Equine Cranial Fractures Flashcards
What predisposes cranial/facial bones to sequestration?
They are flat and lack a good blood supply ->
Most common cause of cranial fractures?
Trauma - catch teeth on wire or board; kick injuries; run into fence
OPEN FRACTURES = MOST COMMON!
How can progressive dental disease cause a cranial fracture?
Osteolysis (of incisive bone)
How to dx cranial fracture?
Hx, clinical signs; rads (intra-oral views), CT
Which cranial nerve is damage?
Facial Nerve (CN VII)
What comprises supportive care?
Rehydration (horses lose Cl++ –> alkalosis), prevent inflammation (IV DMSO & NSAIDs), evaluate the eyes (ulcers? laceration?)
Why should you never remove loose teeth prior to repair?
Don’t take out b/c a good chance that the tooth has active blood supply / isn’t completely “dead” yet.
When to choose surgery over conservative management
If the tooth is displaced enough that it interferes with their ability to eat, is maloccluded; fracture is bilateral; ō’s cosmetic goals for Pt
When to use Cerclage wire to repair fracture? Advantages?
SYMPHYSIS FRACTURE
Easy to apply, versatile, inexpensive
Method of Cerclage wire repair (intra-oral method)?
Figure 8 method, include at least 2 teeth on either side of fracture**.
Using large-gauge needle + drilling 2mm holes.
When to use an intra-oral splint?
Unstable, bilateral mandible fractures
Fixed with wire loops that
When to use an external fixator? Precautions?
to preserve tooth roots
Need to make sure the housing is hazard-free (so fixator doesn’t get caught/stuck on anything. May need to adjust diet (can’t chew on hay -> only eat mashed food)
Important precautions when placing internal fixations (screws, plates)? Post-op risks?
Avoid tooth roots (unfortunately also where tension side is) -> have to resort to placing the plate VENTRALLY (less structures/muscle) or laterally
Risks: plate breaks, instability still apparent in fracture
Sx method that preserves blood supply?
Use of Richards Bone Hook -> prepare hole in adjacent bone -> wire sutures
Periosteal flaps, muscle flaps, and cancellous bone grafts require what type of procedure?
Reconstruction sx
