Oral fractures in dogs of Brazil--a retrospective study

A retrospective study was performed in 100 dogs with 121 mandibular and 21 maxillary fractures. Dog fight (43.0%) and automobile (12.0%) trauma were the most common etiologies for fracture. The cause of fracture was unknown in 23.0% of the cases, while pathologic fractures occurred in 13.0% of cases. Young dogs (< 1-year-old) and dogs > 8-years of age were most affected. Mandibular fractures occurred in 90 dogs (90.0%), with two dogs (2.2%) having concurrent maxillary fractures. Maxillary fractures only were diagnosed in 10 dogs (10.0%). The molar region (47.1%) was the most commonly affected location for mandibular fracture, followed by fractures of the symphysis and parasymphysis (30.6%), premolar region (17.4%), angular process (4.1%) and vertical ramus (0.8%). In fractures of the mandibular region, the mandibular first molar tooth was often (85.9%) involved while the canine teeth were involved in 67.5% of symphyseal and parasymphyseal fractures. The most common fracture of the maxilla was the maxillary bone (52.4%), followed by the incisive (33.3%), palatine (9.5%), and nasal (4.8%) bones.     

Mandibular Fractures in the Cat A Retrospective Study

A retrospective study was made of 75 mandibular fractures in 62 cats. Mandibular fractures comprised 14.5% of all fractures seen in 517 cats. Automobile trauma was the cause of injury in more than 50% of the cases. The mean age of patients was 29.5 months. Symphyseal fractures were most common (73.3%), followed by fractures of the body (16%), condyle (6.7%), and coronoid process (4%). Sixty-seven percent of the fractures were stabilized. Cerclage and interfragmentary wiring were the most common forms of fixation. Antibiotics were administered to 73.6% of the patients. Complications were reported in 24.5% of the cats. Malocclusion and soft tissue infections were the most frequent complications. Complications developed more commonly in cats with multiple or open fractures. Clinical union occurred by an average of 6 weeks (range, 3-12 weeks) for symphyseal fractures, 10 weeks (range, 8-16 weeks) for body fractures, 6 weeks for coronoid fractures, and 6 weeks (range, 4-8 weeks) for condylar fractures.     

Miniplate Fixation for Repair of Mandibular and Maxillary Fractures in 15 Dogs and 3 Cats

Maxillofacial miniplates and screws were used for skeletal fixation in 15 dogs and 3 cats that sustained a variety of mandibular and maxillary fractures. These implants were used as neutralization or buttress fixation in 11 caudal (junction of the ramus with the mandibular body) and 2 rostral mandibular fractures, 4 maxillary fractures, and 2 zygomatic arch fractures. All but one of the fractures healed with appropriate occlusion and excellent function. In one case of a rostral mandibular fracture, soft tissue dehiscence occurred accompanied by a loss of the fixation and subsequent distraction of the bone fragments; reasonable function was obtained by performing a rostral mandibulectomy. Plate contouring and application of the miniplates along the appropriate biomechanical lines of stress was easily performed and permitted the biomechanical principles of tension band fixation to be applied in most cases. Miniplate fixation, either used alone or in combination with other fracture fixation techniques, achieved sufficiently rigid skeletal fixation to provide uncomplicated healing and good to excellent functional and cosmetic results in 14 dogs and 3 cats.     

A survey of bone fractures in the cat

A survey of 108 bone fractures in the cat was made over a 1 year period in a city practice in south west England. Seventy-three per cent involved the pelvic limb. The three bones most commonly affected were femur (38%), pelvis/sacrum (22%) and mandible (16%). Forty-five cases were the result of road accidents and 75% of cats were 2 years old or less.
Treatment of femoral shaft fractures by intramedullary pinning gave good results. The majority of proximal epiphyseal separations and femoral neck fractures responded well to conservative treatment. 'Cage rest' was used successfully to treat severely comminuted femoral shaft fractures. All cases of pelvic fracture were treated conservatively (up to 3 weeks 'cage rest'). Separation of the mandibular symphysis and fracture of the horizontal ramus healed readily. Repair of tibial (10%) and humeral (5%) fractures was without complications.     

Treatment of spinal fractures using Lubra plates. A retrospective clinical and radiological evaluation of 15 cases

The purpose of this retrospective study was to review the clinical use along with the short- and long-term outcome in patients treated with Lubra plates to stabilize spinal fracture and dislocations that were considered unstable at time of surgery according to the 'three compartment theory'. The data that were collected included breed, age, gender, body weight of the patients, cause of injury, neurological grade (pre- and postoperative), radiographic findings, surgical treatment, and clinical and radiological outcome. Thirteen dogs and two cats were included with thoracic (1 case), thoracolumbar (3 cases), midlumbar (5 cases) and caudal lumbar (6 cases) vertebral fractures. For stabilization, the small-sized (3 cases), medium-sized (6 cases), and large-sized (6 cases) Lubra plates were used. The clinical outcome was excellent in 10/15 patients, functional in 2/15 and poor in 3/15 with a median follow-up period of nine years (range 2 months to 12 years). The fractures eventually stabilized by ventral spondylosis. No implant failure was seen, however demineralization of the spinous processes necessitated implant removal in one case. Our results suggest that Lubra plating is an appropriate technique for thoracolumbar and lumbar vertebral fractures as well as luxations in dogs and cats. The prognosis for neurological recovery was excellent when the animal had a neurological grade of 3 and was not paralyzed.     

Temporomandibular joint injuries and ankylosis in the cat

Objective: To evaluate cause, location, treatment, and the clinical outcome of traumatic temporomandibular joint (TMJ) lesions and TMJ ankylosis in cats. Methods: Cats with TMJ injuries were included in this study. Lesions were classified as luxations, fractures of the condylar process, and intra-articular temporal bone fractures. Signalment, cause and type of injuries, treatment methods, clinical outcome, complications and joint ankylosis were assessed and evaluated statistically. Results: Temporomandibular joint lesions were observed in 82 of 161 cats with maxillofacial injuries. One hundred forty-nine TMJ lesions were determined in 112 joints. Falling was the most common cause and fractures of the condylar process were the most common types of injuries. Isolated TMJ injuries and caudal TMJ luxations were mainly caused by falling. Condylectomy was used in ankylosis, chronic luxation, reluxation and in two cases with multiple TMJ lesions. Ankylosis was observed in 10.97% of cases and was generally observed in fracture combinations of condylar process and mandibular fossa (χ2 = 8.52; p <0.05). No significant relationship between age and development of ankylosis (χ2 = 3.995; p >0.05) was found. Conclusion: In contrast to previous studies, traumatic TMJ lesions were observed in a considerable amount of cats with maxillofacial injuries, and fractures of the condylar process were the most common type. Lesions caused by falling were mostly simple, whereas vehicular trauma caused more complicated lesions. Ankylosis did not appear as a rare condition. Any cat with TMJ injury is susceptible to the development of ankylosis.     

Coxofemoral luxations in cattle: 22 cases (1980-1985)

Traumatic, unilateral coxofemoral luxation was diagnosed in 22 female dairy cattle (12 calves less than or equal to 13 months old, 10 adults). Physical examination differentiated between dorsal and ventral luxations, but could not distinguish luxations from fractures of the proximal aspect of the femur that occurred in 2 additional adults. Luxations were confirmed by radiography in 5 animals. Closed reduction was accomplished in only 1 calf. A craniolateral surgical approach to the hip, using mechanically assisted traction, was successful in reducing 95% (20/21) of the luxations. Craniodorsal luxations (16) were most common. Ninety-four percent of the animals were ambulatory before surgery. None had concomitant musculoskeletal injuries and 75% (12/16) survived for a long period. Five of 6 animals with ventral luxations arrived recumbent, with serious complicating musculoskeletal injuries, and only 2 of these animals survived for a long period. Calves had a better long-term survival rate (75% vs 50%) and a lower reluxation rate (17% vs 40%), compared with adults.     

Mandibular Fractures in the Dog A Retrospective Study of 157 Cases

One hundred fifty-seven mandibular fractures in 105 dogs occurred most frequently in male dogs less than 1 year of age. Automobile trauma was the most common cause. Fractures in the premolar region were significantly more frequent than fractures in other regions, and 113 fractures (72%) were open. One hundred forty-two fractures were stabilized, with tape muzzles being the most common method. Postoperative complications, the most common being dental malocclusion, occurred in 53 fractures (34%). Acceptable cosmetic and functional results were achieved in 89 dogs (85%). Fractures in the rostral portion of the mandible had shorter average time to clinical union than other mandibular fractures. Average time to clinical union for fractures in the caudal portions of the mandible was longer than that currently reported.     

Equine idiopathic cheek teeth fractures: part 2: a practice-based survey of 147 affected horses in Britain and Ireland

REASONS FOR PERFORMING STUDY: There is limited information on the prevalence of idiopathic cheek teeth (CT) fractures in the general equine population and on which CT are most commonly affected. OBJECTIVES: To obtain information on the prevalence of fracture patterns and clinical details of idiopathic CT fractures. METHODS: Details of cases with idiopathic CT fractures encountered were obtained via a questionnaire sent to suitably experienced veterinary practitioners and equine dental technicians (EDTs). RESULTS: Details of 147 horses that suffered a total of 182 idiopathic CT fractures; and median 0.4% (range 0.07-5.9%) of horses examined were diagnosed with such fractures; 133 maxillary CT and 49 mandibular CT fractures were found; maxillary Triadan 09s and 10s were preferentially fractured (46% of all fractured CT); fracture patterns included maxillary CT slab fractures (through 1st and 2nd pulp chambers) in 87 teeth (48% of all fractured CT), maxillary CT midline sagittal fractures (through the infundibula) in 31 CT; and various other types of maxillary CT fractures in 15 CT. In the mandibular CT, lateral slab fractures (through the 4th and 5th pulp chambers) were found in 28 CT and a variety of other fracture patterns in the other 21 mandibular CT. Clinical signs included quidding in 33% of cases, bitting and behavioural problems (29%) and halitosis (12%), however 39% of horses with idiopathic CT fractures were asymptomatic. Treatments included oral extraction of the smaller dental fragment in 37% of cases, extraction of the entire fractured tooth (9%); removal of sharp edges on the remaining part of fractured tooth (14%); reduction of height of the opposite tooth (4%); other surgical or endodontic treatments, or referral of case for further investigation and treatment (10%); or no specific treatment (39%). Following treatment, 81% of cases were reported to be asymptomatic, 6% had ongoing clinical problems and the outcome was unclear in 13% of cases. CONCLUSIONS: Idiopathic CT fractures are present in approximately 0.4% of horses and may variably cause none to severe clinical signs. Most idiopathic CT fractures respond well to treatment. POTENTIAL RELEVANCE: Understanding of the prevalence, clinical findings and treatment of idiopathic CT fractures will improve management of these disorders.     

Lip avulsion and mandibular symphyseal separation repair in an immature cat

A 12-week-old kitten was presented for symphyseal separation, comminuted rostral fractures of the mandibles, avulsion of the mandibular lip, andfractured teeth. Oral examination and intraoral dental radiographs demonstrated a mandibular symphyseal separation and the presence of developing tooth buds. Cerclage wire was placed circumferentially around the mandibles for 2-weeks to provide stabilization of the mandibular symphyseal separation. Clinical examination 9.5-months following surgery demonstrated normal occlusion with enamel hypoplasia affecting the mandibular canine teeth. Intraoral dental radiographs showed a partial bony union of the mandibular symphysis and vital, developing mandibular canine teeth.     

Results of extra-articular stabilisation following open reduction of coxofemoral luxation in dogs and cats

This report describes 14 dogs (mean age six years, mean bodyweight 25 kg) and three cats (mean age 9-3 years, mean bodyweight 6–7 kg) with coxofemoral luxations of one to 91 days duration (median four days). In 47 per cent of the cases concomitant fractures or luxations (including three bilateral luxations) were present. Closed reduction was immediately unsuccessful in five cases and eventually unsuccessful in seven cases, whereas in five cases the nature of the additional trauma required surgical intervention. Via a craniolateral approach to the hip joint, combined with trochanter osteotomy in 24 per cent of the cases, the luxation was reduced and remnants of the capsule were sutured in 82 per cent of the cases. In all cases an extra-articular iliofemoral suture band was applied to limit the range of motion of the femoral head. The technique is described and illustrated in detail. The success rate proved to be strongly related to the suture material and varied from excellent to poor. This extra-articular stabilisation technique had excellent results in acute and chronic coxofemoral luxations in dogs when multifilamentous non-absorbable material was used, even when no additional non-weightbearing sling was used.     

Complications after implantation of a modular total hip prostheses compared with fixed head prostheses

164 total hip prostheses of different manufacturers were implanted over an 8-year period. Clinical records were evaluated with a complication rate of 29.0% (42 of 145 joints) or 31.7% (39 of 123 dogs). The complications encountered in dogs that received the modular hip prosthesis (Biomécanique, Bretigny-sur-orge, France) amounted to 16.3% (15 of 92), dogs that received a fixed head prosthesis (5 different manufactures) had 39% complications (28 of 72). Although the complication rate was influenced by different surgeons (n = 5) with different system predelictions and a different learning curve it was obvious that luxations (n = 6 of 10) and stem fractures (n = 5) more often occurred with the fixed head prosthesis systems. These stem fractures might be due to implant material failure or due to improper cementation followed by fatigue material failure. Femur fracture or infection were encountered with both prosthesis systems.     

Sacroiliac Fracture-Separation in the Dog: A Study of 92 Cases

The case records of 92 consecutive dogs that suffered sacroiliac fracture-separation were examined. Seventy-seven per cent (71 of 92) had unilateral sacroiliac injury and 23% (21 of 92) had bilateral sacroiliac injury. Of the unilateral cases, 93% (66 of 71) of the dogs had associated acetabular, ilial, femoral, or tibial fractures; coxofemoral luxations; or cruciate injuries. Eighty-five per cent (78 of 92) of the dogs had either bilateral sacroiliac injury or unilateral sacroiliac injury and other orthopedic injuries of the opposite limb, thus disabling both hind limbs.
Sixty-five per cent (60 of 92) of the dogs received lag screw fixation of the sacroiliac joint. Of 29 dogs that were re-radiographed on an average of 437 days following fixation, 38% (11 of 29) showed evidence of loosening of the lag screw fixation.a
Screws that were placed in the body of the sacrum in some dogs resulted in the fewest loosened fixations (12%, 2 of 17), compared to other locations of screw placement. The fixation had loosened in 7% (1 of 14) of dogs that had a cumulative screw depth/sacral width of 60% or more, compared with 48% of dogs (10 of 21) where cumulative screw depth was less than 60%. The number of screws per fixation and whether the separation was fully reduced or not did not affect whether the fixation loosened.     

Tension band stabilization of fractures and luxations of the thoracolumbar vertebrae in dogs and cats: 38 cases (1993-2002)

OBJECTIVE: To determine the outcome of dogs and cats in which a tension band technique was used to stabilize traumatic fractures and luxations of the thoracolumbar vertebrae. DESIGN: Retrospective study. ANIMALS: 38 client-owned animals (22 dogs and 16 cats) weighing between 1.4 and 45 kg (3 and 99 lb). PROCEDURE: Medical records of cats and dogs that underwent tension band stabilization of thoracolumbar fractures and luxations at the University of Zurich between 1993 and 2002 were reviewed. The stabilization technique was a modification of a spinal stapling technique with a figure 8 hemicerclage wire placed in a tension band fashion across the lesion. Neurologic status, lesion location and type, and concomitant traumatic injuries were assessed from the medical records and preoperative radiographs. Clinical outcome and complications were determined through follow-up examinations or telephone conversations with the owners. RESULTS: Complete or satisfactory neurologic recovery was achieved in 30 (79%) patients. Seven patients were euthanatized (6 owing to poor neurologic recovery and 1 owing to implant failure), and 1 dog was managed at home despite paraplegia. Clinically, only 4 patients (11%) had evidence of implant or fixation failure; all were dogs weighing > 16 kg (35 lb). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the tension band technique may be appropriate for stabilization of fractures and luxations of the thoracolumbar vertebrae in cats and small- or medium-sized dogs. In larger dogs, fixation strength may be insufficient to stabilize certain fracture types and ancillary external or internal fixation methods may be needed.     

Antimicrobial Susceptibility of Microorganisms Isolated from Equine Orthopedic Patients

Positive cultures were obtained from 60 equine orthopedic cases during a 12 year period (1974-1985). These cases consisted of 34 long or cuboidal bone fractures, 13 arthrotomy/arthroscopy procedures for removal or internal fixation of a fracture, 7 proximal splint bone fractures, and 6 facial or mandibular fractures. Excluding the 13 arthrotomies, only 10 (21%) of the 47 were open fractures. Multiple organisms were isolated from 36 cases (20 long or cuboidal bone fractures, 7 splint bone fractures, 5 mandibular fractures, and 4 intra-articular fractures). Of the 142 isolates, 35 (24%) were members of the family Enterobacteriaceae, 33 (23%) Streptococcus spp., and 25 (18%) Staphylococcus spp. with the majority being coagulase positive (65%). Other organisms isolated were Pseudomonas spp. (16, 11%), obligate anaerobes (11, 7%), and Actinobacillus spp. (7, 5%). the remaining 10% consisted of Pasteurella spp., Bacillus spp., Corynebacterium spp., Micrococcus spp., and Actinomyces spp. When comparing results between two time periods (1974-1979 and 1980-1985) there was an increase in the percentage of coagulase positive staphylococci isolates resistant to all antimicrobics tested except oxacillin and amikacin, and Escherichia coli isolates were resistant to all but amikacin. For Pseudomonas spp., resistance to gentamicin increased in the second time period (1980-1986). During the initial time period (1974-1979) culture tests for obligate anerobes were not conducted until 1975. No anerobes were cultured during those initial 5 years; however, one third of those isolated after 1980 were resistant to penicillin and ampicillin.(ABSTRACT TRUNCATED AT 250 WORDS)     

Simple techniques for the internal stabilization of fractures and luxations in the sacrococcygeal region of cats and dogs.]

Two useful techniques for the repair of caudal sacral fractures and sacrococcygeal fractures/luxations are described. Pre- and postoperative clinical, neurological and radiological findings in 16 operated animals (13 cats and 3 dogs) were compared with findings in 17 (13 cats and 4 dogs) conservatively treated animals. In the surgically treated patients follow up findings were characterized by absence of hyperesthesia and a higher number of animals with recovered tail function. The authors suggest the use of these techniques in cases of caudal sacral fractures or sacrococcygeal fractures/luxations.     

Equine idiopathic cheek teeth fractures: part 3: a hospital-based survey of 68 referred horses (1999-2005)

REASONS FOR PERFORMING STUDY: There is limited information available on the more serious sequellae of idiopathic cheek teeth (CT) fractures. OBJECTIVES: To obtain information on clinical and ancillary diagnostic findings in referred horses with idiopathic CT fractures. METHODS: Details of all horses suffering from idiopathic CT fractures referred to the Equine Hospital at the University of Edinburgh 1999-2005 were examined, and information concerning fracture patterns, clinical and ancillary diagnostic findings, treatments and long-term response to treatments were obtained and analysed. RESULTS: A total of 60 maxillary and 17 mandibular idiopathic CT fractures were diagnosed in 68 horses. Fracture patterns included maxillary CT lateral slab fractures (45%), maxillary CT midline sagittal fractures (16%) and various other patterns of maxillary CT fractures (17%). In the mandibular CT, lateral slab fractures were found (12%) and various other CT fracture patterns were present in 10%. The more centrally positioned CT (maxillary and mandibular Triadan 08s and 09) were preferentially fractured. Clinical signs included quidding in 47% of cases; bitting and behavioural problems (28%); signs of apical infection, including bony swellings and nasal discharge (21%); anorexia/weight loss (15%); halitosis (13%); and buccal food impaction (12%). The treatment of all cases was conservative whenever possible and included corrective rasping of the remaining tooth (46% of cases); oral extraction of the smaller and loose dental fragment (32%) and extraction of the entire fractured tooth by oral extraction (28%) or by repulsion (13%). Prophylactic treatment of adjacent, nonfractured CT with carious infundibula was possibly of value in preventing further midline sagittal maxillary CT fractures. CONCLUSIONS: Horses referred with idiopathic CT fractures frequently have clinical signs of apical infection of the fractured CT and these teeth require extraction, orally if possible. More conservative treatment of idiopathic CT fractures without signs of gross apical infection can resolve clinical signs in most cases. POTENTIAL RELEVANCE: In the absence of apical infection, extraction of only the loose dental fragments of CT with idiopathic fractures is usually successful.     

High-rise syndrome in cats

High-rise syndrome was diagnosed in 132 cats over a 5-month period. The mean age of the cats was 2.7 years. Ninety percent of the cats had some form of thoracic trauma. Of these, 68% had pulmonary contusions and 63% had pneumothorax. Abnormal respiratory patterns were evident clinically in 55%. Other common clinical findings included facial trauma (57%), limb fractures (39%), shock (24%), traumatic luxations (18%), hard palate fractures (17%), hypothermia (17%), and dental fractures (17%). Emergency (life-sustaining) treatment, primarily because of thoracic trauma and shock, was required in 37% of the cats. Nonemergency treatment was required in an additional 30%. The remaining 30% were observed, but did not require treatment. Ninety percent of the treated cats survived.     

Coxofemoral luxation in two foals wearing hindlimb casts

Two foals wearing hindlimb casts developed coxofemoral luxations 6 days and 9 days after the casts were applied. One foal had a cast on one hindlimb up to the proximal portion of the tibia and the other foal had tube casts on all 4 limbs. Although the incidents that resulted in the luxations were not observed, they probably occurred during awkward attempts to stand or from being pushed by the mare, with the affected limb being caught under the body in a forward extended and adducted position.     

A retrospective study of dystocia-related vertebral fractures in neonatal calves

Forty-seven cases of neonatal vertebral fractures/luxations occurred in a 21 year period (1967-1987). All of the fractures were located between the 11th thoracic vertebra and the fourth lumbar vertebra; 77% occurred at the thoracolumbar junction. All but one case was associated with a forced extraction, either unspecified (53%), mechanical (28%), or manual (17%).

A weak calf or continuous recumbency since birth was the major clinical sign. Hemorrhage around the kidneys, adrenal glands, and in perivertebral muscles was a consistent necropsy finding and a useful indicator that a thoracolumbar fracture was present. In addition to the vertebral fracture, the prominent necropsy findings were subdural and epidural hemorrhage, myelomalacia, spinal cord compression or severed spinal cord, and fractured ribs. All of the calves died or were euthanized without regaining locomotory function.