Management of Bilateral Head-Condyle Fractures and Chronic Dislocation In Children: Case Report

Abstract

Introduction : Mandibular condyle fracture in children which is late to be treated can cause complications. The management of mandibular condyle fractures in children still controversial between open reduction and closed reduction. The management of maxillofacial fractures in children need to be considered properly due to the growth period in maxillofacial bone. Case Report : A 7-year-old girl patient came with complained her mouth couldn’t close tightly. Patient fell from a motorcycle about 2 months ago. A month after the accident, patient has been treated in private hospital but was unsuccessful. Patient’s mouth still couldn’t close tightly. Intraoral examination shown open bite in patient’s bite relation. Radiographic examination shown discontinuity in bilateral mandibular head-condyle. Patient has been diagnosed with temporomandibular joint dislocation and bilateral head-condyle fracture, then treated with condylectomy. Result : At sixth month control, the opening of patient’s mouth was 3 cm and the occlusion was normal. Discussion: The late management in children’s mandibular fracture can cause complications, such as ankylosis. If it was not treated immediately, it may be impaired the growth of jaw. Surgery or open reduction is the best choice of treatment when long-standing fracture has persisted and ankylosis occurred. Conclusion : The management of mandibular condyle fracture must be treated immediately and based on the accurate diagnosis, it can reduce and eliminate the possible complications. In this case, the treatment was late to be performed so the surgical intervention was necessary due to fibrous tissue that has been formed in temporomandibular joint and interfered the mandibular movement.