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Remodeling of a Nontreated Displaced Parasymphyseal Fracture of a Child

Kerem, Hakan MD; Usluer, Ayşen MD; Yoleri, Levent MD

Journal of Craniofacial Surgery: July 2011 - Volume 22 - Issue 4 - p 1358-1360
doi: 10.1097/SCS.0b013e31821c947f
Clinical Studies

There have been considerable advances in the management of craniomaxillofacial injuries in children. Conservative approaches such as close observation, a liquid-to-soft diet, and analgesics can be used for the management of mandibular fractures without displacement and malocclusion. However, displaced fractures need to be an anatomic reduction and immobilization. The basic principle of displaced mandibular fractures in both children and adults is the stabilization of fracture fragments forming the pretraumatic contour and occlusion state until osteosynthesis occurs. The major differences of pediatric fractures from adults are the flexibility of bones and very rapid healing pattern. Therefore, reduction in pediatric age group must be accomplished earlier. This case was an 11-year-old boy presented with a severely displaced parasymphyseal mandibular fracture resulting from a fall. He was given a soft diet and analgesic, given anti-inflammatory treatment of edema, and scheduled for operation. Subsequently, it was surprisingly observed that there was a significant improvement in the fracture line on the 12th posttraumatic day. The comparison of maxillofacial computed tomographic scans of the first and 12th posttraumatic days revealed a noteworthy remodeling and a remarkable approximation of the fracture lines. It can be concluded that bone remodelization in the pediatric age groups is perfect and very rapid, even in severely displaced fractures.

From the Department of Plastic, Reconstructive and Aesthetic Surgery, Celal Bayar University, Manisa, Turkey.

Received October 11, 2010.

Accepted for publication November 4, 2010.

Address correspondence and reprint requests to Hakan Kerem, MD, 75 Yıl Mh, M. A. Ersoy Bul No: 67/1 Manisa, Turkey; E-mail:;

The authors report no conflicts of interest.

© 2011 Mutaz B. Habal, MD