Use of a pinless external fixator for unilateral mandibular fracture repair in nine equids.
Authors: Haralambus Rhea Maria Anna, Werren Cecile, Brehm Walter, Tessier Caroline
Journal: Veterinary surgery : VS
Summary
# Pinless External Fixation for Equine Mandibular Fractures Unilateral mandibular fractures in horses present a challenging surgical problem, and optimal stabilisation technique remains debatable given the anatomical complexity of the equine jaw and the functional demands of mastication. Rhea and colleagues evaluated the AO/ASIF pinless external fixator (PEF) in nine equids with unilateral mandibular fractures, applying a minimum of four clamps under general anaesthesia and monitoring fracture configuration, complications, healing outcomes and owner satisfaction. Seven of the nine horses achieved successful bony union with satisfactory functional recovery; two were euthanatised—one due to post-operative recumbency and one following PEF dislodgement at the owner's request. Whilst complications occurred in several cases (PEF dislodgement in three equids, bone sequestration in three, and weight loss in one), these were generally manageable through sequential removal of sequestra and hardware, with associated drainage resolving fully. The pinless fixator offers a minimally invasive approach with negligible risk of iatrogenic tooth root damage compared to traditional pinned systems; however, clinicians should counsel clients that aftercare is labour-intensive and dislodgement remains a realistic possibility, particularly in uncooperative patients or those with compromised recovery protocols.
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Practical Takeaways
- •PEF is a viable minimally invasive option for unilateral mandibular fracture repair in horses with good healing outcomes, but requires careful aftercare and monitoring for dislodgement
- •Plan for extended post-operative management including potential drainage issues and bone sequestration; have contingency for PEF replacement if dislodgement occurs
- •Discuss realistic expectations with owners: 78% success rate with good healing, but complications are common and aftercare is time-consuming
Key Findings
- •All 9 equine mandibular fractures were successfully stabilized using pinless external fixator (PEF) with minimum of 4 clamps
- •7 of 9 cases (78%) healed with good outcome and owner satisfaction; 2 euthanized (1 post-operative recumbency, 1 owner decision)
- •Complications occurred in 7 cases: PEF dislodgement (3), bone sequestration (3), and weight loss (1), but most resolved with appropriate management
- •PEF technique provided minimal invasiveness with no tooth root interference compared to alternative fixation methods