Application of locking compression plates as type 1 external fixators to treat unilateral mandibular fractures in four equids and one dromedary.
Abstract: To describe a novel fixation of open, unstable, unilateral mandibular fractures applying a locking compression plate as an external skeletal fixator (ESF-LCP). Methods: Four horses and one dromedary. Methods: Short case series. Methods: Animals presented with unstable, open, unilateral fractures of the mandible. Fracture fixation was performed under general anesthesia. A 4.5/5.5 narrow LCP was applied externally above the level of the skin and combined with intraoral tension band wiring. Results: Fracture fixation was achieved successfully using an ESF-LCP. Minimal tissue manipulation was required during application and removal of the construct. The ESF-LCPs provided adequate access to the wounds at the fracture site, were well tolerated, and did not interfere with any objects in the animals' environment. Mild drainage at the screw-skin interface developed in all cases, requiring early implant removal due to surgical site infection in one case. The use of longer plates was associated with superficial pressure necrosis of the skin in the masseter area in two cases. Implants were removed after 3 to 12 weeks, and the long-term functional outcome after 11 to 41 (median 13) months was good in all cases. Conclusions: Stabilization of mandibular fractures with ESF-LCP led to good outcomes in this case series. The use of longer plates positioned more caudally and in a ventrolateral position seemed associated with surgical site infection and pressure necrosis of the skin. Conclusions: Use of a locking compression plate as an external skeletal fixator seems to offer a viable alternative to treat unilateral mandibular fractures, especially when these are open and/or infected.
© 2021 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
Publication Date: 2021-11-17 PubMed ID: 34787314DOI: 10.1111/vsu.13748Google Scholar: Lookup
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Summary
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The study explores the use of locking compression plates as type 1 external fixators to treat single-sided mandibular fractures in four horses and one dromedary, revealing that this method proved effective in stabilizing fractures and led to good long-term outcomes.
Research Methodology
- The researchers carried out a short case series study involving four horses and one dromedary.
- The animals in the study were suffering from unstable, open, unilateral fractures of the mandible.
- The process of fracture fixation was conducted under general anesthesia.
- An externally applied narrow 4.5/5.5 Locking Compression Plate (LCP) was used, placed above the level of the skin. This was coupled with intraoral tension band wiring.
Results and Findings
- Successful fracture fixation was accomplished using the External Skeletal Fixator- Locking Compression Plates (ESF-LCP) technique.
- The application and removal of the ESF-LCP required minimal tissue manipulation.
- The ESF-LCPs allowed for proper access to the wounds at the fracture site, were well-adjusted by the animals, and did not cause any interference with elements in the animals’ environment.
- All cases exhibited mild drainage at the screw-skin interface, with one case needing an early removal of the implant due to an infection at the surgical site.
- Pressure necrosis of the skin in the masseter area was observed in two cases, which was associated with the application of longer plates.
- The implants were removed between 3 to 12 weeks post-surgery, and the long-term functional outcome ranged from 11 to 41 months (median: 13 months) and was good in all the conducted cases.
Conclusion
- The application of Locking Compression Plates (LCPs) as External Skeletal Fixators (ESFs) proved to be an effective solution for stabilizing mandibular fractures, resulting in good long-term outcomes among the animals included in the case series.
- The use of longer plates and their positioning more caudally and in a ventrolateral position were found to be associated with surgical site infection and pressure necrosis of the skin.
- The use of a Locking Compression Plate (LCP) as an external skeletal fixator seems to present a viable alternative for the treatment of unilateral mandibular fractures, especially when these fractures are open and/or infected.
Cite This Article
APA
Mählmann K, Noguera Cender A, Ehrle A, Lischer CJ.
(2021).
Application of locking compression plates as type 1 external fixators to treat unilateral mandibular fractures in four equids and one dromedary.
Vet Surg, 51(2), 341-352.
https://doi.org/10.1111/vsu.13748 Publication
Researcher Affiliations
- Equine Clinic, Surgery, and Radiology, Freie Universität Berlin, Berlin, Germany.
- Equine Clinic, Surgery, and Radiology, Freie Universität Berlin, Berlin, Germany.
- Equine Clinic, Surgery, and Radiology, Freie Universität Berlin, Berlin, Germany.
- Equine Clinic, Surgery, and Radiology, Freie Universität Berlin, Berlin, Germany.
MeSH Terms
- Animals
- Bone Plates / veterinary
- Camelus
- External Fixators / veterinary
- Fracture Fixation, Internal / veterinary
- Horse Diseases
- Horses
- Mandibular Fractures / surgery
- Mandibular Fractures / veterinary
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