Osteosynthesis of bilateral, displaced incisive bone fracture in a horse.

Overview

• This study reports the diagnosis, surgical treatment, and successful recovery of a nine-year-old horse with complex bilateral fractures of the incisive bone and associated structures.
• The researchers used advanced imaging and osteosynthesis techniques to restore bone alignment and functionality with a favorable cosmetic outcome.

Case Background and Clinical Presentation

• A nine-year-old Trakehner mare presented three days after severe nasal bleeding (epistaxis).
• Symptoms included intermittent foul-smelling nasal discharge containing feed material and noticeable forward displacement (rostral displacement) of the upper incisor teeth.
• These clinical signs suggested trauma to the upper jaw and nasal region.

Diagnostic Imaging Findings

• Radiographs (X-rays) and computed tomography (CT) scans were performed for detailed assessment.
• Findings included a complete comminuted fracture (multiple bone fragments) of the right side nasal process of the incisive bone and maxillary bone.
• An oblique, complete fracture was seen on the left side nasal process of the incisive bone and maxillary bone.
• Additional open fractures involved the nasal septum and palatine bone, leading to displacement of the incisors rostrally.
• An abnormal oronasal communication (connection between mouth and nasal cavity) developed due to the fractures.

Treatment Approach

• The fractures were treated surgically via osteosynthesis, a method of bone fixation to aid healing.
• A locking compression plate (LCP) was applied to the left incisive bone to stabilize the fracture.
• Cerclage wire (metal wire loops) was used to connect the incisors and premolars of the upper jaw on both sides, providing additional stabilization.
• To minimize pressure on the fracture sites during chewing, the length of the incisors was adjusted.
• Soft tissues of the hard palate were sutured to encourage healing and were managed with daily flushing to keep the oronasal communication clean and promote closure.

Clinical Outcome

• The mare maintained good clinical condition throughout the treatment period.
• At a 9-week follow-up, the upper jaw showed stable bone alignment and satisfactory cosmetic appearance.
• CT imaging confirmed proper bone positioning and complete healing of associated soft tissues.

Significance of Findings

• This case highlights successful management of complex bilateral incisor region fractures in a horse using combination fixation techniques.
• Adjusting incisor length to reduce mastication pressure and daily care of soft tissue injuries were important components of recovery.
• The positive clinical and imaging results demonstrate that thorough diagnostic imaging and appropriate osteosynthesis can restore function and appearance even in complicated facial fractures in equines.