External skeletal fixation in the management of equine mandibular fractures: 16 cases (1988-1998).
Authors: Belsito K A, Fischer A T
Journal: Equine veterinary journal
Summary
# External Skeletal Fixation for Equine Mandibular Fractures Between 1988 and 1998, Belsito and Fischer evaluated 16 horses (30% of their total mandibular fracture caseload) managed surgically using external skeletal fixation (ESF), comparing three distinct techniques: transmandibular Steinmann pins anchored in fibreglass or steel-reinforced acrylic bars; larger self-tapping threaded pins similarly secured; and cortical bone screws incorporated into reinforced splints. All 14 horses presenting for fixator removal at an average of 56 days post-placement demonstrated stable fractures with functional occlusion of both incisor and cheek teeth, enabling rapid return to complete oral feeding without nasogastric or oesophagostomy supplementation. Complications were limited to three cases: two horses developed pin-tract drainage and ring sequestra requiring curettage several months after removal, whilst one required fixator replacement to access infected wounds. This study reinforces ESF as a reliable option for mandibular fracture repair in horses, particularly valuable for practitioners seeking techniques that support rapid functional recovery and maintain the horse's ability to eat and hydrate normally during the healing period—a significant advantage over more restrictive management protocols that necessitate alternative feeding routes.
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Practical Takeaways
- •ESF is a viable surgical option for mandibular fractures in horses, with good functional outcomes including rapid return to normal feeding without supplementation
- •Be prepared for pin tract complications (drainage, sequestra) in about 1 in 5 cases, which may require curettage 4-5 months post-removal
- •Technique selection (Steinmann pins vs. threaded pins vs. cortical screws in acrylic bars) should be tailored to fracture configuration, but all three methods produced successful outcomes
Key Findings
- •External skeletal fixation successfully repaired 16 of 53 (30%) equine mandibular fractures with stable fractures and adequate occlusion at average removal time of 56.2 days
- •Three surgical techniques using transmandibular pins, threaded pins, or cortical bone screws incorporated into methyl methacrylate bars were effective
- •Complications occurred in 3 horses (19%) including persistent drainage, ring sequestra, and one tooth root damage requiring extraction
- •All horses achieved normal incisor and cheek tooth alignment and returned to full feed without nasogastric tube or oesophagostomy supplementation