Page 251 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

226 CHAPTER 1

VetBooks.ir 1.423 1.424

Fig. 1.423 A sedated horse undergoing a standing Fig. 1.424 CT cross-sectional reconstruction of a
CT acquisition. (Photo courtesy Sarah Powell) fracture of the vertical ramus of the right mandible.

then removal may be indicated. It is often thought
1.425
that removal of avulsed deciduous teeth is warranted,
but the fracture may involve the dental sac of the
developing permanent tooth below. Damage to this
may cause maleruption of the developing permanent
tooth, so every effort should be made to preserve
deciduous teeth if possible. Fractures confined to the
tooth alone (see Fig. 1.415) may also warrant tooth
extraction, but recent developments in endodon-
tic debridement and restoration techniques mean
that this may not always be necessary (Figs. 1.426,
1.427). Most displaced fractures will benefit from
reduction and fixation and some more extensive
lesions will mandate it. The speed of healing of head
injuries is high when compared with injuries involv-
ing the distal limbs. Most fractures involving the
incisive region of the maxilla, the rostral mandible
or avulsions of the incisors can be held in reduction
using cerclage wires placed between the remaining
intact incisor teeth (Figs. 1.428, 1.429). This proce-
Fig. 1.425 CT three-dimensional reconstruction of dure can be completed in the standing sedated horse
a fracture of the vertical ramus of the mandible. with perineural local anaesthesia. If all the incisor