Caudal mandibular fracture repair using three-dimensional printing, presurgical plate contouring and a preformed template to aid anatomical fracture reduction

Abstract

Case summary Two cats were presented with mandibular fractures following head trauma. Following a CT scan, both were diagnosed with fractures of the ramus. The CT scans were used to print three-dimensional (3D) models of the mandibular fractures, which were used to pre-contour stainless steel mini-plates. These were fixed to the models and the screw positions used to produce a stainless steel template. The template was used as a pattern during surgery to drill holes in the ramus so that the pre-contoured mini-plates could be fixed in the exact same position as they had been on the 3D model. The fractures healed in both cats achieving normal jaw function and occlusion. Relevance and novel information Conventional techniques used to treat caudal mandibular fractures in cats, such as maxillomandibular fixation and bignathic encircling and retaining device (BEARD), are associated with significant patient morbidity and postoperative complications. Internal rigid fixation is difficult because of small bone size, requirement for considerable plate contouring and difficulty in achieving accurate anatomical reduction of caudal mandibular fractures. These are the first reported cases of mini-plate fixation of caudal mandibular fractures in cats using 3D models, pre-contouring of bone plates and the use of a template to facilitate accurate plate positioning, which may provide an alternative technique suitable for fixing caudal mandibular fractures in cats.