Application of Sutures for Skull Stabilization: A Novel Technique for Cranioplasty in Fennec Fox (Vulpes zerda)

Abstract

Skull fractures in fennec foxes (Vulpes zerda) are a serious issue that demands urgent intervention because of the species' fragile cranial structure. Compressed fractures can cause brain injury, bleeding within the skull, and neurological disability. Failure to promptly manage these complications can be fatal. A 1-month-old, 0.29 kg female fennec fox suffered a traumatic bite wound to its head from a skunk. Panalai Veterinary Hospital received a referral for the fennec fox, which showed signs of lethargy, ataxia, and left circling. The heart rate, respiratory rate, capillary refill time (CRT), and rectal temperature were within normal range. Diagnostic imaging, including a computed tomography (CT) scan, revealed collapse of the frontal and parietal bones, invading the left parietal-temporal lobe of the brain, and a fracture of the vertical ramus of the left mandible. Surgical interventions were performed with frontal and parietal bone decompression, as well as suturing the fractured skull using a tapered needle and a 4-0 polydioxanone suture in a simple interrupted pattern, without the use of skull mesh. Postoperative care included intensive monitoring, hyperbaric oxygen therapy, and acupuncture to promote brain healing, wound recovery, and neurological improvement. The fox was administered amoxicillin-clavulanic acid, followed by a switch to cefovecin sodium for infection control; pregabalin for neuropathic pain; meloxicam for inflammation management; vitamin B complex and Aktivait dog® for nerve function support; and dimenhydrinate to alleviate vestibular signs. The wound, appetite, ataxia, and left circling were gradually improving. The fox fully recovered within two months and returned to a normal daily life, although it continued to exhibit mild circling before eating. This case highlights the importance of prompt and comprehensive treatment for skull fractures in fragile species. The successful application of straightforward surgical techniques demonstrates their practicality and adaptability for managing complex cranial injuries in small animals. These methods could serve as a valuable reference for addressing similar challenges in other small exotic mammals with delicate skull structures.