Page 128 - Manual of Equine Field Surgery

124 HEAD AND NECK SURGERIES

covered with a small amount of acrylic. In young,

rapidly growing horses, both sides of the mandible

should be included in the fixation to the premo-

lars to minimize the risk of developing disparate

mandibular growth or placing undue stress on the

symphysis.
' Bilateral fractures in the interdental space with
;·

1
I~ f' displacement are often unstable and require more

i than wire fixation. In comminuted fractures of the

"
interdental space, the mandible tends to collapse

when the wires are tightened. A buttress is needed

to maintain the mandible in position. Acrylic

reinforcement of intraoral wiring can be used in

some of these fractures, resulting in a relatively
B
stable fixation.12 Ideally, cold curing acrylic should

be used or the acrylic should be lavaged with

saline as the acrylic is curing.

A ~e.,...,_~;t~ A tension band wire is placed from the incisors

Figure 20-2 A, Rostral mandibular fracture involv- to the first or second cheek tooth as previously

ing the first left incisor and all three right incisors. described. After the wires are placed, an intraoral

In older horses, the canines can be used to anchor the splint is made by molding acrylic around the wires

stabilizing sutures. B, Note the "notch" in the canine to and contouring it to fit the mouth from the

help hold the wires in position (arrow). incisors to the second cheek tooth. The wires run

(

I

I

A

I

B c

Figure 20-3 A, Positioning of drill through cheek between first and second cheek teeth for insertion of tension

band wire for repair of rostral mandibular fracture. B, Initial wire insertion to repair rostral mandibular fracture
•
involving the right incisors. 111 young horses, a 14- or 16-guage needle can be used to insert the wires between teeth.

In older animals, a small drill (about 2 mm) can be used to provide a path for the wire. C, Wires in place for repair

of a rostral mandibular fracture involving tl1e right incisors in the absence of canine teeth. After the wires are tight-

ened, the tied ends should be folded over against the gum to minimize soft tissue irritation. A small amount of acrylic

may be applied over the wire ties to minimize irritation.