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215 Mandible Fractures in 120 Children: Demographics, Treatment, Outcomes, and Early Growth Data

Smith, Darren M. M.D.; Bykowski, Michael R. B.S., M.A.; Cray, James J. Ph.D.; Naran, Sanjay M.D.; Rottgers, S. Alex M.D.; Shakir, Sameer B.S.; Vecchione, Lisa D.M.D., M.D.S.; Schuster, Lindsay D.M.D., M.S.; Losee, Joseph E. M.D.

Plastic and Reconstructive Surgery: June 2013 - Volume 131 - Issue 6 - p 1348–1358
doi: 10.1097/PRS.0b013e31828bd503
Pediatric/Craniofacial: Original Articles
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Background: Optimal management of pediatric mandible fractures demands that the practitioner balance reduction and fixation with preservation of growth potential and function. The ideal synthesis of these goals has not yet been defined. The authors catalogue their experience with pediatric mandible fractures at a major pediatric teaching hospital with reference to demographics, injury type, treatment, and outcomes to inform future management of these injuries.

Methods: Demographics, management, and outcomes of pediatric mandible fractures presenting over 10 years at a pediatric trauma center were assessed. Cephalometric analysis was conducted. Relationships among demographics, fracture type, management, outcomes, and growth were explored.

Results: Two hundred fifteen mandible fractures in 120 patients younger than 18 years were analyzed (average follow-up, 19.5 months). The condylar head and neck were fractured most frequently. Operative management was significantly more likely for children older than 12 years (p < 0.05). Operative management and multiple fractures were significantly associated with a higher rate of adverse outcomes (p < 0.05), but no adverse outcomes were considered to significantly affect mandibular function by patient or surgeon. No significant growth differences existed on cephalometric analysis between our cohort and age- and sex-matched controls (p > 0.05).

Conclusions: This study reports the demographics, treatment, and early follow-up of a sizable cohort of pediatric mandible fractures. Management principles for these injuries are outlined. Although definitive recommendations must be withheld until longer follow-up is available, the data presented here show that the treatment protocols used at the authors’ center have yielded largely uncompromised mandibular function and growth thus far.

Pittsburgh, Pa.

From the Children’s Hospital of Pittsburgh.

Received for publication November 29, 2012; accepted December 19, 2012.

Disclosure:The authors have no financial interest to declare in relation to the content of this article.

Presented at the 56th Annual Meeting of the Plastic Surgery Research Council, in Louisville, Kentucky, April 28 through 30, 2011, and the 14th Congress of the International Society of Craniofacial Surgery, in Livingstone, Zambia, August 27 through September 2, 2011.

Joseph E. Losee, M.D., Children’s Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Children’s Hospital Drive, 45th and Penn, Pittsburgh, Pa. 15201,

©2013American Society of Plastic Surgeons