Long-term clinical outcome of maxillofacial fractures in horses: A retrospective study of 30 cases (2020-2024).

Research Overview

• This study evaluated the long-term recovery, complications, and return to functionality in horses that suffered maxillofacial (skull and facial) fractures, analyzing 30 cases treated between 2020 and 2024.
• The study found that nearly all treated horses healed well and returned to their previous performance levels, despite some experiencing cosmetic defects and minor complications.

Study Purpose and Design

• Purpose:
  • To assess long-term outcomes including healing, complications, cosmetic impact, and return to function in horses with maxillofacial fractures.
• Design:
  • Retrospective observational study reviewing clinical records of 30 horses treated for skull fractures over a 4-year period (2020-2024).
  • Data sources included patient signalment, fracture details, imaging results, treatments applied, hospitalization duration, and follow-up information from structured owner questionnaires.
  • Descriptive statistics summarized the collected data.

Patient and Fracture Characteristics

• 30 total horses with diagnosed skull fractures were included.
• Fracture specifics:
  • 28 out of 30 fractures were displaced, meaning bone fragments were misaligned.
  • 16 fractures involved the frontal bone, a critical facial structure.
• Imaging:
  • Computed tomography (CT) scans, which offer detailed 3D images, were performed in 11 cases to better characterize the injuries.

Treatment Approaches

• 29 horses received treatment; 25 were managed surgically, while 4 underwent conservative (non-surgical) treatment.
• One horse was euthanized due to severity or complications.
• Surgical management:
  • Sinus lavage (washing out the sinus cavities) was performed in 22 of the 25 surgical cases (84%) to reduce infection risk and promote healing.
  • Postoperative hospitalization lasted a median of 11 days, but ranged from 4 to 57 days depending on case complexity.
• Medications:
  • Antimicrobials (antibiotics) were administered for a median of 15 days to prevent or treat infections.
  • Non-steroidal anti-inflammatory drugs (NSAIDs) were given for a median of 8 days to control pain and inflammation.

Complications and Recovery

• Complications observed included:
  • Temporary nasal discharge in 9 horses (31%), a sign of possible sinus irritation or minor infections.
  • Wound infections occurred in 2 horses (6.9%), which were likely managed successfully.
• Long-term follow-up averaged approximately 2.3 years (median 830 days), with a range from about 5 months to nearly 5 years.
• Successful outcomes were reported for 28 of 29 treated horses (96.6%), demonstrating high rates of healing and recovery.
• Cosmetic defects (visible deformities or irregularities) persisted in 22 horses (75.9%), but these did not appear to affect functional recovery.
• Performance:
  • Of 26 horses with follow-up data on activity, all returned to their previous level of use, indicating that the injuries did not impair athletic or work capabilities.

Conclusions and Clinical Implications

• Maxillofacial fractures in horses can be effectively managed with timely and appropriate treatment, often involving surgery and supportive care such as sinus lavage and medications.
• Despite the high frequency of displaced fractures and involvement of critical facial bones, the prognosis for healing and return to function is excellent.
• Although cosmetic defects are common, they do not significantly affect the horse’s performance or quality of life based on owner reports.
• These findings reassure veterinarians and owners that horses with such fractures can expect favorable long-term outcomes when given proper care.