Surgical reconstruction of a severely comminuted mandibular fracture in a horse

Abstract

SummaryA Palomino gelding presented for evaluation of a mandibular fracture and physical examination revealed swelling and excoriation of the skin over the ventral mandible. Upon further examination, malalignment of the incisors was appreciated in addition to instability and crepitance of both the rostral aspect and vertical ramus of the mandible. Radiographic examination revealed a comminuted fracture within the interdental space and fractures of both vertical ramii of the mandible. Under general anaesthesia via tracheotomy intubation, the fractures of the vertical ramii were reduced and compression plating techniques used along the caudal‐lateral border of both ramii for stabilisation. Intraoral tension band wires were used for repair of the interdental space fracture. A type II external skeletal fixator using Steinmann pins and polymethyl methacrylate connecting bars was applied to increase stability. The horse was maintained on broad spectrum antibiotics and phenylbutazone and discharged following 6 days of hospitalisation. Radiographs were taken 10 weeks after surgery and revealed evidence of adequate healing. On follow‐up 20 months later, the horse was reported to have no difficulties eating and was maintaining its bodyweight. This case is unique due to the severity of the mandibular fracture. The authors are unaware of any previous reports of such a severely comminuted mandibular fracture and its successful reconstruction employing multiple surgical techniques.