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Surgical debridement and primary closure of the oral mucosa for repair of open mandibular pars incisiva fractures in three neonatal calves

Iwan Locher Dr Med Vet1, Karl Nuss Dr Med Vet2, David Rediger Med Vet1, Tanja Schmid Dr Med Vet2, David Devaux Dr Med Vet2, Adrian Steiner Dr Med Vet, MS1, and Emma Marchionatti DMV, MSc1
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  • 1 Clinic for Ruminants, Vetsuisse-Faculty, University of Bern, 3012 Bern, Switzerland.
  • | 2 Clinic for Ruminants, Vetsuisse-Faculty, University of Zürich, 8057 Zürich, Switzerland.

Abstract

CASE DESCRIPTION

3 neonatal female calves (ages, < 1 to 4 days) were examined because of mandibular trauma.

CLINICAL FINDINGS

Physical examination indicated that each calf had an open fracture of the mandibular pars incisiva (rostral mandibular fracture) with ventral displacement of the incisors at the affected region. Oral radiographs were obtained for 1 calf and revealed that 5 incisors were fractured at the level of the apical dental buds.

TREATMENT AND OUTCOME

Each calf was anesthetized. The fracture site and surrounding tissues were surgically debrided and flushed with sterile 0.05% chlorhexidine solution. The laceration in the oral mucosa was closed with absorbable suture in an interrupted horizontal mattress pattern. Additionally, a Penrose drain was placed during primary closure and removed 4 days later in 1 calf. The fractured incisors were removed during primary debridement in another calf. All calves received perioperative antimicrobials and analgesics. One calf developed mild osteomyelitis of the rostral mandible, which resolved with additional surgical debridement and antimicrobial treatment. That calf and another developed mild brachygnathia. At the time of last follow-up (3 to 13 months after hospital discharge), all 3 calves were eating and growing as expected.

CLINICAL RELEVANCE

3 calves with open rostral mandibular fractures were successfully managed by surgical debridement and primary closure of the oral laceration. The procedure was easy to perform, did not require specialized equipment, and was less expensive than other repair methods. This procedure may be an effective and economic on-farm treatment alternative for calves with rostral mandibular fractures.

Abstract

CASE DESCRIPTION

3 neonatal female calves (ages, < 1 to 4 days) were examined because of mandibular trauma.

CLINICAL FINDINGS

Physical examination indicated that each calf had an open fracture of the mandibular pars incisiva (rostral mandibular fracture) with ventral displacement of the incisors at the affected region. Oral radiographs were obtained for 1 calf and revealed that 5 incisors were fractured at the level of the apical dental buds.

TREATMENT AND OUTCOME

Each calf was anesthetized. The fracture site and surrounding tissues were surgically debrided and flushed with sterile 0.05% chlorhexidine solution. The laceration in the oral mucosa was closed with absorbable suture in an interrupted horizontal mattress pattern. Additionally, a Penrose drain was placed during primary closure and removed 4 days later in 1 calf. The fractured incisors were removed during primary debridement in another calf. All calves received perioperative antimicrobials and analgesics. One calf developed mild osteomyelitis of the rostral mandible, which resolved with additional surgical debridement and antimicrobial treatment. That calf and another developed mild brachygnathia. At the time of last follow-up (3 to 13 months after hospital discharge), all 3 calves were eating and growing as expected.

CLINICAL RELEVANCE

3 calves with open rostral mandibular fractures were successfully managed by surgical debridement and primary closure of the oral laceration. The procedure was easy to perform, did not require specialized equipment, and was less expensive than other repair methods. This procedure may be an effective and economic on-farm treatment alternative for calves with rostral mandibular fractures.

Contributor Notes

Dr. Schmid's present address is Swissvets AG, 6056 Kägiswil, Switzerland.

Address correspondence to Dr. Locher (iwan.locher@vetsuisse.unibe.ch).