Executive Editor: Amy Kapatkin General Editor: Frank Verstraete

Authors: Boaz Arzi, Ana Nemec

Dog CMF

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Glossary

Midface, Frontonasal: Simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Non- or minimally displaced simple frontonasal fractures that are relatively stable Basic surgical experience, no specialized skills Basic equipment only
Plate fixation Displaced simple frontonasal fractures that are unstable or non-displaced (depending on fracture configuration and soft tissue trauma) Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Frontonasal: Comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Non- or minimally displaced comminuted frontonasal fractures that are relatively stable and do not result in functional disturbances Basic surgical experience, no specialized skills Basic equipment only
Plate fixation Displaced comminuted frontonasal fractures that are unstable and result in physiological disturbances Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Zygomatic arch: simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Non- or minimally displaced simple zygomatic arch fractures that are relatively stable and are not displaced laterally or into the orbit Basic surgical experience, no specialized skills Basic equipment only
Plate fixation Displaced simple zygomatic arch fractures that are unstable and grossly displaced laterally or into the orbit, reducing the orbital volume and resulting in exophthalmos Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Zygomatic arch: Comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Comminuted minimally displaced zygomatic arch fractures that do not result in instability or reduction of orbital volume Basic surgical experience, no specialized skills Basic equipment only
Plate fixation Comminuted displaced or minimally displaced zygomatic arch fractures that result in instability and reduction of orbital volume or bone fragment impingement on the eye Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Caudal: Simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Minimally displaced caudal midface fractures that do not result in malocclusion Basic surgical experience, no specialized skills Basic equipment only
Intraoral splint fixation Minimally displaced caudal midface fractures that result in malocclusion, with the fracture line mesial to the fourth maxillary premolar tooth Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Displaced caudal midface fractures that result in malocclusion, regardless of the fracture line location Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Caudal: Comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Minimally displaced comminuted caudal midface fractures that do not result in malocclusion or functional disturbances Basic surgical experience, no specialized skills Basic equipment only
Intraoral splint fixation Minimally displaced caudal midface fractures with some comminution that result in malocclusion, with the fracture line mesial to the fourth maxillary premolar tooth Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Displaced comminuted caudal midface fractures that result in malocclusion, regardless of the fracture line location Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Rostral: Simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Intraoral splint fixation Minimally displaced rostral midface fractures that result in malocclusion Some specialized surgical experience Simple surgical and imaging resources
Maxillomandibular fixation Displaced and minimally displaced rostral midface fractures that result in malocclusion Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Displaced rostral midface fractures that result in malocclusion with insufficient bone surface and quality Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Rostral: Comminuted

Please select a treatment option:
Treatment Main indication Skill Equipment
Intraoral splint fixation Minimally displaced rostral midface fractures with some comminution that result in malocclusion Some specialized surgical experience Simple surgical and imaging resources
Maxillomandibular fixation Displaced and minimally displaced rostral midface fractures with minimal comminution that result in malocclusion Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Displaced rostral midface fractures with comminution that result in malocclusion with insufficient bone surface and quiality Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Palatal: Nondisplaced fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Soft tissue debridement/management Simple minimally displaced palatal fractures with soft tissue damage Basic surgical experience, no specialized skills Basic equipment only
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Palatal: Displaced fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Soft tissue debridement/management Simple displaced palatal fractures with soft tissue damage Basic surgical experience, no specialized skills Basic equipment only
Intraoral splint fixation Simple displaced palatal fractures with soft tissue damage Some specialized surgical experience Simple surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Panfacial: Nondisplaced fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Nondisplaced panfacial fractures which are relatively stable and without functional disturbances Basic surgical experience, no specialized skills Basic equipment only
Maxillomandibular fixation Non or minimally displaced panfacial fractures which are relatively stable and with some functional disturbances Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Non or minimally displaced panfacial fractures which are relatively stable and with some functional disturbances Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Midface, Panfacial: Displaced fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Plate fixation Displaced or severely displaced panfacial fractures which are unstable causing functional disturbances Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures Midfacial fracture with poor quality bone, and/or infection, or displaced and devitalized bone fragments, or in presence of moderate to severe periodontal disease Some specialized surgical experience Simple surgical and imaging resources

Mandible, Symphyseal separation

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced symphyseal separation Basic surgical experience, no specialized skills Simple surgical and imaging resources
Circummandibular wiring Minimally displaced or displaced symphyseal separation Basic surgical experience, no specialized skills Basic equipment only

Mandible, Parasymphyseal: Simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced parasymphyseal separation when more stability is needed Basic surgical experience, no specialized skills Simple surgical and imaging resources
Circummandibular wiring and dental composite Minimally displaced or displaced parasymphyseal fractures when more stability is needed Basic surgical experience, no specialized skills Simple surgical and imaging resources

Mandible, Parasymphyseal: Comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced parasymphyseal fractures when more stability is needed Basic surgical experience, no specialized skills Simple surgical and imaging resources
Circummandibular wiring and dental composite Minimally displaced or displaced parasymphyseal fractures when more stability is needed Some specialized surgical experience Simple surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Rostral: Unilateral simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced rostral unilateral comminuted fractures Some specialized surgical experience Simple surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Rostral: Unilateral comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced rostral mandibular fracture when more stability is needed Some specialized surgical experience Simple surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Rostral: Bilateral simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced rostral bilateral simple fractures Some specialized surgical experience Simple surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Rostral: Bilateral comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced rostral bilateral comminuted Some specialized surgical experience Simple surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Body: Unilateral simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced fractures of the mandibular body Some specialized surgical experience Simple surgical and imaging resources
Intraosseous wiring Minimally displaced and interdigitating fractures of the mandibular body Some specialized surgical experience Basic equipment only
Plate fixation Minimally displaced or displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Body: Unilateral comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced fractures of the mandibular body Some specialized surgical experience Simple surgical and imaging resources
External skeletal fixator Severe comminuted and infected fractures (e.g. gunshots wounds) Highly experienced and skilled surgeon Simple surgical and imaging resources
Plate fixation Minimally displaced or displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Body: Bilateral simple

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced fractures of the mandibular body Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Minimally displaced or displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Body: Bilateral comminuted

Please select a treatment option:
Treatment Main indication Skill Equipment
Wire reinforced intraoral splinting Minimally displaced or displaced mandibular body fracture Some specialized surgical experience Simple surgical and imaging resources
External skeletal fixator Severe comminuted and infected fractures (e.g. gunshots wounds) Highly experienced and skilled surgeon Simple surgical and imaging resources
Plate fixation Minimally displaced or displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Caudal: Unilateral simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Minimally displaced caudal mandibular fractures Basic surgical experience, no specialized skills Basic equipment only
Maxillomandibular fixation (MMF) Displaced simple caudal fractures Basic surgical experience, no specialized skills Simple surgical and imaging resources
Intermaxillary fixation (IMF) screw and elastic chain Minimally displaced unilateral caudal fractures Some specialized surgical experience Simple surgical and imaging resources
Intraosseous wiring Minimally displaced and interdigitating caudal unilateral simple fractures Some specialized surgical experience Basic equipment only
Plate fixation Minimally displaced or displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Caudal: Unilateral comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Minimally displaced caudal mandibular fractures Basic surgical experience, no specialized skills Basic equipment only
Intermaxillary fixation (IMF) screw and elastic chain Minimally displaced unilateral caudal fractures Some specialized surgical experience Simple surgical and imaging resources
Maxillomandibular fixation (MMF) Minimally displaced or displaced caudal fractures Basic surgical experience, no specialized skills Simple surgical and imaging resources
Plate fixation Minimally displaced or displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Caudal: Bilateral simple fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Intermaxillary fixation (IMF) screw and elastic chain Minimally displaced caudal fractures Some specialized surgical experience Simple surgical and imaging resources
Maxillomandibular fixation (MMF) Minimally displaced or displaced caudal mandibular fractures Basic surgical experience, no specialized skills Simple surgical and imaging resources
Plate fixation Displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Caudal: Bilateral comminuted fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Intermaxillary fixation (IMF) screw and elastic chain Minimally displaced mandibular fractures Some specialized surgical experience Simple surgical and imaging resources
Maxillomandibular fixation (MMF) Minimally displaced or displaced caudal mandibular fractures Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Displaced mandibular fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
Salvage procedures When the fracture is not reparable due to poor quality, infected or devitalized bone due to moderate to severe periodontal disease Some specialized surgical experience Basic equipment only

Mandible, Ramus fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Minimally and moderately displaced mandibular ramus fractures Basic surgical experience, no specialized skills Basic equipment only
Maxillomandibular fixation (MMF) Minimally and moderately displaced mandibular ramus fractures Some specialized surgical experience Simple surgical and imaging resources
Plate fixation Moderately to severely displaced unilateral or bilateral ramus fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Mandible, Temporomandibular joint fractures

Please select a treatment option:
Treatment Main indication Skill Equipment
Nonsurgical fracture management Minimally displaced TMJ fractures Basic surgical experience, no specialized skills Basic equipment only
Intermaxillary fixation (IMF) screw and elastic chain Displaced and minimally displaced fractures Some specialized surgical experience Simple surgical and imaging resources
Maxillomandibular fixation (MMF) Severely displaced fractures with malocclusion Some specialized surgical experience Simple surgical and imaging resources
Condylectomy When the condylar process fracture is non-repairable Highly experienced and skilled surgeon Full specialized surgical and imaging resources

Mandible, Defect nonunion

Please select a treatment option:
Treatment Main indication Skill Equipment
Plate fixation Defect nonunion fractures Highly experienced and skilled surgeon Full specialized surgical and imaging resources
*Skill
Basic surgical experience, no specialized skills Basic surgical experience, no specialized skills
Some specialized surgical experience Some specialized surgical experience
Highly experienced and skilled surgeon Highly experienced and skilled surgeon
*Equipment
Basic equipment only Basic equipment only
Simple surgical and imaging resources Simple surgical and imaging resources
Full specialized surgical and imaging resources Full specialized surgical and imaging resources

1.1 2018-06-21