Equine orbital fractures: a review of 18 cases (2006-2013).

OBJECTIVE To review the clinical features, treatments, complications, and outcomes of horses with traumatic orbital fractures. STUDY DESIGN Retrospective study. SAMPLE POPULATION Eighteen horses with confirmed orbital fractures. PROCEDURES Medical records of horses presenting with orbital fractures between 2006 and 2013 were reviewed. Signalment, etiology of fracture, clinical signs, fracture descriptions, diagnostic imaging, treatments, complications, and outcomes were evaluated. RESULTS Eighteen horses presented with orbital fractures resulting from rearing in a confined space (n = 5), being kicked (4), colliding with a stationary object (3), and unknown trauma (6). Radiography and computed tomography were effective at classifying fractures and evaluating sinus/nasal involvement. Epistaxis/sinusitis were associated with fractures of the zygomatic process of the temporal bone (n = 3) and comminuted fractures of multiple bones (5). Seventeen fractures required treatment, with fifteen receiving a combination of medical and surgical therapy. Surgery included reduction of large bony fragments (n = 8), removal of small fragments (12), stabilization with a wire implant (1), and sinus trephination and lavage (5). Factors contributing to a favorable outcome included: globe retention (n = 16), vision (14), comfort (15), cosmesis (9), and return to previous function (13). CONCLUSIONS Horses sustaining orbital fractures treated promptly with medical and surgical therapy have a favorable prognosis for return to function and cosmesis. Fractures affecting the zygomatic process of the frontal bone are unlikely to involve the sinus/nasal cavities. Epistaxis and sinusitis warrant more aggressive therapy and decrease functional and cosmetic outcome.

[1]  S. Puchalski.  Advances in equine computed tomography and use of contrast media. , 2012, The Veterinary clinics of North America. Equine practice.

[2]  B. Gilger.  Chapter 3 – Diseases and Surgery of the Globe and Orbit , 2011 .

[3]  S. Reed,et al.  Diagnostic utility of computed tomography imaging in equine intracranial conditions. , 2010, Equine veterinary journal.

[4]  D. Brooks,et al.  Ocular trauma in the horse , 2010 .

[5]  P. Dixon,et al.  Epistaxis in the horse , 2010 .

[6]  P. Clegg.  J.A. Butler, C.M. Colles, S.J. Dyson, S.E. Kold, P.W. Poulos, Clinical Radiology of the Horse, third ed., Wiley Blackwell, 2008, ISBN101405171081, 748 pp.; £139.50 (hard) , 2009 .

[7]  N. Kannegieter,et al.  Management of equine skull fractures using fixation with polydioxanone sutures. , 2008, Australian veterinary journal.

[8]  C. Plummer.  Exophthalmos in the horse , 2007 .

[9]  M. Mudge,et al.  Field fracture management. , 2007, The Veterinary clinics of North America. Equine practice.

[10]  B. Schaer.  Ophthalmic emergencies in horses. , 2007, The Veterinary clinics of North America. Equine practice.

[11]  Jeffrey J. White,et al.  Imaging and Clinical Evaluation of the Lacrimal Drainage System , 2006 .

[12]  T. Michau.  Chapter 1 – Equine Ocular Examination: Basic and Advanced Diagnostic Techniques , 2005 .

[13]  T. J. Cutler.  Chapter 2 – Diseases and Surgery of the Globe and Orbit , 2005 .

[14]  H. Tremaine.  Management of skull fractures in the horse , 2004, In Practice.

[15]  R. MacKay.  Brain injury after head trauma: pathophysiology, diagnosis, and treatment. , 2004, The Veterinary clinics of North America. Equine practice.

[16]  A. Pease,et al.  Computed tomography dacryocystography evaluation of the nasolacrimal apparatus. , 2004, Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association.

[17]  S. Eggli,et al.  Hoof kick injuries in unmounted equestrians. Improving accident analysis and prevention by introducing an accident and emergency based relational database , 2002, Emergency medicine journal : EMJ.

[18]  A. Dart,et al.  Surgical repair of skull fractures in four horses using cuttable bone plates. , 2001, Australian veterinary journal.

[19]  P. Gavin,et al.  Physical principles and technical considerations for equine computed tomography and magnetic resonance imaging. , 2001, The Veterinary clinics of North America. Equine practice.

[20]  G. Daniel,et al.  Cross-sectional imaging techniques in veterinary ophthalmology. , 2001, Clinical techniques in small animal practice.

[21]  S. Dyson,et al.  Clinical Radiology of the Horse , 1993 .

[22]  D. Leach.  Biomechanics and the physiological costs of equine locomotion: a need for more research. , 2010, Equine veterinary journal. Supplement.

[23]  R. Stanley,et al.  Skull and orbital blow-out fractures in a horse. , 2010, Equine veterinary journal. Supplement.

[24]  W. Chapman,et al.  Four cases of traumatic optic nerve blindness in the horse. , 1986, Equine veterinary journal.

[25]  J. Caron,et al.  Periorbital skull fractures in five horses. , 1986, Journal of the American Veterinary Medical Association.

[26]  D H Leach,et al.  A review of research on equine locomotion and biomechanics. , 1983, Equine veterinary journal.

[27]  D. Feeney,et al.  Radiology in ophthalmic diagnosis. , 1980, The Veterinary clinics of North America. Small animal practice.

[28]  A. Turner.  Surgical Management of Depression Fractures of the Equine Skull , 1979 .

[29]  S. Miller,et al.  Management of fractures of the supraorbital rim. , 1978, The Journal of trauma.