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Surgical Management of Bilateral Mandibular Fracture and Tongue Laceration in a Goat.

Abstract

A Osmanabadi cross female goat was presented with history of mandible fracture and tongue laceration following dog bite. Clinical examination revealed fracture of both horizontal mandible rami and tongue laceration. The fracture fragments were aligned and retained in position by interfragmentary wiring and lacerated tongue was sutured using simple interrupted manner. Tape muzzle and modified aluminium splint were applied as external co-aptation for additional support. Routine post-operative care was given and advised liquid diet. Animal had an uneventful recovery.

Keywords: Goat; interfragmentary wiring; mandible; tongue laceration

Introduction

Fractures of mandible in caprines is comparatively rare. The most frequently mandible fractures are caused by trauma, neoplasia, dental diseases or diseases of bone itself (Theresa et al., 2013). Delay or failure to repair these fractures may result in malocclusion, teeth loss, non-union, malunion, delayed healing, loss of function and less cosmetic appearance (Henninger and Warren, 1997).

Variety of fixation methods have been used to repair these types of fractures, including tension band wiring, interfragmentary wiring, interdental wiring, bone plates, screws, intra-oral acrylic splints and external skeletal fixators. In this overall point of view, majority of these fractures are amenable to repair with interfragmentary wiring alone. This interfragmentary wiring methods are relatively simple, provide adequate stability and do not require special equipments (Henninger and Warren, 1997).

Tongue lacerations are commonly reported in children (Bank et al., 2004) but rarely in animals. It can occur from falls, automobile accidents, as penetrating injuries from sticks, bites or other objects. Haemorrhage and disfigurement are the two most common concerns in these injuries although loss of function, infection and swelling compromises the airway as a sequelae (Donat et al., 1996).

Materials and Methods

A three month old Osmanabadi crossbred female goat was presented with history of mandible fracture and tongue laceration following dog bite. Animal was having deformity of lower jaw and tongue laceration. Physical examination revealed depression, inward inclination of portion of jaw and copious amount of blood stained saliva drooling out from mouth. Palpation of affected area elicited pain and open fracture on both horizontal rami of mandible (Fig.1). Examination of oral cavity under general anaesthesia revealed full thickness transverse laceration of tongue involving half breadth of tongue (Fig. 2). On clinical examination, temperature, heart rate and respiratory rate were within normal range.

Animal was stabilized with intravenous fluids. General anaesthesia was induced using Ketamine hydrochloride @ 2mg/kg and Diazepam @ 0.2mg/kg were given intravenously and maintenance using Diazepam and Ketamine combination to effect. The oral cavity was thoroughly irrigated with normal saline followed by 0.5% Povidone iodine solution. After manipulative reduction of fracture, holes were made in cortex on either side of fractures. Orthopaedic wire was passed through the guide holes and tightened (Fig.3). The wound margins of tongue were surgically debrided of necrotic and contaminated tissues. The repair was performed using polyglactin 910 (vicryl) No. 1-0 in simple interrupted suturing pattern with knots inside (Fig. 4). The sutures ensured obliteration of dead space and proper apposition of lingual mucosa on dorsal and ventral surfaces. Tape muzzle and modified aluminium splint were applied as external coaptation for additional support to mandibular fracture (Fig. 5). Post-operatively, animal was given Ceftriaxone @ 15mg/kg intravenous twice daily for 5 days, Meloxicam @ 0.2mg/kg subcutaneous once daily for 5 days, inj. Anti-rabies vaccine according to standard schedule (5 dose), inj. Tetanus toxoid (1 dose) and fluid therapy for three days. Advised liquid diet for one week followed by semi-solid diet.

Results and Discussion

After 3rd post-operative week, there were no complications and animal started taking food and water normally. The objective of surgical treatment of mandible fractures to restore normal occlusion, provided stability that can support fracture healing and allows normal eating and drinking simultaneously (Siddiqui et al., 2012). Variety of techniques are available to treat mandible fracture. In that interfragmentary wiring method can easily adopted to such fractures, since it is relatively simple, inexpensive, does not require much special equipments and provide adequate stability.

Although, complications like wire loosening or failure, tooth loss, malocclusion, osteomyelitis, sequestration as well as chronic discharge are reported (Cetinkaya and Demirutku, 2012). However, our technique had no such reported complications.

Conclusion

It was concluded that interfragmentary wiring along with tape muzzle and modified aluminium splint as external co-aptation for additional support can used for mandibular fracture repair in goats. Early intervention and prompt treatment in such tongue laceration allow complete resolution.

References

Bank, D.E., Diaz, L., Behrman, D.A., Delaney, J. and Bizzocco, S. (2004). Tongue entrapment in an aluminium juice can. Paediatr. Emerg. Care. 4: 242-43.

Cetinkaya, M. and Demirutku A. (1998). Interfragmental fixation of rostral mandibular fracture with cerclage wire in a thoroughbred English horse.Tirk J.Vet. Anim. Sci. 36:

Donald L. Maisel R. H. and Mathog, R.H.(1996). Injuries to the mouth, pharynx and esophagus. In Pediatric Otolaryngology, 3rd Ed., Philadelphia:WB Saunders, p. 1183-84.

Henninger, R. W. and Warren, B. (1997). Rostral Mandibular and Maxillary Fractures: Repair by Interdental Wiring. AAEP Proc. 43: 136-37.

Siddiqui, M. I., Telfah, M. N., Rashid, J. and Taleb, S. A. (2002). Modified Interdental Wiring Technique for Man-dibular Fractures in Camels - A Clinical Study. J. Vet. Anim. Sci. 2: 57-60.

Theresa, W. F., Curtis, W. D., Caroline, V. H., Ann, L. J., Catriona, M. M., Mary, A. G. R., Kurt, S., Schulz and Michael D.W. (2013). Small Animal Surgery. 4nd Ed., Elsevier Inc. 1106-1118p.

B.R. Balappanavar (1), M.S. Vasanth (2) and Mahesh S. Hugar (3)

Department of Veterinary Surgery and Radiology Veterinary College Karnataka Veterinary, Animal and Fisheries Sciences (KVAFSU) Hassan - 573202 (Karnataka)

(1.) Assistant Professor and Corresponding author. E-mail: drbrbalu123@gmail.com

(2.) Dean

(3.) Post Graduate Scholar
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Title Annotation:Short Communication
Author:Balappanavar, B.R.; Vasanth, M.S.; Hugar, Mahesh S.
Publication:Intas Polivet
Article Type:Clinical report
Date:Jul 1, 2016
Words:948
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