Wolfs Elias, Arzi Boaz, Guerrero Cota Jose, Kass Philip H, Verstraete Frank J M
School of Veterinary Medicine, William R. Pritchard Veterinary Medical Teaching Hospital, University of California, Davis, Davis, CA, United States.
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, United States.
Front Vet Sci. 2022 Aug 15;9:932587. doi: 10.3389/fvets.2022.932587. eCollection 2022.
Treatment of craniomaxillofacial (CMF) trauma in dogs often requires a multidisciplinary approach and a thorough understanding of the CMF anatomical structures involved. This retrospective study aimed to utilize computed tomography (CT) studies of immature dogs evaluated for CMF trauma and to describe common fracture locations, treatment modalities, and complications, as well as the fracture healing outcomes. The medical records and CT studies of 94 dogs under 1 year of age over a 13-year period were evaluated. The skeletal location of CMF fractures, as well as the severity of displacement and fragmentation of each fracture, was recorded. Case demographic data and trauma etiology were also recorded. Animal bites accounted for the majority of trauma (71.0%). The most likely bone or region to be fractured was the maxillary bones, followed by the molar region of the mandibles. Up to 37 bones or specific regions were fractured in any given patient, with an average of 8.8 ± 3.1 fractured bones or regions per dog. Rostral mandibular trauma was associated with intra-articular fractures of the temporomandibular joint ( = 0.016). Patients sustained concomitant injuries in 32% of the cases. Muzzle therapy was the main treatment performed for most dogs (53.2%), followed by soft tissue closure (47.9%) and selective dental extractions (27.6%). Healing complications were recorded in 71.6% of the dogs, with malocclusion being the most reported complication (55.2%), and associated with dentate mandibular jaw fractures ( = 0.05). The average number of complications per dog was 2.4. No statistically significant association was found between treatment modality and healing outcome. There was a positive correlation between the severity of fracture fragmentation and displacement and a negative healing outcome (all rho >0.7). Further treatment was required in 55.6% of the dogs. Additional dental extractions were performed in 77.7% of patients. Healing complications were common in the immature CMF trauma case. Thus, the need for a comprehensive assessment of the entire CMF region during the initial visit, as well as follow-up, preferably using CT or cone beam CT, is underscored.
犬颅颌面（CMF）创伤的治疗通常需要多学科方法以及对所涉及的CMF解剖结构有透彻的了解。这项回顾性研究旨在利用对因CMF创伤接受评估的幼犬进行的计算机断层扫描（CT）研究，描述常见骨折部位、治疗方式和并发症，以及骨折愈合结果。对13年间94只1岁以下犬的病历和CT研究进行了评估。记录了CMF骨折的骨骼位置，以及每处骨折的移位和碎裂严重程度。还记录了病例人口统计学数据和创伤病因。动物咬伤占创伤的大多数（71.0%）。最易发生骨折的骨骼或部位是上颌骨，其次是下颌骨的磨牙区。任何给定患者中最多有37处骨骼或特定区域发生骨折，每只犬平均有8.8±3.1处骨折的骨骼或区域。下颌前部创伤与颞下颌关节的关节内骨折相关（P = 0.016）。32%的病例中患者伴有其他损伤。口鼻部治疗是大多数犬（53.2%）的主要治疗方式，其次是软组织闭合（47.9%）和选择性拔牙（27.6%）。71.6%的犬记录到愈合并发症，错牙合是最常报告的并发症（55.2%），且与下颌有牙颌骨骨折相关（P = 0.05）。每只犬的平均并发症数为2.4。未发现治疗方式与愈合结果之间有统计学显著关联。骨折碎裂和移位的严重程度与愈合结果呈正相关，与不良愈合结果呈负相关（所有rho>0.7）。55.6%的犬需要进一步治疗。77.7%的患者进行了额外拔牙。愈合并发症在未成熟CMF创伤病例中很常见。因此，强调在初次就诊时以及随访期间对整个CMF区域进行全面评估的必要性，最好使用CT或锥形束CT。
