Management of isolated unilateral tooth-bearing mandibular body fractures in children: an institution's 30 year experience
Alvaro Reategui1, Joseph Lopez1, Pooja Yesentharao2, Joaquin Reategui3 Robin Yang2, Richard J. Redett2, Paul N. Manson1, Amir Dorafshar Dorafshar4
1Yale-New Haven Hospital, 2Johns Hopkins Hospital, 3Larner College of Medicine at the University of Vermont, 4Rush University Medical Center
Background: Mandibular body fractures can cause severe and long-term morbidity in the pediatric population. Nonetheless, there is insufficient data on the treatment and management of this specific fracture type in children. This study aimed to investigate the etiology, treatment, and outcomes of pediatric mandibular body fractures by analyzing our institution's experience managing these uncommon injuries Methods This was a 30-year retrospective, longitudinal cohort study of pediatric patients presenting to a single institution with isolated, unilateral, mandibular body fractures. Patient data was extracted from electronic medical records, while subgroup analysis was completed by dentition stage. Result:s A total of 14 patients met inclusion criteria, of whom 8 (57.1 %) had deciduous, 3 (21.4%) had mixed, and 3 (21.4%) had permanent dentition. Deciduous dentition patients with displaced, mobile or comminuted fractures underwent ORIF, while those with non-displaced and/or non-mobile fractures received soft diet or closed treatment with MMF. For the mixed dentition cohort, all patients (100%) received closed treatment with MMF. Among permanent dentition patients, most patients (66.6%) underwent ORIF regardless of fracture severity. The post-ORIF complication rate was 20% (dental maleruption). Our treatment algorithm is shown in Figure 1 Conclusions Isolated, unilateral mandible body fractures are relatively uncommon in the pediatric population, and management differs by dentition stage and injury pattern. While isolated body fractures had considerable associated morbidity, this fracture pattern did not result in major growth restrictions or malformations.
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