External Repair of Lizard Mandibles

Mandibular fracture repair in small animal patients, including reptiles, is difficult, as the procedure must balance repair stability with the patient’s ability to eat and maintain metabolism. 

This case series describes medical management and external coaptation of unilateral mandibular fracture in 2 bearded dragons (Pogona vitticeps). The author used principles of veterinary dentistry to facilitate bone healing. 

Analgesia and anesthesia were administered, fractures were aligned, and soft tissue defects were repaired in both patients. A metal wire (ie, section of a paperclip) was fashioned around the jawline to provide a base for stabilization. Dental acrylic was applied to adhere the wire to exterior mandibular skin. During treatment, additional dental acrylic was applied several times to re-adhere the wire to the skin.

A surgical tape splint was used as an adjunct to fracture stabilization. Because reptiles have a lower rate of metabolism, the splint was left on for the full duration of healing but was temporarily removed (and replaced) every 48 hours for tube feeding, which was continued until external stabilization was no longer necessary. Esophagostomy tube placement was not necessary. 

External coaptation was successful in both cases, and patients achieved functional healing in 7 to 9 weeks.

Key pearls to put into practice:

External coaptation using a metal wire and dental acrylic is a viable option for open, unilateral, simple mandibular fractures in bearded dragons.

Dental acrylics and ultraviolet healing lights for dentistry are increasingly common in veterinary clinics and are easily obtained from most veterinary suppliers.

Although reptiles typically heal more slowly than mammals, many fractures can be managed without direct surgical intervention.

Tube feeding is critical for meeting caloric requirements for basal metabolic rate and healing. Multiple commercial and home-prepared diets are available.