A veterinarian at Tufts University has figured out how to give a dog his face back after a severe accident.
Randy Boudrieau, a veterinary orthopedist, is using titanium plates, just like the ones used in human reconstructive surgery, to repair hair fractures in canine companions. The fractures are most commonly seen when a (human) driver flies through the windshield of a vehicle, but are occasionally seen in dogs after severe accidents like being hit by a car.
Because these injuries are rarely seen, most vets don't know how to fix them, so many dogs are left to heal slowly and painfully on their own, with only cover-all medicines like anti-inflammatories and pain relievers to treat them. Some dogs have their skulls wired back together if their bone fragments are big enough - that is, if they haven't shattered into tiny pieces - but neither process gives enough relief to a dog whose facial bones have broken into many small segments.
In humans, the accepted method for treating broken bones is to keep them from moving around. That's why we use casts, splints, and braces, but when bones are broken into many small parts, the job is much harder.
Take it from Boudrieau , who spent a year in a cast after she shattered her elbow (spoiler: it was awful). So, when people suffer facial fractures, doctors attach metal plates to the pieces of facial bone that are the thickest and biggest - and then attach the smaller pieces to them. As a result, the bones move as little as possible, and when they do move around, they do so as basically one unit.
Finding those thicker and bigger fragments isn't too hard - they were initially discovered in humans in 1980, when fancily-named physical anthropologist E. Lloyd Du Brol shone a light through a (vacant) human skull and saw which pieces let the least light through. It was rudimentary, but it worked. Surgeons still use Du Brol's findings today, even if they've never heard of him.
Boudrieau took a page out of Du Brol's book and shone a light through a (vacant) dog skull, and found similar thick parts of bone that could be singled out for possible titanium plates. He found that the same types of plates that work well for human faces were just as good for man's best friend.
"The whole idea is that you work on the simplest fracture first, and gradually proceed sequentially through the more difficult areas," explained Boudrieau, while "trying to stay in the areas of the thicker bone."
Boudrieau's most recent patient was a 4-year old lab named Burton, who was hit by a car and suffered multiple facial fractures. His snout was completely dislodged from the rest of his face, and more injuries circled his cheeks and eyes. His guardian, Janine Stuczko, was panicked by what she saw when she rescued her dog from the street.
"I heard all the bones in his muzzle grinding, like fingernails on a chalkboard," she says. "It was awful. His muzzle was squished down to his eye socket."
Burton needed ten plates during his five-hour surgery, but it was a success. One day later, the adorable patient was already able to eat soft foods, something that would have been impossible without his operation. Today, he is eating and playing normally, 21 months after his accident (presumably, Tufts wanted to see how he healed up before announcing the success of the project).
Boudrieau thinks more vets should be proactive in treating fractures like Burton's,
"What I basically propose is to stop treating these cases conservatively," he says. "We've got the equipment to fix them. You can go from a dog that looks and feels like hell to one that's comfortable and eating by the next day."
Tufts announced their development in their veterinary magazine, Cummings Veterinary Medicine.
