Mandibular fractures in infants and young children

Introduction: Pediatric mandibular fractures are uncommon and rarely reported in infants. We believe them to be far more common in clinical practice.

Aim: To evaluate the incidence, patterns, diagnostic and treatment modalities of mandibular fractures in young children.

Materials and methods: We retrospectively surveyed 18 years of hospital computer records . The keywords “facial skeleton fracture”, “Mandibular fracture” guided the search.

Results: Of 1411 hospitalized patients that were evaluated for mandibular fractures, only 124 were younger than 10 and selected for the study.

Etiology, fracture pattern, and treatment modalities were age related. Isolated mandibular symphysis fractures were predominant in infants and were caused by “innocent” trauma. Only one-third of the older children presented isolated symphysis fractures. Combined symphysis and condylar fractures were seen in older children.

Conservative treatment (soft diet, antibiotics, physiotherapy) prevailed in younger children for all types of fractures. Only one third of the older children were treated by intermaxillary fixation (IMF) and /or open reduction and internal fixation (ORIF). Children in all age groups tolerated well IMF. Few patients presented with post-traumatic soft tissue infection which were controlled by antibiotic treatment. No long term complications were documented.

Conclusion: mandibular symphysis is the most common facial fracture site in infants and this pattern changes with age. Symphysis fractures can be caused by mild trauma. Whenever a condylar fracture is diagnosed in an infant a symphysis fracture is missed until proven otherwise. We present developmental data that explains this phenomenom. Conservative treatment suffices for the treatment of most fractures.

Conflict of interest: None declared.

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Jan 27, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Mandibular fractures in infants and young children
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