Locking compression plate osteosynthesis of complicated mandibular fractures in six horses

J. M. Kuemmerle; M. Kummer; J. A. Auer; D. Nitzl; A. E. Fürst

doi:10.3415/VCOT-08-01-0001

Veterinary and Comparative Orthopaedics and Traumatology, Inhaltsverzeichnis

Vet Comp Orthop Traumatol 2009; 22(01): 54-58
DOI: 10.3415/VCOT-08-01-0001

Clinical Communication

Schattauer GmbH

Locking compression plate osteosynthesis of complicated mandibular fractures in six horses

J. M. Kuemmerle

¹Equine Hospital, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland

,

M. Kummer

¹Equine Hospital, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland

,

J. A. Auer

¹Equine Hospital, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland

,

D. Nitzl

²Section of Diagnostic Imaging, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland

,

A. E. Fürst

¹Equine Hospital, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland

› Institutsangaben

Abstract

Summary

Complicated mandibular fractures were recognised in one foal, one pony and four horses. The foal was two months old while the adult animals ranged in age from 12 to 24 years. Three horses had a unilateral horizontal ramus fracture. Two fractures were open and one was closed. Comminution was present in one of these patients while the other two horses had marked displacement of the fragments. Two suffered from comminuted fractures of the horizontal and vertical ramus of the mandible. One of these patients had open and infected fractures. One foal had a bilateral horizontal ramus fracture with marked periosteal ‘new bone’ formation and malalignement which required corrective osteotomy. Each horse underwent locking compression plate (LCP) osteosynthesis consisting of open fracture reduction and application of one to three 4.5/5.0 mm LCP at the ventral, lateral or caudal aspect of the mandible under fluoroscopic control. Two 3.5 mm LCP were used in the foal. Plate fixation was supported by application of a cerclage wire construct between the incisor and premolar teeth in most patients. Complete fracture healing, with an excellent functional and cosmetic outcome, was achieved in all of the patients. Complications encountered included seroma formation, screw and wire breakage, as well as implant and apical tooth root infections. The LCP was removed after fracture healing had occurred in four patients.

Keywords

Horse - mandibular fracture - osteosynthesis - locking compression plate

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Referenzen

References
1 DeBowes RM. Fractures of the mandible and maxilla. In: Nixon AJ. editor. Equine fracture repair. 1^sted Philadelphia: W.B Saunders; 1996: 323-335.
2 Auer JA. Craniomaxillofacial disorders. In Auer JA, Stick JA. editors. Equine Surgery. 3^rded. St. Louis: Saunders Elsevier; 2006: 1341-1362.
3 Peavey CL, Edwards RB, Escarcega AJ. et al. 3^rd Fixation technique influences the monotonic properties of equine mandibular fracture constructs. Vet Surg 2003; 32: 350-358.
4 Henninger RW, Beard WL, Schneider RK. et al. Fractures of the rostral portion of the mandible and maxilla in horses: 89 cases (1979–1997). J Am Vet Med Assoc 1999; 214: 1648-1652.
5 Fürst A, Lischer C, Röthlisberger U. et al. AO Vet news: case report. AO International Dialogue 2000; 13: 21
6 Auer JA. AO Vet News. AO International Dialogue 2001; 14: 19
7 Auer JA. Mandible, maxilla and skull. In: Fackelman GE, Auer JA, Nunamaker DM. editors. AO principles of equine osteosynthesis. 1 ed Stuttgart: Georg Thieme Verlag; 2000: 35-50.
8 Baker GJ. Endodontic therapy. In Baker GJ, Easley J. editors. Equine dentistry. 2^nded. London: Elsevier Saunders; 2005: 295-303.
9 Frigg R. Locking Compression Plate (LCP). An osteosynthesis plate based on the Dynamic Compression Plate and the Point Contact Fixator (PCFix). Injury 2001; 32 (Suppl. 02) 63-66.
10 Niemeyer P, Sudkamp NP. Principles and clinical application of the locking compression plate (LCP). Acta Chir Orthop Traumatol Cech 2006; 73: 221-228.
11 Kaab MJ, Frenk A, Schmeling A. et al. Locked internal fixator: sensitivity of screw/plate stability to the correct insertion angle of the screw. J Orthop Trauma 2004; 18: 483-487.
12 Florin M, Arzdorf M, Linke B. et al. Assessment of stiffness and strength of 4 different implants available for equine fracture treatment: a study on a 20 degrees oblique long-bone fracture model using a bone substitute. Vet Surg 2005; 34: 231-238.
13 Gardner MJ, Brophy RH, Campbell D. et al. The mechanical behavior of locking compression plates compared with dynamic compression plates in a cadaver radius model. J Orthop Trauma 2005; 19: 597-603.
14 Ricci WM, Tornetta P. Biomechanical investigation of locked vs. non-locked diaphyseal plate-screw fixation constructs in osteoporotic and non osteoporotic human cadaveric bone. 52^ndAnnual Meeting of the Orthopaedic Research Society 2006. Chicago: Illinois;
15 Levine DG, Richardson DW. Clinical use of the locking compression plate (LCP) in horses: a retrospective study of 31 cases (2004–2006). Equine Vet J 2007; 39: 401-406.
16 Trotter GW. Osteomyelitis. In Nixon AJ. editor. Equine fracture repair. 1^sted. Philadelphia: WB Saunders; 1996: 359-366.
17 Dixon PM. Dental anatomy. In Baker GJ, Easley J. editors. Equine Dentistry. 2^nded. Philadelphia: Elsevier Saunders; 2005: 25-48.