Case: Management of jaw fractures with external fixation
29th December 2013
A spaniel in training as an explosives sniffer dog suffered a complex jaw fracture after an RTA. An external fixator with many clamps, pins and bars let us fiddle with the alignment until we were happy the pieces of the jaw were back where they should be and all closed well.
A pup of just a few weeks of age presented after tangling with an older dog. The altercation resulted in a broken jaw for the pup. This was first stabilised with a cerclage wire. The wire passed through a bone tunnel in the front of the jaw; it wrapped around teeth in front of and behind the fracture, and then it exited underneath the chin where it was secured with a twist knot. The occlusion (the meeting of the teeth) was judged very satisfactory.
It was thought that placement of a feeding tube in this young pup (see separate article on this subject) would have been problematic, and we wanted to get the pup back to eating normally as soon as possible. But there was some concern that a single cerclage wire would not be strong enough or rigid enough to prevent movement at the fracture site and to prevent loss of alignment of the fracture ends.
So we placed two threaded pins and a simple external fixator to reinforce the repair. Although the metalwork was relatively heavy for the pup, she seemed very happy with it and was eating within an hour of recovery from anaesthetic. Rapid bone healing was expected in a pup of this age. The fixator was removed under a short general anaesthetic 3-4 weeks later. In the meantime, a cage had been used to prevent mishaps and the owner had been vigilant to prevent the fixator from tangling with objects. We were very pleased with the final result.