Successful treatment of an open incisive bone fracture using a locking compression plate combined with intraoral cerclage wiring

A 7-year-old Warmblood mare presented with bilateral epistaxis, facial swelling and deviation of the nose and upper lip. Upon clinical and computed tomographic examination a complete, oblique, open and displaced fracture of the nasal process of the incisive bone of the left and right maxilla was found. In order to maintain a good alignment and reduction in the fracture, a temporary retention with cerclage wire connecting the incisors of the mandible and maxilla was used. The fracture was then treated surgically with a 3.5-mm narrow-locking compression plate on the dorsolateral aspect of the incisive bone in combination with oral cerclage wiring. The intra-oral cerclage wiring was removed 12 weeks post-surgery, while the plate remained in situ. Minor post-surgical complications consisted of transient facial nerve paralysis and swelling. Follow-up radiographs taken 8 weeks after surgery documented good fracture healing. Nine months after surgery the mare has returned to her intended use and showed excellent cosmesis.