Management of Pediatric Mandibular Fractures

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Good afternoon

K . R . Vardan

2nd yr Postgraduate studentSibar institute of dental sciences

Guntur, Andhra Pradesh

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MANAGEMENT

OF

PEDIATRIC MANDIBULARFRACTURES

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Etiology

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Fall from height

Sports and physical abuse.

Road traffic accidents

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Frequency

5% of mandibular fractures were in children aged 6-11years- Rowe's 1969 .

Thoren reported that 7.7% of mandibular fracturesoccur in children younger than 16 years and 2.9%occur in children younger than 10 years.

Only 12% of pediatric mandibular fractures occur inpatients younger than 6 years.

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Fracture localization

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49%

8%

9%

22%

(12%)

(2%)

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Signs and symptoms

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Pain and local edema

Difficulty to open the mouthMalocclusion

Deviation on opening the mouth

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9

Types of fracture

Simple Greenstick fracture (rare, exclusively in children)

Fracture with no displacement (Linear)

Fracture with minimal displacement

Displaced fracture

Comminuted fracture

Extensive breakage with possible bone and soft tissue loss

Compound fracture

Severe and tooth bearing area fractures

Pathological fracture

(osteomyelities, neoplasm and generalized skeletal disease)

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Presentation

Complete trauma evaluation

Assessment of occlusion

Associated injuries

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Factors to beconsidered

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How different ischild

mandible

High Tooth to Bone ratio.

More cancellous.

Growth at different places of mandible.

More soft tissue cushioning

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Case :1

4 yr f

C/C: Mandibular pain and

Malocclusion.

PMHx: previously healthy

Associated symptoms:

denies neck pain

PDH: IMF for 2 weeks.

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Mechanism of injury fall from building.

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Mock surgery

Open reduction

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Placement of acrylic splint

Circum mandibular wiring

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Post op OPG

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2nd follow up OPG

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Case 2

Chief complaint:Fracture of lower

jaw.

History.of presentillness:History oftrauma 4 days ago.

CT scan wasadvised by physician,CT revealed fractureof mandible

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Treatment plan: Adv reduction of fractureand

stabilizationusing cap splint

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Cap splint

Interdental wiringInterdental wiringInterdental wiring

Interdental wiring

Circum mandibular wiring

Stabilisation

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Post op OPG

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2nd follow up OPG

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Treatment options

Before age 2 years

Acrylic splint with circum mandibular wiring.

2-5 years

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Miniplate with dental tension band

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Factors to beconsidered

Growth of mandible.

Esthetics.

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Complications

TMJ Ankylosis .

Delayed healing ,nonunion and Malunion.

Malocclusion

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