Management of fractures of the mandible in small animals

Abstract

MANDIBULAR fractures are commonly seen in practice, comprising up to 6 per cent of all fractures in dogs and between 11 and 23 per cent of all fractures in cats. A better understanding of fracture biology and the relatively recent development of simple acrylic fixation methods have improved the management of mandibular fractures in dogs and cats. These techniques are effective and inexpensive and have reduced the complication rate previously associated with mandibular fracture repair. This article describes the anatomy of the mandible and discusses the biological, biomechanical and clinical factors which need to be taken into account for the successful management of mandibular fractures. It goes on to consider the options for mandibular fracture/luxation repair and reviews the techniques involved.

Author's reply

“…What I did state was that four intact teeth are required for optimal fixation strength. This is intuitive and in agreement with other authors (Bennett and others 1994, Glyde and Lidbetter 2003, Voss and others 2009). There are two other issues associated with interarch bonding that Mr Johnston and colleagues do not consider, including the ability to rapidly free the jaw to allow for an emergency intubation and a way to manage cases such as case 1 in my report, which was missing two mandibular canines.…”

“…The problems relating to fixation of the jaw in too open a position were discussed and a specific guideline was provided for ensuring this was avoided. It was advised that the tips of the canine teeth should overlap, in line with other authors (Glyde and Lidbetter 2003). With this degree of opening, cats could and did eat orally without problem, including the cat shown in figure 3 (p. 41).…”

“…Tape muzzles do not provide adequate stability for many jaw injuries and are, in my opinion, difficult to maintain and poorly tolerated by cats. Other authors are in agreement; Glyde & Lidbetter (2003) stating ‘this method is unsuitable for use in cats and brachycephalic dogs’. Bennett & others (1994) state that ‘[tape muzzles] do not work well on cats’.…”

A retrospective study of 109 dogs with mandibular fractures

“…Anatomical location and conformation of these fractures can play an important role in the selection of treatment methods and can aid in prognostication of fractures (7,8).…”

The comparative biomechanics of the reinforced interdental crossover and the Stout loop composite splints for mandibular fracture repair in dogs

“…An important consideration is the presence of the alveolar canal in the ventral third of the mandibular body. It contains the inferior alveolar nerve, the mandibular alveolar artery and the mandibular alveolar vein (10,11). The mandibular alveolar artery provides the main blood supply to the teeth and the alveolar bone.…”