Cranial Fractures - Equine Flashcards
Goal for cranial fractures
Reduce & maintain fractures until healed
Restore function
Prevent disfiguration
Types of teeth in horses
Incisors
Canines
Premolars
Molars
Bones in the equine skull
Incisive bone
Nasal bone
lacrimal bone
frontal bone
parietal bone
maxillary bone
zygomatic bone
palatine bone
temporal bone
occipital bone
mandible
nuchal crest
General considerations
Head trauma is common in all ages
Good soft tissue blood supply
Variable soft tissue coverage
Mechanical demands for fracture fixation less challenging than distal limb
Function + cosmetic outcome is important
Etiology for fractures
Trauma
Pathologic fracture (progressive dental disease)
Neoplasia
Assessing /diagnosing
Excessive salivation, ST swelling, instability, dental malalignment, facial asymmetry, protruding tongue, foul Oder
Imaging DX
Radiographs - multiple views, Intra oral view, tooth root involvement is important
CT can help
Management
Why did trauma occur?
Shock status
Brain/neuro signs
Stabilizing is key
- rehydrate - prevent alkalosis (Cl) or acidosis (Na,Ch3)
-prevent inflammation
-evaluate eyes
Preoperative management
Tetanus prophylaxis
Broad spectrum antibiotics
Analgesics
Hydration /nutrition
No not remove loose teeth prior to repair
Management decisions
Conservative or surgically
displacement
malocclusion
stability
bilateral vs unilateral
ability to eat
cosmetics
Cerclage wire use
Fracture of symphysis
Most frequently applied
Easy application, very versatile, inexpensive
Intra oral splint
unstable bilateral mandible fractures
fixed with wire loops
dental acrylic may be applied to add
stability
External fixator
preserve tooth roots
dietary management
hazard-free housing
Options for surgical
Internal fixation - plates, screws - avoids tooth root, tension side is oral
Intra - oral fixation - splints, cerclage wire
Extra - oral fixation - external fixation
Reconstructive procedures
Periosteal flaps
Muscle flaps
Cancellous bone graft
