ARTICLE WRITTEN BY DR MARTIN DOLINSCHEK FROM MIDLAND BULLSBROOK VET
Ace is an 18 month old foal that, like foals are prone to do, grabbed on to a playmate’s canvas rug and got his lower jaw stuck in the leg strap. His owner Shannon realised straight away that something was wrong when Ace came in with a swollen lower lip and was unwilling to eat.
Dr Paula Bell-Cross was quickly on the scene and immediately recognised the seriousness of the situation. After sedation, Ace was assessed and a fracture of the left lower mandible (jaw bone) was diagnosed. Appropriate pain relief and antibiotics were administered and he was locked up with only soft feed overnight.
The following morning Dr Martin Dolinschek sedated Ace and put him in his portable crush. This allowed the surgery to proceed in a safe manner, both for the surgeons and the patients alike. Ace’s head was suspended in a special halter that puts his head at a comfortable working height.
Following sedation and mandibular nerve blocks, Ace’s mouth was flushed with copious amounts of dilute chorhexidine and the fracture site was closely examined. Fractures of the lower mandible are common in foals which play with all manner of objects including fences and hay nets. When they get their jaw stuck and pull back, the teeth get caught and the mandible is likely to break. Luckily for Ace, he had only broken one side of his jaw and a good prognosis was given for a full recovery.
The wound was cleaned and debrided of all the blood clots and feed that had become wedged in overnight. A stainless steel surgical wire was then passed through his cheek and between two of his cheek teeth. This provided an anchorage point for the ‘splint.” The wires were then used to pull the fracture back into alignment and the ends were then twisted together to provide good stability. Dental impression material was used to ‘hide’ the sharp ends of the wires to stop them rubbing on his very mobile lips and tongue. The teeth above the fracture were ground down using the latest dental equipment – the Powerfloat, so that chewing did not push on the fracture site. Good alignment was attained and Ace recovered from his sedation very well.
Whilst some horses object to having a wire brace in their mouth, Ace has so far tolerated it very well. Whilst he is a bit grumpy because he is not allowed to graze, he is nonetheless a model patient. Shannon flushes his mouth daily and he has just finished a long course of antibiotics. The wire will be removed after 4-6 weeks and full functionality can be expected. Foals need regular dental checkups to prevent overcrowding causing permanent displacement of teeth. They also get sharp enamel points very quickly due to the soft nature of their young teeth.
UPDATE
27.07.08
Ace is doing really good, his jaw is healed nicely and he is now allowed to have hay again and go out in the paddock for short periods of time and under supervision. He was a model patient, and it doesn't seem to have done him any harm being locked in, he enjoyed all the attention he got.
We would like to thank Martin for taking such good care of Ace and making this situation less stressful.
