACT

This study was performed to report etiology, clinical presentation, and outcome of mandibular fractures in immature dogs treated with non-invasive or minimally invasive techniques. Immature dogs diagnosed with mandibular fractures from 2001 to 2016 were included in this study. Diagnosis of the mandibular fracture was achieved by oral examination and diagnostic imaging in the anesthetized dog. Twenty-nine immature dogs with 54 mandibular fractures were selected. Within the mandibular body, the regions of the developing permanent canine and first molar teeth were most commonly involved (46.4% and 35.0%, respectively). Within the mandibular ramus, 53.8% of the fractures were located in its ventral half, and 38.5% in the condylar process. Muzzling was applied in 72.4% of the dogs. All dogs had clinical healing with resolution of signs of pain and recovery of mandibular function. Mean time for clinical healing was 21 ± 9 days. Age of the dog and duration of muzzling were significantly associated with the time needed for clinical healing. In immature dogs, fractures of the mandibular body occur most commonly in the regions of the developing permanent canine and first molar teeth, while fractures of the mandibular ramus are most commonly found in its ventral half and the condylar process. Non-invasive or minimally invasive management of mandibular fractures in immature dogs carries a good prognosis regarding clinical healing and recovery of mandibular function. Dogs should be monitored for the development of dental abnormalities and/or skeletal malocclusion until permanent teeth have erupted and jaw growth is completed.


Subject(s)
Dog Diseases , Malocclusion , Mandibular Fractures , Animals , Dog Diseases/diagnostic imaging , Dog Diseases/etiology , Dogs , Malocclusion/etiology , Malocclusion/therapy , Malocclusion/veterinary , Mandible , Mandibular Condyle/diagnostic imaging , Mandibular Condyle/surgery , Mandibular Fractures/etiology , Mandibular Fractures/surgery , Mandibular Fractures/veterinary , Molar , Retrospective Studies
14.
Vet Surg ; 51(2): 341-352, 2022 Feb.
Article in English | MEDLINE | ID: mdl-34787314

ABSTRACT

OBJECTIVES: To describe a novel fixation of open, unstable, unilateral mandibular fractures applying a locking compression plate as an external skeletal fixator (ESF-LCP). ANIMALS: Four horses and one dromedary. STUDY DESIGN: Short case series. METHODS: Animals presented with unstable, open, unilateral fractures of the mandible. Fracture fixation was performed under general anesthesia. A 4.5/5.5 narrow LCP was applied externally above the level of the skin and combined with intraoral tension band wiring. RESULTS: Fracture fixation was achieved successfully using an ESF-LCP. Minimal tissue manipulation was required during application and removal of the construct. The ESF-LCPs provided adequate access to the wounds at the fracture site, were well tolerated, and did not interfere with any objects in the animals' environment. Mild drainage at the screw-skin interface developed in all cases, requiring early implant removal due to surgical site infection in one case. The use of longer plates was associated with superficial pressure necrosis of the skin in the masseter area in two cases. Implants were removed after 3 to 12 weeks, and the long-term functional outcome after 11 to 41 (median 13) months was good in all cases. CONCLUSION: Stabilization of mandibular fractures with ESF-LCP led to good outcomes in this case series. The use of longer plates positioned more caudally and in a ventrolateral position seemed associated with surgical site infection and pressure necrosis of the skin. CLINICAL SIGNIFICANCE: Use of a locking compression plate as an external skeletal fixator seems to offer a viable alternative to treat unilateral mandibular fractures, especially when these are open and/or infected.


Subject(s)
Horse Diseases , Mandibular Fractures , Animals , Bone Plates/veterinary , Camelus , External Fixators/veterinary , Fracture Fixation, Internal/veterinary , Horses , Mandibular Fractures/surgery , Mandibular Fractures/veterinary
15.
J Am Vet Med Assoc ; 258(11): 1254-1258, 2021 Jun 01.
Article in English | MEDLINE | ID: mdl-33978444

ABSTRACT

CASE DESCRIPTION: 3 neonatal female calves (ages, < 1 to 4 days) were examined because of mandibular trauma. CLINICAL FINDINGS: Physical examination indicated that each calf had an open fracture of the mandibular pars incisiva (rostral mandibular fracture) with ventral displacement of the incisors at the affected region. Oral radiographs were obtained for 1 calf and revealed that 5 incisors were fractured at the level of the apical dental buds. TREATMENT AND OUTCOME: Each calf was anesthetized. The fracture site and surrounding tissues were surgically debrided and flushed with sterile 0.05% chlorhexidine solution. The laceration in the oral mucosa was closed with absorbable suture in an interrupted horizontal mattress pattern. Additionally, a Penrose drain was placed during primary closure and removed 4 days later in 1 calf. The fractured incisors were removed during primary debridement in another calf. All calves received perioperative antimicrobials and analgesics. One calf developed mild osteomyelitis of the rostral mandible, which resolved with additional surgical debridement and antimicrobial treatment. That calf and another developed mild brachygnathia. At the time of last follow-up (3 to 13 months after hospital discharge), all 3 calves were eating and growing as expected. CLINICAL RELEVANCE: 3 calves with open rostral mandibular fractures were successfully managed by surgical debridement and primary closure of the oral laceration. The procedure was easy to perform, did not require specialized equipment, and was less expensive than other repair methods. This procedure may be an effective and economic on-farm treatment alternative for calves with rostral mandibular fractures.


Subject(s)
Cattle Diseases , Fractures, Open , Mandibular Fractures , Animals , Cattle , Debridement/veterinary , Female , Fractures, Open/veterinary , Mandible , Mandibular Fractures/surgery , Mandibular Fractures/veterinary , Mouth Mucosa
16.
Vet Surg ; 50(3): 659-667, 2021 Apr.
Article in English | MEDLINE | ID: mdl-33606294

ABSTRACT

OBJECTIVE: To report the radiographic, surgical and postoperative features in horses with unstable oblique mandibular fractures secured with polyaxial pedicle screws (PPS) external fixation construct and intraoral wiring. ANIMALS: Three client-owned horses. STUDY DESIGN: Short case series. METHODS: Two horses each had a unilateral fracture, which did not improve after conservative management, and one horse had bilateral fractures. Clinical and radiographic features were documented. Polyaxial pedicle screw external fixators and intraoral tension band wiring were applied in standing horses after combining sedation and regional nerve anesthesia. Intraoral wires were implanted through a lateral buccotomy between teeth (two horses) or burred through exposed crown (one horse) and then secured around the incisors. The PPS were inserted under radiographic guidance to avoid tooth roots. Healing was assessed with radiographic examination. The PPS external fixator rod and intraoral wires were removed first. The mandible was manipulated, and, if it was stable, the PPS were removed. RESULTS: Implants were removed at 6, 8, or 10 weeks after the mandibles were palpably stable. Complications included broken wires in one horse, bone sequestration in one horse, and infection in one horse. Follow-up communication with the owners 12 to 18 months later confirmed complete healing without further complications of the fractured mandibles or teeth. CONCLUSION: Polyaxial pedicle screw external fixation led to fracture healing and a return to function in all three horses. The complications encountered did not preclude a successful outcome. CLINICAL SIGNIFICANCE: Polyaxial pedicle screw external fixation coupled with intraoral wiring provides an alternative to treat unstable equine mandibular fractures without general anesthesia.


Subject(s)
External Fixators/veterinary , Fracture Fixation/veterinary , Horses/injuries , Mandibular Fractures/veterinary , Pedicle Screws/veterinary , Animals , Bone Wires/veterinary , Male
17.
J Vet Sci ; 21(6): e90, 2020 Nov.
Article in English | MEDLINE | ID: mdl-33263237

ABSTRACT

BACKGROUND: Mandibular fractures are common in camels, leading to considerable economic losses. This study explored methods of improving mandibular fractures repair, adjuvant with interdental wire, or bone plate fixation. Autologous bone marrow (BM) injection enhances osteogenesis and rapid healing. OBJECTIVES: To investigate the effect of autologous BM aspirate as an adjuvant treatment for repairing mandibular fractures in camels with interdental wire, or bone plate fixation. METHODS: Thirty dromedary camels aged 5-8 years and of both sexes were randomly divided into 4 treatment groups: group 1 (n = 10) treated with stainless steel wire fixation and BM injection at the fracture line, group 2 (n = 10) treated with plate fixation and BM injection at the fracture line, group 3 (n = 5) treated with stainless steel bone wire fixation and placebo saline injection at the fracture line, and group 4 (n = 5) treated with plate fixation and placebo injection at the fracture line. The mandibular fractures were followed weekly for 12 weeks postoperatively to assess improvement and healing based on clinical evaluation, radiographic union scale, and bone turnover markers (i.e., bone alkaline phosphatase, osteocalcin, pyridinoline, and deoxypyridinoline). RESULTS: Compared to other groups, elevated bone turnover markers in group 1 were demonstrated (p < 0.05) on the seventh postoperative day. Likewise, compared to other groups, both clinical findings and radiographic union scale significantly improved (p < 0.05) in group 1 on the 56th postoperative day. CONCLUSIONS: BM aspirate has a promising beneficial osteogenic effect on mandibular fracture repair in camels, most notably when combined with interdental wire fixation.


Subject(s)
Bone Marrow/physiology , Bone Plates/veterinary , Bone Wires/veterinary , Camelus/injuries , Fracture Fixation/veterinary , Mandibular Fractures/veterinary , Animals , Female , Fracture Fixation/methods , Injections/veterinary , Male , Mandibular Fractures/therapy
18.
J Vet Med Sci ; 82(2): 204-208, 2020 Feb 18.
Article in English | MEDLINE | ID: mdl-31902835

ABSTRACT

Two-month-old (Case 1) and one-year-old (Case 2) Japanese Black cattle presented with bilateral rostral mandibular open fractures. At presentation, the proximal edges of each fracture were discolored and had a severe stench, indicating necrosis caused by infection. In both cases, a bilateral rostral mandibulectomy over the symphysis was performed. Although the tongues of both animals prolapsed post-surgery, they had no significant problems with eating or drinking. Case 1 showed excellent growth during fattening, and Case 2 successfully became pregnant and gave birth. Rostral mandibulectomy can be an effective surgical option for the treatment of cattle with difficulty in internal or external fixation due to unfavorable necrotic cranial mandibular open fractures.


Subject(s)
Fractures, Open/veterinary , Mandibular Fractures/veterinary , Mandibular Osteotomy/veterinary , Animals , Cattle , Female , Fractures, Open/surgery , Male , Mandibular Fractures/surgery , Treatment Outcome
20.
Acta Cir Bras ; 34(9): e201900906, 2019.
Article in English | MEDLINE | ID: mdl-31826098

ABSTRACT

PURPOSE: To develop 3D anatomical models, and corresponding radiographs, of canine jaw fractures. METHODS: A base model was generated from a mandibular bone scan. With this model it was possible to perform fracture planning according to the anatomical location. RESULTS: The 3D base model of the canine mandible was similar in conformation to the natural bone, demonstrating structures such as canine tooth crowns, premolars and molars, mental foramina, body of the mandible, ramus of the mandible, masseteric fossa, the coronoid process, condylar process, and angular process. It was not possible to obtain detail of the crown of the incisor teeth, mandibular symphysis, and the medullary channel. Production of the 3D CJF model took 10.6 h, used 150.1 g of filament (ABS) and cost US$5.83. CONCLUSION: The 3D canine jaw fractures models, which reproduced natural canine jaw fractures, and their respective radiographic images, are a possible source of educational material for the teaching of veterinary medicine.


Subject(s)
Education, Veterinary/methods , Imaging, Three-Dimensional/veterinary , Mandibular Fractures/veterinary , Models, Anatomic , Printing, Three-Dimensional , Animals , Dogs , Imaging, Three-Dimensional/methods , Mandible/anatomy & histology , Mandible/diagnostic imaging , Mandibular Fractures/diagnostic imaging , Radiography/veterinary , Reproducibility of Results , Time Factors
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