Use of distraction osteogenesis for the correction of deviated nasal septum and premaxilla in a horse

Distraction Osteogenesis in Two Wild Raptors

Distraction osteogenesis was used in 2 wild raptor patients for the repair of tibiotarsal fractures. The first case was a hatching year female peregrine falcon (Falco peregrinus) admitted with an open oblique right distal tibiotarsal fracture. The fracture was surgically managed with the external skeletal fixator intramedullary pin tie-in technique (ESF-IM pin tie-in). Appropriate healing of the fracture site occurred with the ESF-IM pin tie-in. However, there was significant pelvic limb shortening of the affected leg, and the bird consequently developed pododermatitis on the contralateral foot. The second case was an adult female great horned owl (Bubo virginianus) that was admitted with a closed, partially healed, overriding right tibiotarsal fracture. Because of the advanced stage of this fracture, which presented with a fibrous callus, and the already apparent pelvic limb shortening, the ESF-IM pin tie-in was not used. Both patients were fitted with a circular external skeletal fixator (CESF), and distraction osteogenesis was performed until the length of the pelvic limb was deemed anatomically adequate. It is critical that rehabilitated raptors be released without any physical conditions that may reduce their ability to survive and reproduce in the wild. Pelvic limb shortening can potentially predispose a raptor patient to pododermatitis, even with fatal consequences, in both captive and wild environments. The orthopedic technique used here proved useful to repair the limb shortening in both raptor cases, and each bird fully recovered and was released.

Correcting Campylorrhinus Lateralis in a Foal by Bone Distraction: A Case Report

Campylorrhinus lateralis, also known as "wry nose," is a congenital malformation that mainly affects Thoroughbreds. These horses have a unilateral deviation of the maxillae that may be to one side or the other side, and it causes airway obstruction and dental malocclusion. The choice of treatment is not necessarily operation; however, the treatment of choice, which aims to repair the maxillae deviation, is surgical to improve the horse's respiratory condition and correct the dental occlusion. There are currently no reports describing the first surgical technique for such deformity described by Valdez et al. The present study describes the case of a 2-month-old foal of the Mangalarga Marchador breed that was diagnosed with wry nose. The foal presented with accentuated maxillae deviation to the right side, malocclusion of the incisor teeth, and respiratory noises. After diagnosis and physical examination, the foal was treated by surgical correction of the deviation. To correct the deviation, the bone distraction technique with unilateral osteotomy of the right maxillae and fixation of the external bone distractor was chosen. After 90 days, the bone distractor was removed; consequently, malocclusion of the incisors was greatly improved, and respiratory noises were eliminated.

Orthodontic correction of overjet/overbite ('parrot mouth') in 73 foals (1999-2013)

REASONS FOR PERFORMING STUDY

There are limited reports on the efficacy of functional orthodontic correction of overjet or overbite in foals.

OBJECTIVES

To report the outcome of using orthodontic tension bands in combination with an inclined plane biteplate in the treatment of overjet, with or without concurrent overbite, rates of correction of these 2 malocclusions and associated complications. And to examine factors associated with outcomes.

STUDY DESIGN

Retrospective case series.

METHODS

Clinical records for 73 foals treated at a single clinic, by the same surgeon were analysed. Overall change and rates of change in overjet and overbite were calculated. Associations between potential explanatory variables including age, severity of initial malocclusion and surgeon experience were examined using linear regression.

RESULTS

Records for 73 foals (43 colts, 30 fillies) were evaluated. The median number of implant placements per animal was 2 (range 1-4). Of 61 cases with complete records, reduction in overjet and overbite dimensions were achieved in 95% and 90% of foals, respectively, with mean reductions in malocclusions of 9.9 and 8.4 mm, respectively. Complete reduction in overjet was achieved in 25% (15/61) and reduction of malocclusion dimensions to ≤5 mm (i.e. functionally corrected) was achieved in 51% (31/61). Increasing animal age was significantly associated with decreased total reduction in overjet and decreased rate of reduction in overbite. Increased original severity of overbite was significantly associated with increased rate of its correction. Short-term complications included intraoperative haemorrhage, transient facial nerve neuropraxia and irritation of the mare's udder by the brace. Longer-term complications included cheek teeth diastema formation and incisor discoloration and maleruption.

CONCLUSIONS

Using this technique, correction or improvement of these malocclusions is rapid, with minimal complications. Often more than one implant is required. Animal age at the start of treatment is associated with rate and amount of correction achievable, so initiating treatment at an early age is recommended.

The gold standard of dental care: the juvenile horse

Postpartum evaluation of the foal's head and mouth are performed to detect craniofacial malformations and other congenital defects. Detailed oral examination and diagnostic imaging can provide diagnostic and prognostic information about congenital abnormalities of the mouth or skull. Important abnormalities of foals include wry nose, cleft palate, overbite (parrot mouth), and underbite (monkey mouth, sow mouth). Tumors and cysts can be detected in young horses. In juvenile horses, primary dental care procedures include oral examination, management of sharp enamel points, management of deciduous teeth, and management of wolf teeth. Facial or jaw swellings are also important considerations.

Surgical correction of wry nose in four horses

OBJECTIVE

To describe surgical techniques used for correction of congenital nasal deviation (wry nose) in horses (wry nose) and to report outcome.

STUDY DESIGN

Retrospective study.

ANIMALS

Horses (n=4), 5-17 months old with wry nose.

METHODS

Nasal deviation was corrected by transecting the premaxillae/maxillae and nasal bones at their site of maximum curvature and realigning and stabilizing the bones in a more normal alignment using internal fixation. The nasal septum was removed during the same anesthetic period.

RESULTS

For each horse, physical appearance was improved and respiratory stridor eliminated.

CONCLUSIONS

Wry nose can be corrected by transecting the premaxillae/maxillae and nasal bones and stabilizing the transected bones in a more normal alignment; the nasal septum can be removed concurrently.

CLINICAL RELEVANCE

Surgical correction of wry nose may provide a good functional and cosmetic outcome.