History
Jawbreaker was a 4 month old quarter horse colt. He had been turned out overnight into a small pen. In the morning when he and the mare were brought in, blood was noticed coming from his mouth. The regular veterinarian was called out to examine Jawbreaker. Oral examination revealed a likely fracture of the incisive bone. The incisive bone is located within the tissues of the hard palate (the roof of the mouth), and separates the oral cavity from the nasal passage. At that time it was decided to refer Jawbreaker and his dam to Southwest Equine for a more in-depth evaluation.
Upon arrival to Southwest Equine, Jawbreaker and the mare were both a little groggy since they had been sedated for the trailer ride. Oral evaluation revealed that the incisive bone was visibly fractured. It was also noted that large portions of the hard palate and other surrounding soft tissues were reflected away from the boney margins. Radiographs (X-Rays) were taken to determine the extent of the fracture. Radiographs showed that the fracture was complete (all the way through the bone), but did not indicate that any other fractures were present. The owners elected for surgical correction of the fracture at that time.
Jawbreaker was prepared for surgery and the mare was sedated and placed in a stall while he was in surgery. During surgery, the fracture and soft tissue wounds were cleaned of all dirt and debris. The fracture was reduced (ie the bones were put back in a normal position) and the incisors were aligned, fixation wires were placed to hold the bones in their proper place. “Wiring” was performed by drilling between the upper 2nd and 3rd premolar teeth on both sides to allow for placement of an 18 gauge wire. These wires were then brought forward and were guided through the gums on midline, just above the incisors. The wires were manually tightened to provide fracture stability. The soft tissues were then sutured together to regain normal oral anatomy. The fixation wires were then coated with methylmethacrylate to further enhance their strength. Jawbreaker recovered from surgery uneventfully.
After surgery Jawbreaker was treated with injectable antibiotics for three days as well as IV flunixin meglumine (Banamine) for 5 days. The Banamine was then discontinued and Jawbreaker was switched to oral antibiotics for another 6 days. Jawbreaker and the mare were fed soaked alfalfa pellets. This was done to prevent the teeth from grinding on the fixation wires as much as possible. Jawbreaker had a great appetite and was able to nurse and eat normally post-operatively. Radiographs were taken ten days after surgery. Radiographs showed that at that time the fracture was healing, but still visible and the fixation wires were still intact. Jawbreaker continued to do well and was sent home with instructions to repeat radiographs in 2-3 weeks.
Four weeks after surgery, radiographs were repeated of Jawbreaker’s fracture. These radiographs showed that the fracture line was remodeling, however still visible and that the fixation wires were still intact. At that time it was recommended to recheck in one month to re-asses the fracture.
At the next re-check (2 months after surgery) the fracture line was still faintly visible, but healing as expected.
Jawbreaker’s fixation wires were removed by his regular veterinarian on the farm 3 months after surgery (sorry we don’t have further radiographs!). His veterinarian reported that he was doing great at home and back to being a normal foal without his “braces”
Take away message: Horses like to hurt themselves! If you find blood around the oral cavity, your horse should have prompt evaluation by a veterinarian to evaluate for a jaw fracture (either upper or lower). Fortunately, the oral cavity heals very well in horses if the fracture is reduced and stabilized promptly and most horses with jaw fractures do great. Some jaw fractures cannot be surgically repaired, but may still heal with appropriate veterinary care, so don’t despair!
