Objectives
To describe a novel fixation of open, unstable, unilateral mandibular fractures applying a locking compression plate as an external skeletal fixator (ESF-LCP).
Animals
Four horses and one dromedary.
Study design
Short case series.
Methods
Animals presented with unstable, open, unilateral fractures of the mandible. Fracture fixation was performed under general anesthesia. A 4.5/5.5 narrow LCP was applied externally above the level of the skin and combined with intraoral tension band wiring.
Results
Fracture fixation was achieved successfully using an ESF-LCP. Minimal tissue manipulation was required during application and removal of the construct. The ESF-LCPs provided adequate access to the wounds at the fracture site, were well tolerated, and did not interfere with any objects in the animals’ environment. Mild drainage at the screw-skin interface developed in all cases, requiring early implant removal due to surgical site infection in one case. The use of longer plates was associated with superficial pressure necrosis of the skin in the masseter area in two cases. Implants were removed after 3 to 12 weeks, and the long-term functional outcome after 11 to 41 (median 13) months was good in all cases.
Conclusion
Stabilization of mandibular fractures with ESF-LCP led to good outcomes in this case series. The use of longer plates positioned more caudally and in a ventrolateral position seemed associated with surgical site infection and pressure necrosis of the skin.
Clinical significance
Use of a locking compression plate as an external skeletal fixator seems to offer a viable alternative to treat unilateral mandibular fractures, especially when these are open and/or infected
