Long‐term clinical outcome of maxillofacial fractures in horses: A retrospective study of 30 cases (2020–2024)

Objective To assess long‐term outcome, complications, and return to function in horses with maxillofacial fractures. Study design Retrospective observational study. Animals A total of 30 horses with skull fractures (2020–2024). Methods Clinical records were reviewed for signalment, fracture characteristics, imaging, treatment, and hospitalization. Long‐term outcome was obtained via structured owner questionnaires addressing healing, complications, cosmetic appearance, and performance. Descriptive statistics were applied. Results A total of 29 of 30 horses received treatment (25 surgical, 4 conservative); one was euthanized. A total of 28 fractures were displaced (and 16 involved the frontal bone). Computed tomography was performed in 11 cases. Postoperative median hospitalization after surgery was 11 days (range: 4–57). Sinus lavage during surgery was performed in 22 of 25 surgically treated horses (84%). Median antimicrobial and non‐steroidal anti‐inflammatory drug (NSAID) administration lasted 15 (range: 4–26) and 8 days (range: 2–24), respectively. Complications included temporary nasal discharge in nine horses (31%) and wound infection in two horses (6.9%). At a median follow‐up time of 830 days (range: 142–1754), 28 of the 29 treated horses (96.6%) were successfully recovered. Cosmetic defects were recorded in 22 animals (75.9%). Of the 26 horses with available performance follow‐up, all returned to their previous level of use. Conclusion Maxillofacial fractures in horses were successfully managed in nearly all cases, with favorable long‐term outcomes and minimal impact on performance, despite frequent cosmetic defects. Clinical significance With timely treatment and supportive care, maxillofacial equine skull fractures carry an excellent prognosis for healing and return to use.