OklahomaHorses Magazine November 2021

16 OklahomaHorses • November/December 2021 Now That’s a Headache Facial Trauma and Fractures in the Horse By Megan Williams, DVM, DACVS A s an equine surgeon, I deal with the self-inflicted traumas of my patients. Usually, this manifests as wounds or cuts on the limbs; however, occasionally those traumas affect the head. Head wounds can be simple lacerations involving only the skin and requiring a few sutures placed by your veterinarian. Lacerations involving the eyelids, nostrils or lips are more challenging to repair with a cosmetic, functional outcome. Things get more complex when the trau- ma is severe enough to result in fractures of the facial bones — the bony orbit protect- ing the eye, the nasal bones overlying the nasal passages or the bones overlying the paranasal sinuses. These types of fractures often result in multiple small pieces, a bit like a jigsaw puzzle. If you suspect that your horse has fractures and/or trauma to the bones of the skull, have your veterinarian examine the horse as soon as possible. With these types of injuries, you might notice cuts or breaks in the skin overlying the fractures, and some of the fracture fragments may be visible. If there is not a break in the skin and there are fractures involving the sinuses, air may accumulate beneath the skin, termed emphysema. Fractures involving the sinuses and/or nasal passages usually exhibit bleeding from the nose on the affected side(s). Swelling of varying degrees may be noticeable as well, particularly if the injury is more than a few hours old. An initial examination of the horse by your veterinarian will likely include a thorough physical examination, sedation, and gentle cleaning and palpation of the wounds. Radiographs of the skull may be taken to get a better idea of which bone(s) are involved and the extent of the fractures. Fractures that involve the nasal passages, particularly if both sides of the nose are af- fected, can result in swelling severe enough to impair the horse’s breathing. For these cases, a temporary tracheostomy (tempo- rary opening in the trachea with placement of a tracheostomy tube for the horse to breathe through) may be needed. Course of treatment depends on the severity and extent of the injuries. Less extensive fractures with minimal displace- ment may warrant only repair of the skin lacerations, allowing the fractures to heal on their own. Surgical repair of the fracture fragments, usually under general anesthesia, may be recommended for more extensive fractures A horse that was sutured after suffering facial trauma. A horse that also suffered facial trauma.