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"T" a one year old, M/N feline was presented to the emergency service for a traumatic oral injury. The owners were not aware of the cause, but suspected the cat may have fallen from a large tree.
The patient was medically stabilized and digital skull radiographs were taken to evaluate the extent of the injury.
After the case was worked up. "T" was transferred to our dental practice for more complete evaluation and oral surgical repair.
The dental digital images demonstrated a complex compound right mandibular fracture with multiple fragments. The central fragment caused significant intra and extraoral soft tissue damage.
Goals for oral surgical fracture repair.
Rapid return to eating
Normal bite occlusion
Surgery begins with an extra-oral approach to reduce and stabilize the distal, middle and ascending ramus fragments. Fixation was accomplished with the use of surgical orthopedic wire in a cerclage and a hemi-cerclage technique.
A particulate bone allograft (Feline PerioMix Veterinary Transplant Services ) was packed into the fracture site to accelerate bone healing. A surgical membrane ( ACell Vet ) was wrapped around the site to protect the fracture and graft from invading epithelial cells. The site was then closed in the normal fashion.
Intra-oral incisions were made into the gingival and alveolar mucosal tissue to expose the anterior fragmented segment.
The segments were aligned and orthopedic wire was placed to give maximum stability. Again, a bone graft and membrane were placed to protect the new bone growth.
Post - Op Images