Standing

Fractures of the rostral mandible or the incisive bone with or without involvement of the incisors can be repaired in the standing horse using sedation and local anesthesia. For this purpose the head can be rested on padded stand.

The head should be supported by a padded head stand or fixed to the roof.
The mouth is held open using two wedges made from hard rubber or plastic placed between both sides of the cheek teeth.

The head region involved is generously clipped and surgically prepared, and the mouth is rinsed liberally.
All fracture wounds are carefully cleaned and rinsed. This involves gentle trimming the soft tissue wound edges with a scalpel if necessary and debridement of bones with a sharp spoon accompanied by rinsing with 0.05 % chlorhexidine solution to remove all debris.

General anesthesia is required for the treatment of complicated fractures. Nasal intubation is of great advantage rendering unobstructed view to the oral cavity.

Less invasive procedures such as intraoral wire fixation of rostral fractures involving the incisors are commonly carried out in the standing, sedated horse. Alveolar and infraorbital nerve blocks provide regional anesthesia for these cases.