Open reduction versus close treatment in management of children mandibular fracture: A systematic review

Abstract

Mandibular fractures in children are the most common facial bone injury, which is 39% of all fractures. Adequate treatment of mandible fractures was still debated to restore the best physiological and aesthetic outcome. This systematic review aims to compare open reduction and closed treatment outcomes in children with mandibular fractures based on evidence from the current study. Four electronic databases were used: PubMed, ScienceDirect, Directory of Open Access Journals (DOAJ), and Google Scholar. Studies included were randomized and non-randomized clinical studies written in English and published in the last 10 years (2014). Children patients under 18 years of age, of any sex, with any mandible fracture treated with any functional appliance. Data was collected using a standard form agreed upon by two independent reviewers. The risk of bias and quality were assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). Ten studies were selected for this systematic review, including 554 patients. Half of studies chosen had a high risk of bias, 4 were deemed to have a moderate risk of bias, and one had a low risk of bias. Comparing ORIF and close treatment, we get the incidence of complications versus cases respectively, 9/182 versus 5/372. The data collected, although there is still a lot of bias in this review. We support close treatment as the first line treatment for children’s mandible fractures because the minimal number of possible complications.