Equine Skull Fractures: A Review of 13 Cases Managed Conservatively (2018–2022)

This retrospective study reviews the clinical features, computed tomography (CT) findings, complications and outcomes of horses with skull fractures involving the facial bones. Medical records from the Royal Veterinary College, Hatfield, United Kingdom, and the Universidad Complutense, Madrid, Spain, were reviewed to identify horses presented for head CT with a history of skull fracture involving the facial bones between 2018 and 2022. Thirteen horses were included. Secondary sinusitis was present in 10 of the horses with the rostral maxillary, caudal maxillary and ventral conchal sinuses being the most commonly affected. There was associated fracture of dental structures in three cases. Treatment was conservative in seven cases, while in six horses some minimal surgical intervention was undertaken and included the removal of loose bony fragments and trephination for sinoscopy in two cases, fragment removal and sinus flush through a Foley catheter in three cases and dental extraction in one case. Prognosis was reported to be good to excellent in 10 horses. Among the most common complications, cosmetic sequalae was recorded in three cases. Overall conservative management of skull fracture should be considered a viable option for cases where perfect cosmetic results are not expected and where economics may be a limitation.