Application of locking compression plates as type 1 external fixators to treat unilateral mandibular fractures in four equids and one dromedary.
Authors: Mählmann Kathrin, Noguera Cender Andrea, Ehrle Anna, Lischer Christophorus J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Mandibular fractures in equines present significant clinical challenges, particularly when open or unstable, as traditional internal fixation may prove difficult or contraindicated in contaminated wounds. Mählmann and colleagues reported outcomes in four horses and one dromedary treated with a novel approach: 4.5/5.5 narrow locking compression plates (LCPs) applied externally as skeletal fixators and combined with intraoral tension band wiring, requiring minimal soft tissue manipulation during both placement and removal. All five animals achieved successful fracture stabilisation with good long-term functional outcomes at 11–41 months post-removal (median 13 months), though implants required removal between 3–12 weeks; importantly, mild drainage at screw-skin interfaces occurred in all cases, with one requiring early removal due to surgical site infection, and superficial pressure necrosis developing in two animals where longer plates were positioned more caudally. This technique offers distinct advantages for contaminated or open unilateral mandibular fractures—particularly superior wound access and minimal periosteal disruption compared to conventional internal fixation—though practitioners should carefully consider plate length and positioning, preferring shorter constructs in a more cranial, dorsally-positioned application to mitigate skin complications. The ESF-LCP approach appears especially valuable when infection risk is high or anatomy renders traditional plating inadvisable, though the consistent development of pin-tract drainage necessitates careful post-operative management and client counselling regarding infection risk.
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Practical Takeaways
- •ESF-LCP offers a viable alternative for managing open, unstable, or infected mandibular fractures with minimal soft tissue trauma and good access for wound management
- •Plate positioning matters: keep plates short and positioned more rostrally and dorsally to minimize skin complications and infection risk
- •Plan for implant removal after 3-12 weeks with expectation of good functional recovery and normal eating/drinking long-term
Key Findings
- •External skeletal fixation using locking compression plates successfully stabilized mandibular fractures in 5 equids with good long-term functional outcomes at 11-41 months
- •Minimal tissue manipulation was required during application and removal of the ESF-LCP construct
- •Mild drainage at screw-skin interface occurred in all cases; longer plates positioned caudally were associated with surgical site infection and pressure necrosis