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Stainless steel plate removal from previous fractured jaw repair
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This four year old female Shih Tzu dog presented with a history of having lower jaw (mandible) fracture repair approximately 1 year ago in Richmond, VA. Upon presentation her breath was foul and significant dental tartar was present, but it was difficult to see what was going on inside the mouth. Our patient was anesthetized in order to examine the mouth more thoroughly and to perform dental hygiene work. In this photo our patient is anesthetized with gas anesthesia administered through the orange endotracheal tube. Once relaxed, our exam revealed an exposed stainless steel orthopedic plate (white arrow) that was creating local inflammation and gum necrosis.
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Radiographs (x-rays) were taken of the skull to assess jaw healing and plate function. The white arrows point to the stainless steel plate used to repair the jaw fracture. Orthopedic wires can also be seen. Even though healing was not perfect the jaw felt solid and stable when manipulated. Therefore, it was decided that the plate and wires needed to come out as they were causing significant oral infection and gum necrosis.
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Dr Poutous carefully unscrewed the stainless steel screws holding the plate in apposition and it was removed with relative ease. The wires were a little more difficult as healing bone had grown into the wires. In the end a little piece of wire was left behind. After a thorough oral and dental cleaning gum tissue was sutured over the defect and our little girl went on to heal well.
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This image shows the stainless steel plate and screws after removal.
Everyone is happy as our patient feels better and her breath is markedly proved!