Equis ISSN 2398-2977

Head: frontal facial fractures - repair

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 impact Head: frontal facial fractures; usually open and comminuted.
  • Owners may be 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.
  • 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.
  • The aim of surgical repair is preservation of the local anatomy, avoidance of infection, and a good cosmetic outcome.
  • Good local blood supply and minimal strain on implants aid the successful treatment.
  • Prognosis:
    • Can be good if all anatomical involvement is taken into consideration at the time of surgery.
    • Better for return to function than for cosmetic outcome but cosmetic outcome is usually acceptable.

Uses

Advantages

  • Rarely a life-threatening injury.

Disadvantages

  • Often substantial soft tissue defects leaving exposed bone.
  • The exposed bone should be covered immediately with adjacent skin or moist bandages to help maintain its viability.

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

  • Good if all anatomical involvement is taken into consideration at the time of surgery.
  • Prognosis is better for return to function than for cosmetic outcome but cosmetic outcome is usually acceptable.

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 Ophthalmol 17 (1), 97-106 PubMed.
  • Dunkel B, Corley K T, Johnson A L et al (2013) Pneumocephalus in five horses. Equine Vet J 45 (3), 367-71 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.
  • Bohanon T C & Gabel A A (1991) Cosmetic repair of a facial deformity by use of a silicone implant in a horse. JAVMA 198 (11), 1957-1958 PubMed.
  • Caron J P et al (1986) Periorbital skull fractures in five horses. JAVMA 188 (3), 280-284 PubMed.
  • Valdez H & Rook J S (1981) Use of fluorocarbon polymer and carbon fiber for restoration of facial contour in a horse. JAVMA 178 (3), 249-252 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.


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