Mandibular Symphyseal Fracture

by: Dr. Sarah Beechler from CARE Animal Emergency Services

Digger is a 4 year old, male neutered, domestic shorthair that presented to CARE emergency after getting into a tussle with the labrador in the house. The owner did not witness the incident but immediately after, Digger jumped up onto a dresser and fell behind. It was then noted that blood was coming from his mouth.

On physical examination, Digger's vitals were normal. There was a puncture wound on his chin and his mouth was hanging open with minimal movement of his lower jaw. There was no active bleeding but there was blood present in and around his mouth. A fracture was visualized at the mandibular symphysis, or the central ridge dividing the left and right mandible.

                              

Bloodwork was performed which only revealed an elevated glucose, likely secondary to stress. An intravenous catheter was placed and Digger was placed on fluids. He was given an anesthestic and pain medication and radiographs of his jaw were performed. They confirmed the fracture and revealed that no other injuries were present. The fracture was then reduced using cerclage wire and radiographs taken post-op confirmed adequate reduction. He recovered from anesthesia smoothly and was started on antibiotics. Digger was discharged the following day.

Mandibular symphyseal fractures are most commonly repaired with cerclage wire. The wire encircles the mandible behind the lower canine teeth allowing reduction and stabilization. The wire is placed with the aid of 18 gauge hypodermic needles. Once the wire is placed, it is tightened and then bent slightly to prevent injury to the owner and to prevent snags on the wire. These fractures typically heal within 6-8 weeks, at which time the wire is removed. Patients are placed on soft or canned food during the post-op period.

Since Digger's initial visit, he has returned to Animal Care Center for his 2 week post-op recheck. His examination was normal and there was no signs of infection. He continues to do well at home and has a good appetite despite the wire present in his mouth. Digger is due for another recheck in a few weeks, at which time the fracture should be healed. The wire will be cut and removed and the skin incisions will be left open to heal.