Management of Mandibular Fractures in Children

Abstract

Twelve children under 11 years of age with mandibular fractures were treated at Buddhist Tzu-Chi General Hospital between January 1991 and December 2000. This comprised 2.7% of all the 439 patients with mandibular fractures. Five (1.1%) were younger than 5 years of age, and the remaining 7(1.6%) were 6 to 11-year old. Traffic accidents were the most common cause of mandibular fractures in our series (9 patients, or 75%). There were 17 fracture sites in these 12 children. Four (33%) patients had more than one fracture sites. Seven (41%) of the fractures involved the symphysis, which was the most common fracture sites in our series. Associated injuries were present in 6(50%) patients. Three (25%) patients had severe associated injuries (one, intracranial injury and two, thoracoabdominal trauma). Methods of treatment included: observation in 4 patients, closed reduction in 2 patients and open reduction and internal fixation in 6 patients. We did not use arch bars. When maxillomandibular fixation was indicated, it was obtained with a combination of dental splints, circummandibular wires and piriform aperture wires.