Equis ISSN 2398-2977

Head: frontal facial fractures

Contributor(s): Jessica A Kidd-Millar, Jessica A Kidd, Carl Kirker-Head, Jarred Williams

Introduction

  • Cause: fractures result from direct trauma such as a kick or other impact; usually open and comminuted.
  • Owners are often very distressed by the visual appearance of the injury.
  • Signs: fractures are often associated with substantial soft tissue defects but these usually respond well to treatment; rarely life-threatening unless damage to the calvarium has occurred.
  • Diagnosis: clinical signs, radiography, endoscopy, neurological and ophthalmological examinations. 
  • Treatment: repair of the fractures is not urgent; initial therapy involves stabilization of the patient and protection of exposed structures.
  • Fracture of these bones can result in trauma to the eye, sinuses, zygomatic process, nasal passages, nasolacrimal duct and cranial nerves.
  • Prognosis:
    • Can be good if all anatomical involvement is taken into consideration at the time of assessment.
    • Prognosis is better for return to function than for cosmetic outcome, but cosmetic outcome is usually acceptable.

Presenting signs

  • Facial swelling with or without wounds.

Acute presentation

  • Evidence of trauma, swelling, and commonly wounds.
  • Patient may have evidence of brain involvement:
    • Alterations in mentation.
    • Cranial nerve deficits.
    • Unable/difficulty rising.
    • Ataxia.

Cost considerations

  • Severity of injury.
  • Brain involvement.
  • Severity of neurologic signs if present.
  • Value of horse.

Special risks

  • Considerable anesthetic risk if traumatic brain injury.
  • Anesthetic recovery risk of fracture repair failure or worsening of original fracture.

Pathogenesis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Diagnosis

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Treatment

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Outcomes

This article is available in full to registered subscribers

Sign up now to purchase a 30 day trial, or Login

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Gerding J C, Clode A, Gilger B C & Montgomery K W (2014) Equine orbital fractures: a review of 18 cases (2006-2013). Vet Ophthal 17 Suppl 1, 97-106 PubMed.
  • Dunkel B, Corley K T, Johnson A L et al (2013) Pneumocephalus in five horses. Equine Vet J 45 (3), 367-371 PubMed.
  • Dowling B A, Dart A J & Trope G (2001) Surgical repair of skull fractures in four horses using cuttable bone plates. Aust Vet J 79 (5), 324-327 PubMed.
  • Ramirez O 3rd, Jorgensen J S & Thrall D E (1998) Imaging basilar skull fractures in the horse: a review. Vet Radiol Ultrasound 39 (5), 391-395 PubMed.
  • Ragle C A (1993) Head trauma. Vet Clin North Am Equine Pract 9 (1), 171-178 PubMed.
  • Caron J P et al (1986) Periorbital skull fractures in five horses. JAVMA 188 (3), 280-284 PubMed.

Other sources of information

  • Auer J A & Stick J A (1999) Ed Equine Surgery. 2nd edn. W B Saunders, USA.
  • Nixon A J (1996) Ed Equine Fracture Repair. W B Saunders, USA.


ADDED