Successful conservative management of multiple skull fracture and quadrate-mandibular medial luxation in a blue-and-yellow macaw (Ara ararauna).

BACKGROUND: We present a case of beak trauma not previously been reported in a blue-and-yellow macaw (Ara ararauna) and its successful conservative treatment. Several cases of fractures affecting the mandibular, maxillary and maxillofacial bones and pterygo-palatine dislocations, which have been studied using traditional radiology and CT; however, quadrato-mandibular luxation has never been described, individually or associated with other trauma.

CASE PRESENTATION: A 4-year-old blue-and-yellow macaw (Ara ararauna) was referred for a recent head trauma. The parrot exhibited right lower beak deviation, difficulty in grasping food and difficulty closing the beak. The parrot was referred for multiple traumatic fractures involving the pterygoid bone, jugal bone and right mandibular arch. The X-ray projections showed an incomplete fracture of the right pterygoid bone, two fracture sites on the right jugal arch, and slight mediorostral displacement of the right quadrate bones. Computed tomography (CT) confirmed the X-ray findings, and indicated additional trauma. The right quadrate bone luxation was manually reduced, and conservative treatment was elected. Analgesia and nonsteroidal anti-inflammatory drugs were provided. Moreover, a soft food-based diet was recommended for 3 weeks to facilitate recovery and reduce facial bone movements and tension. The parrot started eating dry food approximately 1 month after the trauma; full return of apparently normal beak function was achieved by 2 months.

CONCLUSIONS: The CT examination allowed us to obtain a more detailed and complete view of the fractures and traumas and to evaluate the complex articular system of the Psittaciformes beak. For these reasons, CT is recommended for birds with a history of head trauma to select the best treatment for the specific case.