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Jaw fractures are common in both dogs and cats. They often provide a challenge which is difficult to tackle using conventional orthopaedic techniques.
Pins, plates and external fixators often cause damage to tooth roots and the neurovascular bundles within the mandibular and infra-orbital canals. Jaw fractures are often best fixed using a conservative intra-oral approach. Techniques vary but can utilise tape muzzles or interdental fixation using orthopaedic wire and acrylic.
Radiograph of mid body mandibular fracture in a twelve week old Chihuahua puppy.
Fracture stabilised with a tape muzzle and puppy fed via an oesophagostomy feeding tube
In addition to providing stability to allow a fracture to heal it is very important that attention is given to restoring normal occlusion. This is generally much easier using interdental fixation. Pharyngostomy intubation during anaesthesia also helps and removes the need to repeatedly extubate during a procedure to check the occlusion.
Rostral mandibular fracture being stabilised with interdental wire using a Stout multiple loop technique
Acrylic and wire interdental fixation applied to a mid body mandibular fracture. Note the return to normal occlusion allowing normal comfortable function whilst the fracture heals
Understandably post operative inappetance or dysphagia is common after major oral surgery and therefore it is important to be able to offer round the clock nursing in the immeidiate post operative period. Oesophagostomy feeding tubes are routinely used and much better tolerated than nasogastric tubes, especially in cats.