Felis ISSN 2398-2950

Mandible: fracture repair

Contributor(s): Leigh Griffiths, J Yovich

Introduction

  • The aims of surgical fracture repair are to:
    • Attain perfect dental occlusion.
    • Provide rigid fracture stabilization.
    • Minimize soft tissue damage.
    • Preserve dentition.
    • Maintain patient's ability to eat.

Uses

  • Repair of mandibular fractures Mandible: fracture in order to restore normal occlusion and normal function of the jaw.
  • Repair can range from the simplicity of circumferential wiring of symphyseal fractures to the complexity of reducing multiple/bilateral fractures using interfragmentary wires, external fixation and plates. Selection of an appropriate technique is essential for a good outcome.

Advantages

  • In many cases is essential to attain normal occlusion - malalignment of 2-3mm can prevent the jaw from closing.
  • Early return to pain free function.
  • Reduces risk of malunion/delayed union.

Disadvantages

  • General anesthesia required in a cat which may present in shock or have pulmonary contusions/pneumothorax - these conditions must be treated first.
  • Plating and external fixation are expensive.
  • Interarcade wiring or muzzle taping can potentially result in heat stroke and aspiration pneumonia as a result of inability to open mouth.
  • Placement of implants can damage teeth and mandibular blood supply if placed inappropriately.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Excellent for mandibular symphyseal separations.
  • Good for other mandibular fractures as long as normal dental occlusion is achieved.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Glyde M & Lidbetter D (2004) Management of fractures of the mandible in small animals. In Practice 25 (10), 570-585 ResearchGate.
  • Davidson J R & Bauer M S (1992) Fractures of the mandible and the maxilla. Vet Clin North Am Small Anim Pract 22 (1), 109-119 PubMed.
  • Lantz G C (1981) Interarcade wiring as a method of fixation for selected mandibular injuries. JAAHA 17 (4), 599-603 VetMedResource.

Other sources of information

  • Egger E L (1993) Skull and mandibular fractures In: J D SlatterTextbook of Small Animal Surgery.2nd ed. Philadelphia: W B Saunders Co, pp 1910-1921.


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