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Pediatric Mandibular Fractures
A Free Hand Technique
Steven P. Davison, DDS, MD;
Matthew S. Clifton, MD;
M. Nora Davison, PA-C;
Marc Hedrick, MD;
George Sotereanos, DMD
Arch Facial Plast Surg. 2001;3:185-189.
Background The treatment of pediatric mandibular fractures is rare, controversial,
and complicated by mixed dentition.
Objectives To determine if open mandibular fracture repair with intraoral and extraoral
rigid plate placement, after free hand occlusal and bone reduction, without
intermaxillary fixation (IMF), is appropriate and to discuss postoperative
advantages, namely, maximal early return of function and minimal oral hygiene
issues.
Patients A group of 29 pediatric patients with a mandibular fracture were examined.
Twenty pediatric patients (13 males and 7 females) with a mean age of 9 years
(age range, 1-17 years) were treated using IMF. All patients were treated
by the same surgeon (G.S.).
Results Surgical time for plating was reduced by 1 hour, the average time to
place patients in IMF. The patients who underwent open reduction internal
fixation without IMF ate a soft mechanical diet by postoperative day 3 compared
with postoperative day 16 for those who underwent IMF. Complication rates
related to fixation technique were comparable at 20% for those who did not
undergo IMF and 33% for those who did.
Conclusions We believe that free hand reduction is a valuable technique to reduce
operative time for pediatric mandibular fractures. It maximizes return to
function while minimizing the oral hygiene issues and hardware removal of
intermaxillary function.
From the Divisions of Plastic Surgery, Georgetown University Medical
Center, Washington, DC (Drs Davison and Clifton and Ms Davison), and Surgery,
University of Pittsburgh, Pittsburgh, Pa (Drs Hedrick and Sotereanos).
RELATED ARTICLE
Pediatric Mandibular Fractures—Editorial Comment
Joseph S. Gruss
Arch Facial Plast Surg. 2001;3(3):190.
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