Open reduction and internal fixation obtains favorable clinical and radiographic outcomes for pediatric mandibular condylar fractures

Abstract

PurposeSurgery with open reduction internal fixation (ORIF) for pediatric mandibular condylar fractures (MCF) is controversial. This study aims to evaluate the clinical and radiographic outcomes of the children with MCF treated surgically with ORIF. MethodsThis retrospective study included 9 children diagnosed with MCF and treated surgically with ORIF. Imaging examinations were performed preoperatively and postoperatively. Patients underwent follow-up clinical observations and objective measurements for over 5 years. ResultsAll children recovered well in facial features, facial nerve functions, occlusions, joint movements, maximal incisal opening, and midline deviation postoperatively. The temporomandibular joint (TMJ) pain and click were found in 2 of 9 (22.2%) cases 1 year after surgery and disappeared 2 years later. Mandibular retrusion was always observed in a child (11.1%) postoperatively. The condylar surface appeared unsmooth in panoramic radiographs of 2 (22.2%) cases. Objective measurements showed that a patent (11.1%) had an opening deflection and a limited laterotrusion at the return visits. SNB angles of all cases were within the normal range 5 years after the operation. ConclusionSurgery with ORIF is a relatively safe and effective method for pediatric MCF. The future growth of the mandibular condyle and the long-term TMJ function are lightly influenced in patients postoperatively.