• Cause: motor-vehicle trauma, fall/jumping from a height, animal bite, hit by an object, iatrogenic, pathologic.
• Signs: pain, oral bleeding, serosanguineous oral and/or nasal discharge, crepitus, malocclusion, difficulty opening or closing the mouth, soft tissue bruising, swelling, laceration, or avulsion.
• Diagnosis: history of trauma; clinical signs; diagnostic imaging showing fracture of bones of the lower jaw, upper jaw, face, palate, bones of the temporomandibular joint (TMJ) or associated structures (ie zygomatic arch, coronoid process, etc).
• Treatment: conservative treatment (monitoring if occlusion is good with minimal displacement); non-invasive or minimally invasive fixation (maxillomandibular fixation with muzzling, labial reverse sutures or interarch splinting; interdental wiring with intraoral splinting); invasive fixation (intraosseous wiring; external skeletal fixation; bone plating; partial mandibulectomy/maxillectomy, commissuroplasty).
• Prognosis: greatly depending on the location and extent of jaw fracture, quality and amount of bone in the injured site, and whether teeth are in or near the bone fracture lines.
• Definitions:
  • Mandibular fracture: fracture of the lower jaw (mandible); canine and premolar/molar region often affected in dogs; mandibular symphysis (separation and parasymphyseal fracture) or ramus more affected in cats.
  • Maxillary fracture: fracture of the upper jaw (maxilla and other facial bones); often multiple; life-threatening airway obstruction possible due to displaced bones, swelling, or blood.

Presenting signs

• Pain.
• Oral bleeding and/or epistaxis.
• Serosanguineous oral and/or nasal discharge.
• Crepitus.
• Asymmetry, malocclusion.
• Difficulty opening or closing the mouth.
• Oral bruising and facial swelling.
• Subcutaneous emphysema.
• Lip/cheek laceration, avulsion.

Acute presentation

• Recumbent if in shock or if spinal/orthopedic injuries present.
• Dyspneic if partial airway obstruction or pulmonary contusions/pneumothorax present.

Breed/Species predisposition

• Small breed dogs are at greater risk of iatrogenic (caused examination or treatment) or pathologic jaw fracture (bone loss due to periodontal disease, metabolic conditions or neoplasia).

Cost considerations

• Diagnostic and treatment procedures requiring general anesthesia and surgical techniques are associated with increased cost.

Special risks

• Anesthesia-related risks.
• Trauma to teeth, bone and soft tissues during more invasive treatment.