Page 129 - Manual of Equine Field Surgery

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lntraoral Wire Fixation of Rostral Mandibular and Maxillary Fractures 125

EXPECTED OUTCOME

Rostral fractures usually heal without complica-

tion in 4 to 6 weeks, provided there is adequate

stabilization and permanent tooth buds are not

involved. Fractures involving the interdental space

may require a longer healing period, typically

8 weeks. In most cases, the wires can be removed

in the standing horse with minimal sedation.

COMPLICATIONS

Purulent drainage, bone sequestration, septic

osteitis, difficult mastication, unusual incisor

eruption, wire loosening, and fixation failure are

potential complications. Brachygnathism has also
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Figure 20-4 Comparison of technique to repair the been reported in three foals following repair of

5
same fracture as Figure 20-3 showing how the fracture bilateral fractures of the mandible. In one study,

would be repaired if the canines were present. 27o;o of horses experienced short-term complica-

tions." Fortunately, although short-term cornpli-

cations may be common, the long-term prognosis

through the acrylic and hold it into place. Addi- for functional and cosmetic outcome is favorable.

tional strength can be gained by wiring the acrylic

to the mandible, incisors, or premolars. In frac-

tures that have minimal displacement or maintain COMMENTS

reduction easily, the acrylic may be formed to the

mouth first, allowed to harden, and then removed Young, curious horses typically incur these frac-

prior to the insertion of wires. This allows tures when they try to free themselves after getting

removal of sharp edges or excessive material with their head or teeth caught. Delay or failure to

a rasp or Dremel tool. Holes are then drilled into repair these fractures may result in malocclusion,

the acrylic splint, and the splint is wired to the tooth loss, osteornyelitis, loss of function, and less

mandible, premolars, and incisors. than optimal cosmesis. Because the oral side of
5

the mandible and maxilla is the tension surface,

intraoral wire fixation provides strong, effective
POSTOPERATIVE CARE fixation in many fracture configurations.

.... . '
Postoperative Care
REFERENCES

Medications: Because these fractures are often

open, with significant contamination, broad-spec- 1. Dixon PM: Dental anatomy. In Baker GJ, Easley J,

trum antibiotic therapy should be considered, but editors: Equine dentistry, London, 1999, WB

it generally is not necessary beyond the first 3 to Saunders.

s postoperative days. Nonsteroidal antiinflamrna- 2. Murch KM: Repair of bovine and equine mandibu-

tory drugs are typically administered for 1 to 3 lar fractures, Can Vet J 21:69, 1980.

days. Tetanus prophylaxis should be current. 3. Staton AL: Simplified wiring procedure for frac-

Other: Horses generally return to a normal diet tured jaw, Pulse 2:9, 1988.

immediately after surgery, but in some cases a 4. DeBowes RM: Fractures of the mandible and

pelleted feed or gruel may be of benefit. The maxilla. In Nixon AJ, editor: Equine fracture repair,

mouth may be rinsed out at least twice daily for
Philadelphia, 1996, WB Saunders.
the first week. Additionally, the horses should not 5. Henninger RW, Beard WL: Rostral mandibular and

be ·allowed to gr.aze for 2 to 4 weeks, and the maxillary fractures: repair by interdental wiring,

wires should be checked daily for breakage.
Proc Am Assoc Equine Pract 43:136, 1997.