2011 Volume 60 Issue 4 Pages 341-348
In the treatment of pediatric mandibular fractures, less invasive methods are preferred than in adult cases. However, open reduction and fixation should be considered in cases that have large deviation or incomplete fixation with non-open reduction. In condylar fracture cases, it is important to prevent post-traumatic sequelae such as TMJ ankylosis.
We report a pediatric case of multiple fractures of the mandible. A 6-year-old boy fell from a height of 6 meters onto a road surface after scaling a fence, and was transferred to the emergency room in our hospital. CT scan showed bilateral lateral dislocation of the mandibular condyle with sagittal splitting fracture and a gap on the lingual aspect of the parasymphysial fracture resulting in widening of the inter-ramus width. To obtain anatomical reduction and adequate stability of the anterior for postoperative mouth-opening and closed management of condylar fractures, open reduction and internal fixation were performed in the parasymphysial fracture using titanium mini-plates. Intermaxillary fixation was not applied intraoperatively or postoperatively.
Near-daily jaw exercises commenced on postoperative day 3, and the degree of mouth-opening gradually increased to 40 mm. The plates were removed at 3 months post-operation. No abnormal mandibular function has been observed for 3.5 years post-operation. Careful observation should be continued for a long time in view of the growth of the mandible and permanent dentition.
