Pet Jaw Fracture Repair
What is it?
There are numerous causes of jaw fractures in both dogs and cats, primarily trauma. Others include jaw fractures due to weakening from disease. While there are multiple techniques for the fixation of jaw fractures, at VDS, we prefer to use non or minimally invasive procedures whenever possible.
There are many causes of jaw fractures in dogs and cats, but the most common is trauma (automobile collisions, falls, and fights). However, there are instances when the jaw breaks due to being weakened by a disease called a “pathologic fracture.”
There are numerous techniques for the fixation of jaw fractures. We prefer to use non or minimally invasive procedures at VDS whenever possible.
The most common technique we use is an acrylic splint. Dr. Niemiec published this technique almost 20 years ago (see the link to the abstract below) and has successfully performed it regularly.
An acrylic splint uses the patient’s teeth as the connection points between the broken pieces of the jaw. The jaw is placed in alignment and then the teeth are coved with an epoxy resin to fix the fracture (like a cast). No holes are drilled in the bone, which is great as these holes can easily damage tooth roots, nerves, and blood vessels. In addition, no surgery is required to remove the fixation after healing has occurred. After recovery, the pet is sedated, and the splint is removed from the teeth. The patient has an immediate return to function.
When acrylic splints are insufficient, other techniques are necessary.
Mandibular symphyseal separations are the most common type of “fracture” in a cat. It is typically repaired by circummandibular wiring. The technique is placing a wire around the lower jaw just behind the canines and tightening under the skin below the chin. This will be removed after healing, but again, the bone is not further traumatized by the fixation method (or its removal).
Fractures of the temporomandibular joint (TMJ) or ones that are very far back (behind the teeth) will not be able to be treated with an acrylic splint, and direct fixation is very challenging. However, a new technique relies on the large jaw muscles in the back of the mouth to hold the fracture in position. The jaws are placed in proper alignment, and sutures and buttons are used to hold the jaw in place during healing. This allows for eating and is safer than older methods. After healing, the sutures are removed under sedation.
Occasionally, fractures are too severe to be treated with non-invasive means. These cases can be caused by severe trauma with numerous small fragments (like a gunshot wound), or, more commonly, when a diseased tooth must be extracted from the fracture area.
When a tooth (or root) is extracted, it leaves a large void in the bone, which must be bridged and stabilized. In these cases, interfragmentary wires are added to the splint to aid stabilization. We use wires instead of other so-called rigid fixation methods because it is easier to avoid sensitive structures like tooth roots, nerves, and blood vessels due to their small size and flexibility in placement. These wires are generally removed following healing.